Fixing the damage

Jan. 3—MOSES LAKE — It was, as they say, a dark and stormy night. Now it's the next morning, and you're looking with dismay at the tree that the wind sent crashing into your roof. You've got homeowners insurance, of course, but where do you go from there?

"I hope you have an agent, as opposed to an 800 number," said Chris Arnberg, an American Family Insurance agent in Moses Lake. "If you just have an 800 number, a company ... where you don't have an actual person whose job it is to provide individual service, if you call to ask about opening a claim, they're going to open a claim."

That may not be in the client's best interest, he said, because the company will still count it as a claim even if the homeowner later decides that they don't want to put in a claim, or that the cost of the remedy is less than the insurance deductible.

Speaking with a representative at the insurance company can be tricky, said Amy Teshera, a senior compliance analyst with the Washington State Office of the Insurance Commissioner, on an OIC podcast Monday.

"Even if they don't pay anything out on your claim, if you call and you say 'A tree fell on my roof, is it covered?' that's a claim," Teshera said. "If you say, 'What if a tree fell on my roof?' that's not a claim. That's a coverage question. It's all in the way you pose the question."

"If you have a local agent, then they can have a discussion with you about what happened, maybe even go take a look at it, help you kind of get some guidance on what coverages you have," Arnberg said. "And then you can decide, 'OK, I want to file a claim. This sounds like something that I should use my insurance to remedy.'"

A misstep here could have long-term effects down the road that the policy owner may not even know about, he added. Insurance companies keep a record of all claims, whether they actually cost the company anything or the homeowner ever collected anything.

"I've tried to quote many people who weren't even aware that they had these numerous claims showing up," he said. "There are some carriers that won't even allow you to obtain insurance with them, even if you've never had a claim paid out, but if you have one or more claims closed without payout, that can be a red flag."

With the wind whistling through the roof, it may seem like a good idea to make a claim. The next step, Teshera said, is to mitigate the damage as far as possible. The cost of doing that can be included in the claim, she explained.

"If there's a hole in your roof, if you can, safely, put a tarp up or call somebody to put a tarp up for you, and then take a look at your policy," she said. "Say you have to go out and buy some tarps and you have to buy cinder blocks to put on it ... If you have to do that, your expenses are covered under your policy, if you end up turning in a claim, so you can get paid back for that. And you can actually get paid back for the time it took you to do it. Say it took you 10 hours to secure your home, you could get paid back that expense."

Arnberg recommended getting a local remediation company to secure the roof. Any damage that follows may or may not be covered, depending on the company, he said.

"There are companies that won't cover for the damage of the water coming in. They'll only cover for the damage from the actual event."

Other companies, including his own, would cover the water damage as well unless it was the result of a problem the company already warned the homeowner about, he said.

"If they hadn't discovered that beforehand, then they would pay for everything," he said. "But if they had sent a survey company out to take pictures and then written the customer a letter saying, 'Look, you need to repair your roof, or we're going to change your policy so that if something happens, we wouldn't cover related damage.' And so that way they have notification; they have time to to make those improvements and avoid that. But there are some companies that that's just written into their policy that they'll only cover the initial damage."

That's another time when having a local agent is useful, Arnberg said, because insurance policies can be confusing in the way they're written, and the customer may not be able to work out what's covered until it's too late.

By law, once a claim is filed, the insurance company has 30 days to conduct an investigation, Teshera said. The company will send out an adjuster, who will analyze the damage precisely and figure out how much will actually be needed to repair it.

The adjuster can work directly with whatever contractor the customer chooses to make the repairs, Arnberg said, which is a help to the homeowner because the two professionals speak the same language and can work better together.

"With roofs, there's a certain math that is used (to work out) how much of the roof is damaged," he said. "Say you have a gable-style roof, and there's just two slopes, one on each side. They're going to look at how much of each slope is damaged, and based on what percentage of it is damaged, determine (whether) they replace the whole roof, or they just repair the damaged area or replace the damaged area."

"We do see a lot of questions about what we would call the scope of loss," Teshera said. "Say (your roof is) 25 years old. It was time to replace it anyway and a tree falls on it. The insurance company actually only owes you for the damaged part of your roof. (If) three-quarters of it is not damaged by the tree but should be replaced, it's not covered. And that's a really hard thing for people to accept."

The company also isn't necessarily required to repair it in a particular way, Arnberg said. If the home is in a neighborhood with covenants that dictate, for example, that all doors be the same color, and only one door is damaged, the company isn't bound to match the color, just replace the door.

The biggest mistake homeowners make, Arnberg said, is underestimating how much insurance they need.

"These days, the prices have gone up on everything," he said. "We all feel like everything's expensive. But if you compare the cost of homeowners insurance to, for example, auto insurance, homeowners insurance is dirt-cheap. If you have an average-sized house in Moses Lake, it probably would cost $300,000 to rebuild that house, and most likely your insurance is less than $2,000 a year. (That might have to pay) to rebuild a $300,000 house, replace all the contents inside that house and pay for you to live in another house while they're rebuilding your house.

"I think people need to be less focused on cost when it comes to homeowners insurance," he went on. "For most people, it's the biggest investment they're ever going to make ... So I think cutting corners with homeowners insurance is a big mistake."

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