Typically, damages resulting from normal wear and tear, improper installation, defective handiwork, age, neglect, or lack of maintenance are usually not covered. For example, a fifteen-year-old wood shingle roof shows no evidence of storm-related damage from wind or hail. The shingles are extremely weather-split; they are beginning to cup and curl, and the roof is obviously worn out due to age and normal wear and tear. In this case, coverage will probably be denied. If there is extensive deterioration, where it is obvious the problem has been occurring over a long period, and the insured has failed to take the appropriate measures to correct the problem, coverage may be denied. A shower stall leak is an example of a common problem. Tests show no evidence of a plumbing leak or shower pan leak.
Further examination reveals extensive deteriorated grout in the ceramic tile, which is the source of the leak. In this situation, coverage may be denied. Surface water flood damage is usually covered only if the insured lives in a flood plain and carries government-sponsored flood insurance. Termite damage is generally not covered unless it can be proven that the termites were drawn to the area because of a plumbing leak. Foundation repairs are typically not covered unless it is determined that plumbing problems, such as a slab leak, cause the foundation problems. Damages caused by a structure’s foundation shifting due to unstable soil are not typically covered. There are always exceptions to the rules, and most insurance carriers generally handle losses on a case-by-case basis. For example, a shower stall plumbing line has been leaking over a long period of time. Only recently has visible evidence of the leak occurred. During the course of the repairs, it was also found that the wood framing in the shower stall walls was extremely water-damaged. It is obvious there was no way for the insured to know there was a problem until the evidence visibly manifested itself. In this case, the deteriorated wood framing might be covered. It is essential to understand that a home or business property insurance policy is NOT a maintenance policy. The insured is responsible for maintaining the property and correcting any problems as soon as they become apparent.

Again, We should emphasize that you should contact your agent and refer to your policy regarding all questions pertaining to the specific aspects of your insurance coverage. However, if you look at our different services, you will see that we can provide you with a very generalized list of common damages that are typically covered by many homeowner and business insurance policies that we handle daily. This list is by no means complete. Your individual policy may cover more or less.

A Public Adjuster or Independent Adjuster, commonly referred to as a PA, is a private adjustment firm employee. As has been stated, an insured has the right to employ any outside party’s services to assist them in presenting their claim. A public adjuster will offer to present a scope of repairs to your insurance company on your behalf. However, the PA will charge you a percentage of the total amount your insurance company pays you for their services. As with some contractors, a PA is also likely to take an adversarial position towards your insurance adjuster and company. Beware of the gloom and doom tactics taken by some PAs. They may lead you to believe that your insurance company only wants to settle the claim for as little money as possible and that you will not receive proper compensation for your loss if you do not employ their services. Our experience in the insurance field simply does not support these contentions. It is our opinion that, in most cases, the services of a PA are unnecessary and, in some cases, can be detrimental to the settlement of your loss. We strongly urge anyone considering employing a public adjuster’s services to make every possible effort to work out any problems they may have with their insurance adjuster before signing a contract with a public adjustment firm.

There are several advantages to using a pre-qualified contractor. The contractor naturally guarantees their work. In addition, your insurance company may stand behind the contractor’s work. For example, you incur a loss, file a claim, and your insurance company pays the claim directly to you. You then hire your own contractor to perform the repairs. Now, if the work is not performed correctly or to your satisfaction, you are on your own. There is not much your insurance company can do to help you. However, if a company such as Capstone Construction Co., Inc. is involved, you can be assured that the work will be performed correctly and to your satisfaction. The contractor handles all aspects of the repairs, including the procurement of materials, scheduling of all subcontractors, and overall project supervision. All of the details are handled for you. Many homeowners and/or business owners simply do not know a reputable restoration contractor in their area. If their insurance company does not recommend a contractor, the best an insured can do is to call a company from the telephone Yellow Pages and check with their local Better Business Bureau. Another possibility is that a friend, neighbor, or relative may be able to refer the insured to a contractor.
Nonetheless, when the insurance company calls in a company such as Capstone Construction Co., Inc., the insured can feel much more at ease with the situation because it is understood that the contractor has a long-term working relationship with their insurance company. Details regarding the repair scope are primarily worked out between the contractor and the insurance company, with Capstone representing your interests. In some cases, the insurance company pays the contractor directly upon completion of the repairs, thereby eliminating the need for the insured to be concerned with the disbursement of funds. In most cases, the insured’s only financial responsibility for the covered aspect of the loss is the deductible, usually paid upon job completion.

NO! If you feel uncomfortable with the contractor who your insurance carrier has presented, you have the right to select a contractor of your choice to make the repairs to your home or business. However, you should keep in mind that the insurance carrier will not, in most cases, readily pay an amount over that deemed necessary to make the necessary repairs by a contractor that has been pre-qualified.

The insured has the right to utilize, at his expense, the services of any firm to substantiate the amount of his loss. Most policies provide for a remedy if the insured and the adjuster regarding the value of the loss have reached an impasse. This is commonly referred to as the Appraisal Process. The appraisal process determines the proper indemnification for the damages incurred. We suggest you contact your insurance agent or a qualified attorney for additional information regarding the appraisal process.

Your insurance carrier employs your insurance adjuster, whether directly or indirectly. It is his responsibility to ensure that payments made for the indemnification of your loss are consistent with the terms and conditions of your insurance policy. To that extent, the adjuster is neither on the insurance carrier’s side nor the insured’s side. It is a natural tendency for the insured to believe that proper indemnification of a loss will only result after a long and tedious battle with their insurance adjuster. Our experience has shown that the insured is usually appropriately compensated for his loss as the parameters of the policy language can address it. At Capstone Construction Co., Inc., we work very closely with your insurance adjuster, and it is our job to justify our estimate of repairs (scope of work) and all associated unit costs. Our goal is to help the insured and the insurance adjuster settle a claim expediently and professionally. We believe cooperation with the insurance company and their adjusters will yield more positive results.

Actual Cash Value (ACV) is the cost of replacing or restoring property at prices prevailing at the time and place of the loss, less depreciation. Depreciation determines the Actual Cash Value of property at the time of the loss. For example, if an item is worth $500 new and is expected to last for 5 years, and you have owned the item for 2 1/2 years, then the ACV of that item could be established as 50% of its original value. The amount subtracted from the replacement cost value based on the percentage of the ACV is typically referred to as Depreciation. Depreciation is a decrease in property value over time due to wear and tear or obsolescence.

A deductible is an amount a policyholder agrees to pay, per claim, toward the total amount of an insured loss. For example, if you incur a loss and your insurance company determines that repairs for the damages are going to cost $5,000.00 and your policy has a $500.00 deductible, your insurance company will pay $4,500.00, and it will be your responsibility to pay the remaining $500.00 balance to your restoration contractor.

Each insurance company’s underwriting department reviews claims and the frequency of claims at the time of policy renewal. These matters are subject to the discretion of the underwriting department of your particular company.

The language in most insurance policies requires responsibility on the part of the home or business owner to mitigate his loss. This means that you should take whatever steps are necessary to reduce and/or control any additional damage resulting from the initial loss. For example, if a water pipe in your home should burst and flood your house, you have a responsibility to extract the water from the carpeting as soon as possible. This means you should attempt to perform the extraction yourself or call an Emergency Water Extraction Company such as Capstone Construction Co., Inc.

Your first step is to contact your insurance agent or company as soon as possible to report your claim. Their telephone number is typically found in your insurance policy. When reporting your claim, you should have all the essential information ready, such as your policy number. You should also be prepared to provide as much information as possible regarding the nature of the claim and the type of damage involved.