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View Full Version : Insurance help/advice needed. - VERY LONG



Greg Ladd
10-07-2006, 10:46 AM
Hello everyone,

On Monday afternoon I returned home just after a thunderstorm and found that my 2 DIRECTV satellite receivers, 1 Sony television, computer modem and computer would no longer function.

All of this equipment was plugged into surge protectors but none of the surge protectors were tripped. Neither were any of the house circuit breakers. None of the RG6 cables feeding either the satelite receivers or the modem were protected by surge protection devices in any way.

I called my insurance agent (State Farm)and notified them that I suspected a problem due to a lightning strike.

The next day I called the claims office. They did not yet have my claim in the system. I was told to call back in a hour. Meanwhile I called Dell tech support to see if they could advise me on the computer issue. Kudos to Dell, they diagnosed the problem as a bad motherboard and replaced it at no cost even though I was adamant that I felt it was State Farms' problem to deal with.

When I called State Farm back I was informed that my coverage was limited to $1000 per item due to an energy surge. I asked about lightning damage and was told that the coverage was up to $5000 for lightning damage. I asked the claim rep how he could consider it anything other than a lightning strike as all of the issues were on equipment connected to RG6 cable which normally carries very small amount of current. I told him that I suspected a lightning strike in the yard that may have gone to the ground stakes on both the DIRECTV system and the broadband internet cable.

He then told me that it was my responsibility to prove that it was a lightning strike and that there should be evidence on the house structure. He also said that any of the repair technicians should be able to tell for certain that any damage was caused by lightning.

All of the service people have told me that there is no way that they can say definitively that lightning caused the problems but there is virtually no way it could have been anything else. My 2 nearest neighbors have told me they have not found any problems.

Also, State Farm wants to replace my Sony XBR television which has picture in picture with a model that does not. It would seem to me that the 'like kind and quality' phrase in the replacement coverage policy means that I should have a replacement item that is equal or better than what I had in every respect, even if it costs significantly more than what I paid for it 9 years ago.

I realize that technology has increased considerably over that time but it is not my fault that the television manufacturers do not offer PIP on their cheaper sets now. The Sony XBR I had was a premium model when I bought it.

Any advice on how to peacefully resolve these issues is greatly appreciated. I need to mention that I have always been very pleased with State Farms Auto division. They have always taken care of me to my satisfaction.

Greg

Frank Fusco
10-07-2006, 11:11 AM
Greg, unfortunately, I believe you have answered your own question.
You said....."He then told me that it was my responsibility to prove that it was a lightning strike and that there should be evidence on the house structure. He also said that any of the repair technicians should be able to tell for certain that any damage was caused by lightning.

All of the service people have told me that there is no way that they can say definitively that lightning caused the problems but there is virtually no way it could have been anything else. My 2 nearest neighbors have told me they have not found any problems."

I believe you are [explitive deleted] with regards to this claim.
As said, the best cure is prevention. After your replace (at your own expense) all your stuff invest in one or more uninterrupted power supply (UPS) units. They are about $50.00 each for home use. The brand I prefer is APC. Best insurance you can have.

Cecil Arnold
10-07-2006, 11:40 AM
Greg, I don't know where you live, but rather than take State Farm's offer, you might want to check your yellow pages for a "Public Adjuster." A PA will take a cut of the settlement, but they normally are able to get much better payouts than an individual policy holder. Most of them worked for insurance companies in the past and know the "tricks" to work the system. A friend who I recommended consult a PA, went from a $12,000 offer by her insurance provider to over $30,000 after she got a PA involved. Like most insurance deals, it still didn't completely cover her loss.

Michael Cody
10-07-2006, 12:21 PM
Hello everyone,

On Monday afternoon I returned home just after a thunderstorm and found that my 2 DIRECTV satellite receivers, 1 Sony television, computer modem and computer would no longer function.

All of this equipment was plugged into surge protectors but none of the surge protectors were tripped. Neither were any of the house circuit breakers. None of the RG6 cables feeding either the satellite receivers or the modem were protected by surge protection devices in any way.

Greg

The insurance folks are, as frank said: "I believe you are [expletive deleted] with regards to this claim."

RG-6 in this case carries almost no voltage or amperage... plus there are no power supplies involved here. Lightening is the only possible explanation if you can't find a a dead short somewhere (in which the fact that no breakers were tripped seems to rule out). The cable is like a lightning rod to every item it's hooked to. The strike most likely was to the phone pole since it also took out your cable stuff(cable modem?) and computer which wouldn't be hooked to the satellite dish normally. Finding evidence w/o climbing said pole might be tricky. It's time to get nasty with State Farm. However if it's 1000$ per item even, that should replace everything you have.. If it's 1000$ per incident, then you have issues. The public adjuster is a good route, you will get more for sure.

Greg Ladd
10-07-2006, 12:53 PM
Frank - Just curious..Why do you suggest a UPC rather than a surge protector. The UPC part of the equation only works if I am home to turn something off, if it was on, when the power goes out right? As I wasn't home, I am not quite understanding the benefit. Wouldn't a good quality surge protector with provisions for RG6 connections be just as good?

Cecil - I do not see public adjusters listed in our yellow pages. This is a rather small city with a lot of very small towns scattered around. Any other suggestions as to where I might find a PA.

Michael - I agree with your thinking in regards to the source of the problem. It had to come in through the satellite system and the internet cable as the 2 are not connected in any way.

In regards to the $1000 dollar amount. That is where the issue of the replacement with 'like kind and quality' comes in. I cannot find a CRT tube type television with picture in picture any longer. I feel that State Farm should get me a set with PIP even if it means they have to buy me a new LCD or plasma set. I should be able to get a set with equal features to what I had.

Thanks everyone. - Greg

skip coyne
10-07-2006, 1:01 PM
down here in the "lightning capital " I have a whole house surge protector ,on the service panel .

never lost anything since it was installed .

you might want to look into one

Greg Ladd
10-07-2006, 1:19 PM
The service technician just finished repairing the broadband internet cable hookup. He found a termination block of some type that was burned on the side closest to my house.

He said that some type of surge came from the house side of the grounding rod. He also said that it couldn't have come from their side of the system as they do not use enough current to cause a surge.

How could there be a surge down the cable when there is no power in the cable? Is this the proof that I need that there was a lightning strike in the yard? How could a surge caused by lightning get into the cable system other than a ground rod?

Greg

Rob Littleton
10-07-2006, 1:24 PM
Isnt insurance a GREAT thing to have...............til you need it!!!!!!!!!

The thing that gets me (in the case of car insurance) is you HAVE to have it. Insurance companies are worse than lawyers. They are outright liars and I hate them.

I had an experience recently with a car that backed into me and the dude that backed into me got on the phone to his agent (SAFECO) and his agent said it was their responsibiltiy and would accept it 100%. Turns out it was 50/50 and cost me $1500. My fault I guess for deiving through the parking the lot at the time this bonehead was backing out without looking.............SAFECO was his insurance company.....another bunch of good for nothing LIARS...................

off the soap box now.....................

Sorry to hear about your issue you are having but I bet, at the end of the day, you are gonna be out of pocket because of these wonderful people..........................

Cecil Arnold
10-07-2006, 2:03 PM
Gregg, check in any large city in your area.

Cliff Rohrabacher
10-07-2006, 2:08 PM
In most states the insurance company is obligated to put you back to the position where you were before less deductables.

However your policy ( that thing almost no one reads) may be more specific.

The TV is one of those issues where one side claims one thing about value ( pic in pic) and the other says something else ( cash assessment). In this case it's likely the concept of value that is in debate. You should get a Pic in Pic TV and a Sony of equal or better value. They can argue that the value of the non-pic in pic TV is the same as what your Pic in Pic was worth and they may have a valid argunent - - but then so do you have a valid argument.
They are not automatically right at law.


The fact of a lightning strike:
You do not need a "definitive statement" from a repair guy. All you need is an opinion statement. He doesn't have to swear thet it was lighting nor does he have to make findings to some standard of proof. All he needs to say is that after evaluating the hardware that the damage appears to have been caused by a lightening strike.

The Insh company knows that if they end up in court with you that the juriors will take a dim view of them assuming that they are trying (yet again) to cheat some poor schmuck.

Stick to your guns and don't ask your repair guy to makle definitive statements. Even if he were a witness under oath in court all he'd ever need to say is that his analysis coinvinced him that it was a lightening strike. It matters not that some other tech guy might differ.

Lee DeRaud
10-07-2006, 2:48 PM
I had an experience recently with a car that backed into me and the dude that backed into me got on the phone to his agent (SAFECO) and his agent said it was their responsibiltiy and would accept it 100%. Turns out it was 50/50 and cost me $1500. My fault I guess for deiving through the parking the lot at the time this bonehead was backing out without looking...No offense meant, but it was partly your fault: for dealing with his insurance agent yourself rather than letting your insurance agent do it. They're a lot less likely to try to pull something like that when they're dealing with another insurance company...and even less likely to get away with it.

And part of why you're paying premiums to your carrier is so they can do the heavy lifting in situations like this.

Al Willits
10-07-2006, 3:00 PM
Not sure, but your state may have some sort of insurance commision, might want to check with them also.

Al

Frank Fusco
10-07-2006, 3:38 PM
Frank - Just curious..Why do you suggest a UPC rather than a surge protector. The UPC part of the equation only works if I am home to turn something off, if it was on, when the power goes out right? As I wasn't home, I am not quite understanding the benefit. Wouldn't a good quality surge protector with provisions for RG6 connections be just as good?

Cecil - I do not see public adjusters listed in our yellow pages. This is a rather small city with a lot of very small towns scattered around. Any other suggestions as to where I might find a PA.

Michael - I agree with your thinking in regards to the source of the problem. It had to come in through the satellite system and the internet cable as the 2 are not connected in any way.

In regards to the $1000 dollar amount. That is where the issue of the replacement with 'like kind and quality' comes in. I cannot find a CRT tube type television with picture in picture any longer. I feel that State Farm should get me a set with PIP even if it means they have to buy me a new LCD or plasma set. I should be able to get a set with equal features to what I had.

Thanks everyone. - Greg

Greg, I just posted something about this elsewhere. Here goes again.
There is a lot of misunderstanding about surge protectors. As a non-electrical layman type, it is my understanding that electricity does not come to your house in a nice steady stream. Rather it fluctuates with 'surges'. A surge protector sorta levels out the stream and prolongs the life of your equipment. A surge protector WILL NOT protect against lightening strikes. They are too simple, crude and slow and not designed for that job. I have had losses (telephones, modems, microwave, etc.) that were 'protected' with surge protectors. On the other hand, UPS units are designed to protect. They are faster, more sophisticated pieces of equipment. They offer the extra feature of allowing your equipment to run for a short period of time in the event of a power loss. That is actually their secondary function. Protection is first.
A $5 surge protector will not save your $1000.00 computer. A $50 UPS will. Good insurance.

Greg Ladd
10-07-2006, 3:39 PM
Cecil - I will check with some larger cities regarding the PA issue fi this doesn't get resolved quickly. Tanks for the heads up on this.

Greg

Greg Ladd
10-07-2006, 3:46 PM
Cliff,

Thank you for the explanations. Your posting sums up the way I thought things should be.

I will try to contact the repair technicians ans see if any of them would we willing to put their opinions in writing.

I have spoken to an electrical engineer about this. He asked me few questions and then said that it absolutely had to be a lightning strike. Would his opinion carry any weight with an adjuster? I won't even say what his opinion of the adjusters' atitude was.

Thanks again. Your response was very helpful.

Greg

Greg Ladd
10-07-2006, 3:48 PM
Al,

I will pursue the insurance commision if the adjuster continues to be bull-headed. My wife says I can be stubborn too. I am willing to bet that I do not give up on this!

Greg

Greg Ladd
10-07-2006, 3:51 PM
Frank,

Thank you for the follow-up post.

I guess I misunderstood the surge protectors. The ones I use are made by APC. I thought that I remembered reading specifically about lightning strike surges on the boxes when I bought them.

I will try to research them more and consider a UPC for lightning if it turns out my memory is wrong once again.

Greg

Frank Fusco
10-07-2006, 7:37 PM
Frank,

Thank you for the follow-up post.

I guess I misunderstood the surge protectors. The ones I use are made by APC. I thought that I remembered reading specifically about lightning strike surges on the boxes when I bought them.

I will try to research them more and consider a UPC for lightning if it turns out my memory is wrong once again.

Greg

If yours is an APC it may be designed to protect against lightning. But do check it out. The $5.00 units won't.

Nancy Laird
10-07-2006, 8:28 PM
Greg. I had a major problem with a State Farm adjuster several years ago, and the adjuster just wouldn't listen. Demand that you are put in touch with his supervisor, and if you don't get anywhere, go to the regional supervisor of adjusters. When I finally got to the regional adjuster, and told them I was talking to a lawyer, they rolled over and paid what should have been paid in the first place.

State Farm, and all the other insurance companies, have been hard-hit in recent years with Hurricane Andrew, Katrina, Rita, et al, earthquakes, forest fires, etc. Most of them have completely stopped trying to settle claims, particularly automobile claims, in the hopes that the customers will take what is offered and walk. You have to get in there and demand your proper reimbursements, and go up the chain of command until you are satisfied.

Nancy

Rob Littleton
10-07-2006, 10:49 PM
[quote=Lee DeRaud]No offense meant, but it was partly your fault: for dealing with his insurance agent yourself rather than letting your insurance agent do it.

Yeah, this is the first time in the US I have to deal with insurance and I learned a lot. One of the lessons is let MY rep do the talking ........... I just wanted my truck repaired and nothing else. I hate dishonesty especially in business.

Anyways, lesson learnt :-(

Joe Jensen
10-07-2006, 11:29 PM
Also, State Farm wants to replace my Sony XBR television which has picture in picture with a model that does not. It would seem to me that the 'like kind and quality' phrase in the replacement coverage policy means that I should have a replacement item that is equal or better than what I had in every respect, even if it costs significantly more than what I paid for it 9 years ago. Greg

Greg, I have State Farm, with "replacement cost" rider. this ensures that I can replace items with their equavalent. I've had claims in the past, and State Farm never dictated what I could buy. Just had to be equivalent. I always buy high end, and I've had no pushback on replacements...joe

Greg Ladd
10-08-2006, 7:18 AM
Nancy,

Unfortunately, I believe you are right.

I will also say that the dealings I have had with State Farm have all gone smoothly when I have been able to deal with female members of their claims departments.When I have dealt with men, it has always gone poorly. I would imagine that part of their tactics are to imtimidate and belittle customers. I am tired of feeling as if I am a crook or have no common sense when dealing with these people.

Greg

Greg Ladd
10-08-2006, 7:22 AM
Joe,

I have had replacement coverage for as long as I can remember; probably 23 years or so.

I to have always tried to buy high end equipment. The replacement process has gone smoothly in the past once I have been able to convince them that an item needs to be replaced.

I believe in this instance that the claims adjuster feels that if I cannot prove that the problems were caused by lightning, he can say that there was an energy surge. This would immediately reduce my coverage to a lower limit and force me to accept a lower value replacement.

Greg

Dennis Peacock
10-08-2006, 9:14 AM
Oh Boy....I just love talking about insurance. :rolleyes: Insert tongue-in-cheek here.;)

Frank Fusco
10-08-2006, 9:17 AM
Nancy,

Unfortunately, I believe you are right.

I will also say that the dealings I have had with State Farm have all gone smoothly when I have been able to deal with female members of their claims departments.When I have dealt with men, it has always gone poorly. I would imagine that part of their tactics are to imtimidate and belittle customers. I am tired of feeling as if I am a crook or have no common sense when dealing with these people.

Greg

The language I would use to describe my feelings about State Farm, I wouldn't use anytime, esepecially on Sunday morning. And they would be deleted.
It started when I was young and just enlisted in the Air Force. State Farm about quadrupled my car rates because I was now in a class that was "likely" to have an accident.
Years later they raised the rates on my home because they decided it was worth much more than I did, about four times. There's more.
I use Shelter now and the company has been excellent.

Joe Pelonio
10-08-2006, 2:56 PM
Think about who would be called as an "expert witness" in court, that's who you need to get to write up a statement that it was lightning. The insurance company has a full staff of lawyers to figure out how to pay out the least possible amount in claims. You might even call a lawyer that advertises "first consultation free" and ask who they would recommend as an expert witness in a case like this. Otherwise I'd search the internet for a place like this near you:

http://www.psihq.com/lightning_specialist.htm

Greg Ladd
10-09-2006, 12:06 PM
Joe,

I will talk to the electrical engineer that I spoke with earlier about writing up something for me. If that doesn't work, I will try to find someone like the link that you posted. Thanks for the advice.

Greg

Greg Ladd
10-09-2006, 4:09 PM
I just got off the phone with State Farm.

There are no CRT tube bases TV's with picture in picture feature available. There are numerous 32" flat panel models available with that feature.

They are saying that they will not authorize the money to replace my set with a flat panel model as that would be considered an upgrade. They claim it is a "company policy." We are talking about $700 difference give or take.

I think we pay around $4000 a year in premiums to State Farm for auto and home coverage.

Have I mentioned that I hate insurance companies? I am trying to get through to the state insurance board now.

Greg

Hugh Jaskok
10-10-2006, 1:08 AM
My favorite question is, how many idiots wait until they have a claim before they read their policy? I guess it's more fun to wait for a claim then piss and moan about how the insurance company is allegedly "hosing" them. Unbelievable, then you people complain about how high your insurance rates are, I guess people must think lawyers are free.

Frank Fusco
10-10-2006, 11:53 AM
My favorite question is, how many idiots wait until they have a claim before they read their policy? I guess it's more fun to wait for a claim then piss and moan about how the insurance company is allegedly "hosing" them. Unbelievable, then you people complain about how high your insurance rates are, I guess people must think lawyers are free.

Almost no one ever reads their homeowners insurance policy. Usually, that is because we don't get one. The mailings we get say the coverage is based on the 'master' policy and that is available on special request. I am sure it is very long and complicated in 'lawyer speek'. The upside is that most states do a good job of regulating insurance companies and your coverage is designed with the consumer in mind, but with exceptions. You still must prove your loss. And, as stated, they will not pay for upgrades. I have had hail damage to my vinyl siding and roof twice in three years. Each time, Shelter ponied up $13,000.00 for the repairs without complaint. I inquired if they would pay some extra to get a siding that was stronger and more resistant to hail and a different, hail proof roof. I asked on the theory that they would save money from future storms. They declined saying they would only pay for the current loss. Doesn't make sense to me. Same with health insurance companies. Some personal stuff here: Years ago I asked our health insurance company if they would pay for a vasectomy. They said that wasn't covered, I had to private pay. I argued that it would be cheaper than them paying for maternity coverage, which they would cover. They agreed but still said no. Go figger.

Hugh Jaskok
10-10-2006, 12:15 PM
You have got to be kidding me about never getting your policy. They have never given you a copy ever? I think you are probably mistaken. Next, why should the ins. co. pay to upgrade your house? They are in the business to indemnify you or make you whole again, not increase the value of your home. By the way, there are provisions in your policy that makes allowance for upgrades if they are mandated by law, like upgraded wiring for example.

Nancy Laird
10-10-2006, 3:16 PM
My favorite question is, how many idiots wait until they have a claim before they read their policy? I guess it's more fun to wait for a claim then piss and moan about how the insurance company is allegedly "hosing" them. Unbelievable, then you people complain about how high your insurance rates are, I guess people must think lawyers are free.

I hope that I didn't take your post to mean that the people discussing this issue on this forum are "idiots." :confused: If so, then I take great offense at your tarring brush. :mad:

Most of us have had homeowners (or similar) insurance for many many years, and we depend on our agents to ensure that the policies provide the coverage that we want. Then when the company tries to renege on the coverage that we are paying for, we have a right to "piss and moan."

I guess you must be an insurance agent or adjuster.

Hugh Jaskok
10-10-2006, 3:34 PM
I, like most people, usually read what's in the box before I buy it.