NBC 5 Responds

Months After Ice Storm, Homeowners Struggle With Insurance Claims

NBCUniversal, Inc.

More than five months after February’s polar vortex and power crisis crippled the state, some North Texans say their homes are in disrepair – despite having insurance coverage.

Read on to learn what consumers can do to navigate insurance questions and disputes.

“We want to get back into our home”

When the power went out, the pipes froze in Brenda Kirby's Garland home.

“We had left the water running. We opened the cabinets, tried to do all that that we were supposed to do,” said Kirby.

Still, water from a dining room sink spilled out and spread through much of the home.

“From the back of the house to the front of the house, it was wet,” said Kirby.

Kirby said her insurance company offered around $46,000 less than what her contractor expected it would take to fix the damage. As a result, Kirby said she is still living in a hotel room.

“We’re not asking for insurance to send us on a trip, to buy us a new car, to add a new wing on our house. We want to get back into our home,” said Kirby.

Kirby hired a public adjuster. Public adjusters are licensed in Texas to work through claims with policy holders for a fee – usually up to 10% of the final insurance settlement.

“We presented all the damages that we can and we've made all the arguments that we possibly can, but the insurance company has set a pretty hard line,” said Adam Brenner – the public adjuster Kirby hired.

Brenner said the insurance company and Kirby were thousands of dollars apart on the cost to replace kitchen cabinets. Kirby also wanted to replace the tile floors in the dining room and kitchen, but the insurance company offered to pay for cleaning the floor and replacing a tile broken during restoration work.

“There was, without a doubt, water underneath the floor as a result of this loss. Unfortunately, the adjuster simply was unable to address that in the actual claims process,” said Brenner.

“They won’t answer my calls”

Jena Gile said she was at the end of her rope when she contacted NBC 5 Responds. After a pipe burst inside her Parker County home, Gile said she racked up just over $12,000 in expenses on her credit card.

“My house is completely torn apart, they won't answer my calls. I don't know what to do,” said Gile.

Gile said she couldn’t get clear answers about what was covered and what wasn’t.

“They sent me a check one time and I said, thank you so much. What is this for?” said Gile. “I don't know what I'm still out and what's been reimbursed.”

Gile holds a policy with Maison Insurance - which is owned by FedNat. A few days after NBC 5 reached out to ask FedNat about Gile’s questions, Gile said a new adjuster called with promising news.

“I finally got a return call and they said they're going to start moving things forward. They have sent another check to start some work,” said Gile.

In an email to NBC 5 Responds, a FedNat spokesperson writes, “FedNat's policy is to not discuss individual claims publicly but the company has made sure that the claims department has reached out directly to the customer to resolve questions.”

The appraisal provision

NBC 5 Responds asked the Kirby’s insurance company, State Farm, about Kirby’s claim.

It told NBC 5 Responds, it can’t speak to specifics because of its privacy policy. State Farm wrote, in part, “When a claim is presented to State Farm we thoroughly investigate the loss. A final decision on a claim is determined by the facts of the loss and the results of the investigation, and we handle each claim on its own individual merits.”

State Farm also pointed to the appraisal provision in its policies – which can be invoked by either party to resolve differences.

“The appraisal process is normally a binding agreement,” said Camille Garcia with the Insurance Council of Texas – a trade group that represents many Texas insurers.

Garcia explained the consumer and insurance company each hire an appraiser to evaluate the claim, then bring in a third-party umpire to make the final call.

“You've paid for that appraiser to come in, you’ve split the cost of the umpire, the umpire decision is the final decision,” said Garcia.

Garcia said the appraisal may offer an alternative to going to court – if the dispute is over the value of the claim. The appraisal wouldn’t change policy limits.

“If you have no mold coverage in your policy, that appraiser or an umpire is not going to come in and say mold coverage now suddenly exists,” explained Garcia.

“Coverages must be determined. Then, it really is the cost of that damage and the repairs that the appraisers and the umpire are going to be looking at,” Garcia added.

The Kirby family said it’s now weighing its options in hopes of getting back into their home.

“Why do we have to fight for something that we’ve paid into for years?” asked Kirby. “There's no sense in this. We've paid into State Farm since the 1980s and we're treated like this.”

Consumer options in Texas

As of July 31, the Texas Department of Insurance said it logged 1,028 complaints related to the February ice storm. Most of the complaints, 689, mentioned plumbing or water damage.

“I think we're going to be hearing about more people in time. We're right at the point in time following the winter storms where people have been doing everything they can to try to work with their insurance company,” said Ware Wendell – executive director of Texas Watch.

Wendell said consumers may see widely different responses following a disaster – depending on your insurance company, your policy, the endorsements, even the adjuster who shows up to handle your claim.

“Insurance companies can string these claims out and nickel and dime you. In doing so, what happens is many consumers give up,” said Wendell.

One option for policy holders is to file a complaint with the Texas Department of Insurance or start with a call to the TDI consumer helpline at 800-252-3439.

“Every case is going to be unique and whenever you believe the company is not treating you fairly, we want to know about that,” said Ben Gonzalez – TDI spokesperson.

Gonzalez said the TDI will ask the insurance company for proof it is following your policy and Texas law.

“What the company doesn't want to happen is to have multiple cases where we're asking them what's going on here because it establishes a pattern of problems with a particular company,” said Gonzalez. “That can trigger a closer look by us at the company's operations.”

Out of 1,028 ice storm-related complaints, the TDI said nearly half the consumers, 479, will get additional money after TDI’s involvement.

What to know before the next disaster

Before you ever have to file a claim, document your damage and your communication with your insurance company. If you talk by phone, follow up with an email highlighting what was discussed to create a written record.

If you have damage, save evidence like the piece of broken pipe or a portion of the carpet that was ruined. Read your policy closely and understand what you’re required to save. The insurance company may ask to inspect those items.

Texas Watch offers tips here.

At least once a year, take a video tour of your home. Use your phone and record video walking through your home, opening drawers and closets. Document model numbers and serial numbers of valuable items. Save the videos to the cloud or email them to yourself in case your phone is destroyed.

If you’re shopping for insurance, the Office of Public Insurance Counsel offers a comparison tool here.

If you’re not able to find a resolution with your insurance company and need to find an attorney. The State Bar of Texas offers a referral service here.

NBC 5 Responds is committed to researching your concerns and recovering your money. Our goal is to get you answers and, if possible, solutions and a resolution. Call us at 844-5RESPND (844-573-7763) or fill out our customer complaint form.

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