I started out as a field adjuster (getting on roofs, going in homes, etc.) but now I'm a desk adjuster. Independent adjusters do not have the authority to approve or deny a claim. So I am the file reviewer and usually when it's early in a CAT claim (catastrophic claim) a lot of new adjusters submit estimates that do not reflect what the correct settlement should be. Dwelling policies for example in North Carolina do not cover damage to fences, whereas a Homeowners policy would. Dwelling policies also do not cover wind driven rain, which the most common denial. You have to have shingles missing or a significant amount of siding missing for this type of loss to apply to your claim.
There really isn't many lulz bullshit claims. At least to me...the ones that are usually hard denials are people who have filed claims for damages for the same things in the past and received a settlement and never did anything with it. Most of these people are very poor, likely on social security as their only source of income and it's sad. The worst part of my job is having to call people and tell them that their claim has been denied for whatever reason.
Recently a friend of mine on FB that has over 100K subscribers for some kind of anime channel bragged about how much coverage his has for his home and how little he has to pay in premiums per year. I advised him that it sounds like he's underinsured and probably has a shitty policy but he insisted that he had the best of the best. He was lucky that Dorian didn't hit Florida, because that probably would've been very bad for him. You can have $750,000 worth of coverage for your home, but what is covered? You better hope you are covered for wind driven rain and have replacement cost endorsements in place. You get what you pay for in insurance just like everything else.
If any of you guys live near the coast and are at risk for hurricane damage I highly advise you to speak with your agent about making sure that your have wind driven rain coverage on your policy. Chances are if you don't and you have a newer roof, those damages to your home through improper flashings on pipe jacks on your roof, poor sealings on your windows, and damage that you might experience blown under your doors will not be covered otherwise. It's very necessary to pay a couple hundred more per year than deal with that when a storm rolls up and causes you thousands of dollars that aren't covered. It sucks man. I hate seeing it at my job, but policy dictates how I have to do my job and in the end I help more people than anything. But please if you guys are in areas that may be at risk for hurricane damage I urge you to speak with your agent to make sure that you are covered for wind driven rain. If you are not, you need to have that conversation asap and pay $40-50 more a month. It is absolutely necessary.
