A few years ago I spoke to another engineer at a social event for an engineering society that I belong to. He was quite pleased with what he did for a living – he evaluated insurance claims for insurance companies that homeowners placed. He prided himself with finding reasons to deny any and all claims that they put in. So much for ethics, but that is a real issue when you file a claim for damage on your house. These people are out there. This is the harsh truth about insurance claims, a lot of the industry is dedicated to keep from paying out.

Of course, to be fair to insurance companies, many more years ago I had a client that put in a claim to his insurance company about a car hitting his house. The car hit the house on the front, and he wanted the deck replaced on the back of the house. He said the car hit caused a pressure wave to travel between the brick veneer and wood framing of the house around to the back, and damage his deck. The client was furious when I wouldn’t go along with the claim. He told me he was filing a complaint against me to the Georgia Board of Professional Engineers and Land Surveyors. I don’t know whether he did or not, I never heard from them. I doubt they take complaints like that too seriously.

So, at the two extremes I’ve run into insurance companies that go to extreme lengths to avoid paying claims, and home owners with unrealistic expectations for a settlement. Fortunately, most are somewhere in between. Assume your house was damaged by a tree falling on it. You want a fair settlement from your insurance company. What do I advise as an engineer?

What Do You Hope To Get?


The first step is to have realistic expectations. You’re not getting a complete renovation. I did look at a house that was a complete loss, but that is unusual. However, you do want your house brought up to what it was before the damage occured. So, once you are through that, I advise you get the insurance company to have their engineer look at your house first. They often try to get you to have an engineer look at the house before they do, and their engineer will then come out and rebut everything your engineer has stated. It’s better to go the other way around. Let them make the statements first, and you have your expert evaluate them.


Sometimes the News Isn’t What You Want To Hear


Understand you may not hear what you want to hear. Recently, I was asked to look at an insurance claim, and I was given the insurance company’s engineer report. It was 36 pages long, and in extreme detail. It was one of the better reports I’ve read. I told the client there was no way I could rebut the findings, and I turned the work down. The harsh truth of insurance claims in this case was the potential client had real damage, but it was not of the type covered by their policy. If I had gone out before that report was done, I probably would have found the same thing. The client would have had to pay for my evaluation out of their own pocket. Sometimes you just can’t get what you want.

On the Other Hand, You Can Win


Another claim I evaluated for a client was a few years back, and his house was hit by a tree. It was a pretty bad strike. In that one I went in to detail that the damage was so extreme that the house was a total loss. The insurance company was not planning on covering that much in the way of damage. However, I was able to bring up a lot of issues I saw which would put their engineer on the spot if they said the damage was not as extreme. The insurance company honored the claim. A lot of things came together on that one. I was able to rebut a finding, there was a lot of damage that I could substatiate, and I was able to use the right terminology.

Getting the Right Engineer


So, the next step is what should be pretty obvious. If you are getting your own engineer, choose one with experience in evaluating insurance claims. The key to getting a claim through is knowing the appropriate language and rationale that makes it harder for them to turn down a claim. By the way, show the engineer any reports the insurance company does. Don’t withold information from the engineer, it won’t help you.

Consider Getting An Attorney


Let’s go to the third step, which is one that will cost you more money initially – consider getting an attorney. I had one that the client put in a claim. The insurance company’s attorney came out and evaluated the house (it was hit by a tree), and he only agreed that the most extreme damage deserved coverage. I wrote a rebuttal. The engineer met the client and me on site. It was weird to say the least. It started with the handshake. The engineer was a big man, and he tried to crush my hand when he shook it. He barely acknowledged my presence, he ignored everything I said. He claimed all the damage was pre-existing in a way that made no sense. The claim was denied again.

I told the client to get an attorney, but the client froze at that idea and wouldn’t do it. An attorney at that point may have made the difference. This is a more extreme case of the harsh truth about insurance claims, the insurance company was not going to cover the damage unless the homeowner fought them. We’ve done a lot of expert witness work, and an attorney can make the difference, but a lot of people are terrified at the thought of getting an attorney.

Call the Media (Probably Won’t Work)


Another extreme step, that works very rarely, is to call in the media. Television stations get loads of calls a day, and they can only look at so many of them. I had a client whose house had a truck run into it, and go right into the living room. It crushed floor joists, but for some reason the insurance company’s engineer refused to acknowledge the damage.

I was a little irritated, so I called a local TV station, and they actually came out. The insurance company got a different engineer, who I knew previously and I think is very good, and we agreed on the repairs. I must say, the people with the insurance company were horrified by the TV station showing up. I can’t guarantee this will work all the time though.

So, to recap, I recommend three steps. First, have realistic expectations. Don’t get into extreme theories of damage so you can get an absurdly high payout. Second, get an engineer to evaluate your damage AFTER the insurance company has done its evaluation. Don’t withold information from the engineer that you think is unfavorable. Third, if all else fails, get an attorney.

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