Late Claim Reporting - 6 Months - Hail?

[insurance1822]

Just had a client's hail claim denied because it wasn't reported in 6 months from the date of loss. Loss apparently occurred back in May 2014 when our area had bad hail storms. Is this standard?

I just called Encompass & they DON'T have this clause.

 

[Josh]

If you read a policy it will almost always include a duty to report within a reasonable amount of time. That's rarely specific, but 30 days is a safe bet. Waiting six months to file a claim is well outside the window.

 

[indienoise]

It will probably depend on the carrier, but i can understand why they would deny a claim for a loss that occurred a year ago. I personally made a hail claim on my house 3 months after the fact but i wasn't given any grief over it. Still, that's very different from a year.

 

[AssociatePI.com]

This is pretty common. It will state the "duties of the insured" in the insurance contract. This will list how long an insured has to report a claim

 

[YouCanCallMeAl]

Just had a client's hail claim denied because it wasn't reported in 6 months from the date of loss. Loss apparently occurred back in May 2014 when our area had bad hail storms. Is this standard?

I just called Encompass & they DON'T have this clause.

Why did he wait so long to turn in the claim?

 

[sshafran]

Just had a client's hail claim denied because it wasn't reported in 6 months from the date of loss. Loss apparently occurred back in May 2014 when our area had bad hail storms. Is this standard?

I just called Encompass & they DON'T have this clause.

I worked in construction and did hail claims when appropriate. I sold over $1M worth of roofs/siding and have met with a ton of adjusters. It is not uncommon for claims to get called in several months after the fact.

Why?

People tend to want to let someone else on their street "make the first claim" so that they can see how it goes. People really are afraid that their insurance will be cancelled or something crazy like that, just by making a legitimate claim. So, they wait. This is typical for hail storms of approx 1 to 2 inches...which still damages but it more subtle and less noticeable from the ground. Once up on the roof, though, you can see the evidence of the hail damage.

Larger hail, most don't wait. These people file claims - most within a week - and then only a few wait until they see all the new roofs going on all around them.

However, a full year is a really long time. The company I worked for would work in an area for up to a year but business started to taper off around the 9-10 month mark. When all the 'storm chasers' left after 2 months we would still be there working with the procrastinators and get a lot of business from months 2-10. A few carriers were specific with 6 month clauses for wind/hail. We typically would know that ahead of time and not waste time on those claims - if those people wanted new roofs/siding, they had to pay retail.

I know, for a fact, that encompass will approve claims beyond 6 months, as they approved one of mine at a 9 month mark. However, it may be policy specific? Maybe they changed their policy since I was in the industry?

If you had a bad hail storm, even a year ago, and it didn't get paid based on that alone (and that language is not in the policy), then the adjuster was probably busy / lazy that day, so he didn't want to do the work (create the scope) to pay the claim. Having met with hundreds of adjusters, trust me, many are just plain idiots trying to toe the company line and find any excuse not to pay the claim.

 

[insurance1822]

I worked in construction and did hail claims when appropriate. I sold over $1M worth of roofs/siding and have met with a ton of adjusters. It is not uncommon for claims to get called in several months after the fact.

Why?

People tend to want to let someone else on their street "make the first claim" so that they can see how it goes. People really are afraid that their insurance will be cancelled or something crazy like that, just by making a legitimate claim. So, they wait. This is typical for hail storms of approx 1 to 2 inches...which still damages but it more subtle and less noticeable from the ground. Once up on the roof, though, you can see the evidence of the hail damage.

Larger hail, most don't wait. These people file claims - most within a week - and then only a few wait until they see all the new roofs going on all around them.

However, a full year is a really long time. The company I worked for would work in an area for up to a year but business started to taper off around the 9-10 month mark. When all the 'storm chasers' left after 2 months we would still be there working with the procrastinators and get a lot of business from months 2-10. A few carriers were specific with 6 month clauses for wind/hail. We typically would know that ahead of time and not waste time on those claims - if those people wanted new roofs/siding, they had to pay retail.

I know, for a fact, that encompass will approve claims beyond 6 months, as they approved one of mine at a 9 month mark. However, it may be policy specific? Maybe they changed their policy since I was in the industry?

If you had a bad hail storm, even a year ago, and it didn't get paid based on that alone (and that language is not in the policy), then the adjuster was probably busy / lazy that day, so he didn't want to do the work (create the scope) to pay the claim. Having met with hundreds of adjusters, trust me, many are just plain idiots trying to toe the company line and find any excuse not to pay the claim.

^very helpful post...thank you. I suspect this particular client of mine is a bum looking to get one over on insurance. But you give perfect examples of reasons why people do wait.