Couple Battles Insurance Company Over Spring Storm Damage - NBC 5 Dallas-Fort Worth
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Couple Battles Insurance Company Over Spring Storm Damage

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    NEWSLETTERS

    (Published Friday, Sept. 4, 2015)

    The storms last spring left behind a path of devastation that some homeowners are still struggling to sort out. One North Texas couple says they had premium coverage, but when they called their insurance company to file a claim, they got the runaround.

    They say the ordeal has been a dream home damage disaster.

    "It was dripping from here all the way down," said Lynette Ross, pointing to a long tea-colored water stain along a wall of the former living room of her Midlothian home.

    The retired teacher and her husband, Chuck, have collected a lifetime of memories that were covered in plastic to protect them from their leaking roof.

    The couple says the damage occurred during storms during the Memorial Day holiday weekend.

    "We walked in on the 23rd [of May] and immediately I saw the stain on the other wall," Ross said, pointing to a water stain.

    Because their home has a tile roof, their insurer, Farmers, suggested they call a specialist.

    "He [the roofing specialist] went all over the roof and said this has to be where it is coming in," she said, pointing to a corner over the formal living area. "He pinpointed 24 tiles that needed to be replaced."

    Ross has a premium plan, so she thought they were covered until an insurance adjuster got up on her roof.

    "He comes down and he says, 'Have you read your policy?' I said, 'Yes.' He said, 'You're not covered,'" Ross recalled, shaking her head. "He goes, 'It doesn't cover blowing rain.'"

    "'Wind-driven rain' is a phrase of art used by insurance adjusters," said Patrick McGinnis, an attorney who specializes in representing policy holders in insurance cases. "So I'm very familiar with it."

    "The policy says the water had to be driven into the house as a result of something that the storm did," McGinnis explained.

    An obvious example, he said, would occur if high winds blew a tree limb through the roof of your home. Clearly the storm created the opening, so insurers would pay for subsequent rain damage as well. But it gets trickier when there's no obvious "storm-created opening."

    McGinnis argues high winds can cause damage to your roof in less obvious ways, like lifting a shingle which then causes a leak. While many insurers won't cover those kinds of situations, McGinnis argues that it should be covered.

    NBC 5 Investigates Consumer Unit asked meteorologists to analyze radar data on May 23. They determined high winds and rain pounded the Ross home as well as the rest of Midlothian that evening with winds between 60 and 70 miles per hour.

    The couple's policy says they have coverage in a windstorm, so they called Farmers Insurance again. A second adjuster examined the roof and, armed with her cell phone, Lynette Ross asked the adjuster to answer her questions on camera.

    "There is no coverage for your claim," he confirmed on tape.

    When NBC 5 Investigates Consumer Unit reached out to Farmers, spokesman Luis Sahagun emailed the following statement:

    "Our homeowners policies clearly state that we cover property damage resulting from the entry of water into a home through an opening created by specific conditions, such as wind or hail. Our investigation and follow-up re-inspection, revealed no such weather-caused openings in the roof, and as a result, we regret that the customer's policy does not cover the water damage. We encourage customers to periodically inspect their roofs, and as with any major investment, conduct regular maintenance as warranted. Our agents are always available if customers have questions about their policies.

    "Additionally, customers who may disagree with a decision can discuss this with a supervisor or manager who will gladly review the claim with them. They can also request a review by the Head of Property Claims."

    As for Ross, she says she's not giving up. She's considering hiring a lawyer.

    "You have got to be able to depend on what you pay for," she said emphatically. "If you pay for insurance, then when you need it, you should be able to have it."

    Her story serves as a lesson to homeowners to talk to their agents about their policies. Experts also advise you have your roof inspected prior to fall storm season.

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