Type of policy: Condo Unit Owner Policy.
City: Diamond Bar, CA.
Description of loss: Customer owned downstairs condo unit, sustained water loss result of toilet tank overflow.
Insurance Adjustment Summary:
- Initial offer from insurance carrier at $10,000.00 (Before deductible).
- Total insurance settlement after JPark Public Adjusters (PA Jae Park), Inc., involvement of adjustment of the claim $35,204.90(Before deductible, for structural and personal contents only). Differences in settlement amount of $25,204.90.
A relatively large single-family home near Los Angeles was flooded at the end of the October 2012.
One morning, the homeowner, Mr. K, found water leaking from the living room and kitchen floor. Until the source of the water leakage could be found, Mr. K opened the window more often than usual for the next three weeks due to the musty odor. He thought the odor and the water leakage would be related. Immediately following a discussion with the insurance broker, he filed a claim. At the end of October, a staff claim adjuster from the insurance company visited the site accompanied by a leak detection expert.
At the site, the staff claim adjuster from insurance company asked whether he could record the statement of Mr. K regarding the situation at the site. For this, Mr. K accepted the request without any hesitation. Mr. K thought there would be no problem whether recording or in writing because he would make a statement according to what he recognized in regard to the situation. While recording, the water leakage expert seemed to inspect the site with the naked eye with leak detection equipment. However, after the site inspection by the insurance company, Mr. K didn’t receive any notification regarding coverage confirmation from the insurance company, even after 20 days. Mr. K felt uneasy about things, so he searched for a PA.
On November 20, after the site inspection the PA found the cause of water leakage as follows: “It is the rupture of a water pipe buried under the concrete slab that supports the house.” After the site inspection, this PA notified the insurance company that Mr. K had hired this PA. I also requested that the insurance company provide the related insurance materials and documents related to the claim adjustment process.
Four days later, on November 24, the insurance company notified me that they couldn’t compensate for this claim. They gave the following reason: “According to the insurance policy, there is a special clause that the damage caused by water leakage lasting more than one week is not covered by the insurance.” In this notification, the report of the accompanied leakage expert was enclosed. He reported that “the water leak had lasted at least four weeks.” The compensation was denied on the basis of the expert’s report.
This PA(Jae Park Public Insurance Adjuster) made a strong objection to the report of the expert, who had only inspected with the naked eye and asserted that the leakage had occurred over at least four weeks. In other words, I asked the insurance company to provide a clear, specific rationale based on scientific tests. Three months later, on February 18, 2013, the insurance company indicated the denial of compensation. This time, the content of the recorded interview between the homeowner Mr. K and the staff claim adjuster from the claim unit was enclosed. In the recorded statement, Mr. K mentioned to the staff claim adjuster from the insurance company, “There was a severe musty odor from the flooding site due to the moisture for the past three weeks, and it seems that the strange smell was due to the water leak.” The insurance company pounced on that sentence, but in doing so it revealed the hidden card that it had concealed up to that point. Mr. K admitted to the staff adjuster from the insurance company that the water leakage had continued more than three weeks, and such content was even recorded. Thus there was nothing this PA could do in regard to the case. Unfortunately, this PA had to notify Mr. K that I couldn’t continue with the case anymore. Now, Mr. K has to handle the repair cost (about $100,000.00) by himself. It is really unfortunate that Mr. K didn’t receive the “free initial on-site visit consultation service” that this PA(Jae Park Public Insurance Adjuster) provides before he filed for claim to the insurance company. This is one of the heartbreaking stories that this PA has encountered in the field. Please remember any verbal and, or written statement that were made to the staff adjuster will be most likely recorded into the file and once statement is recorded it is nearly impossible to delete or retrieve the statement on your claim.
I am sure our readers will understand the nature of the problem in this case.
Photos after the loss:
After the repair: