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Re: Insurance Adjuster Standards for Hail Damage

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Posted by tonyb on June 07, 2001 at 09:17:53:

Re: Insurance Adjuster Standards for Hail Damage
Thu, 07 Jun 2001 09:39:02 -0400
Antone Braga
Richard Lawhern

Dear Richard, if your claim were just a matter of the amount of loss and not the issue of occurrence, you
could resolve it through the appraisal process (a simple form of arbitration, although that has now been
eliminated from many property policies). You mentioned that some of the conditions in your policy are
different than those found at There are a great many changes in wording taking place in most
states that favor insurance companies. Far too many to list here. I've yet to find an authority who can tell
me what states have adopted the newer wording. Some of these changes can be found at The burden of proof is indeed on the policyholder.
However, in the case of amount of loss that can be your strength. Good luck with resolving your claim to
your satisfaction. With your permission, I would like to post this e-mail on our forum, so others can see
some of the pitfalls in property claims.

Best regards,
Tony Braga

Richard Lawhern wrote:

Dear Tony,

You wrote as follows:

From: (Tony Braga)
To: (R. A. Red Lawhern)
Subject: Re: Insurance Adjuster Standards for Hail Damage
Date: Wed, 06 Jun 2001 14:48:35 -0400(A copy of this message has also been posted to the following
Have you thought of filing your formal claim, which starts the matter to
resolution? Claim filing information is at


I filed claim with USAA about seven months after the storm incident that created the damage. The claim
was denied based on the adjuster's assertion that the dimples in my aluminum siding are over two years
old. I then filed request for reinspection, with a copy forwarded to the Virginia State Insurance
Commission. When the second adjuster came out, he brought a witness with him. I'm almost surprised
it wasn't a lawyer.

The claim seems to resolve to one basic issue: USAA adjusters claim that hail impacts to aluminum
siding of sufficient force to dent the siding, will remove pre-existing oxidation in the deepest part of the
dimples created by the impact. The oxidation on the dented wall of my house is uniform inside and
outside of the impact pits. Therefore (the adjuster says) the damage is over two years old. However,
neither of these two bozos could quote a published industry standard that establishes the factual basis for
their assertion. I'm being told that I may have to hire an engineering firm to establish the basis for my
claim. Burden of proof is on me.This kind of nonsense from USAA seems to have aggravated a lot of
people in my area. 45 of them about 10 miles south of me have filed a class action suit against the
company for improper denial of claims. I may end up joining their suit. If life wasn't interesting enough
already, we had another hailstorm last week with half-inch hail accumulating up to 4 inches deep in 10
minutes. This one flattened most of our garden flowers and left the siding un-dented, but speckled with
dirt over two sides of the house. It will be interesting to see if USAA denies that this is
"damage". Thanks for the link to the claims page. Some of the conditions of my policy are a bit
different, but the cautions and reminders of the page are none the less helpful. Disgusted regards, R.A.
"Red" Lawhern, Ph.D.

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