Internal Texas Windstorm Roofing Claims Memo Explains Damage is Not Covered
The independent adjusters for Texas Windstorm Insurance Association may end up being some of the best witnesses for policyholders in the litigation that is starting. The desk TWIA adjusters in Austin are not listening to them and do not trust them to determine what is damage and what is not.
An internal TWIA Claims Memo helps show this. In part, it says:
"Shingles that show no signs of damage other than they are not sealed and can be raised with your hand are not considered windstorm damaged. Some call these "lifted" shingles. Some call them "blown up" shingles. Some call them "unadhered". Regardless of the terminology, these are not considered windstorm damaged. The shingles are mostly laying flat and are continuing to do as they were intended…….to repel water."
The rationale sounds familiar to me because it has been raised before. TWIA wrongly finds that part of a structure that has been physically changed, altered, or what most adjusters are trained and consider "damaged," is not damaged because the item functions as it did before the event. I bet TWIA executives have hired outcome-oriented engineers to help provide an alleged basis for this fabricated argument and adjustment standard not found in the policy.
I will go into a more in-depth discussion of this Tuesday afternoon. However, the memo is instructional because it helps show the mindset of the claims executives reviewing the field adjustment. The "slabbers" were right to March on Austin because the delay and denial of claims are coming from there.
I strongly urge any policyholder to see an attorney before agreeing to the administrative remedy because you give up very valuable rights by doing so. There are many fine and experienced attorneys that are available for a free initial consultation. If denials are based on the type of logic shown above, you will have attorneys wanting to represent you.
This puts me in mind of "Alladin" and that silly parrot, Gilbert Gottfried's voice I think, "Why am I not surprised?!"
Those of us in the field hear this faulty logic excuse daily from adjusters and now we know why. They're parroting what TWIA has told them. One adjuster I dealt with had sent me this:
Story Below:
I received a copy of this email from a member participant and am sharing it with our members. Many of us have discussed the need for your own E & O coverage and this email sure drives home the point!
**********
From: Reggie Warren [mailto:REGGIE@TWIA.ORG]
Sent: Friday, February 13, 2009 1:51 PM
Cc: Reggie Warren
Subject: Lawsuits against IA firms
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The following memo goes out to all IA firms handling TWIA claims. ]
If you or your retained adjuster are sued in a case involving T.W.I.A., you and the adjuster should immediately:
(1) report the claim to your professional liability carrier and personal counsel;
(2) timely file an answer to the lawsuit through your own counsel.
T.W.I.A. is not contractually bound to defend adjusters. Any decision to provide a courtesy defense to adjusters will be made case-by-case. Due to the large volume of cases involving numerous adjusters, we cannot make these decisions before your deadline to answer a lawsuit.
Do not rely on T.W.I.A. or T.W.I.A.'s claims counsel to file an answer for you.
We will send a letter to principals soon with further information.
Please advise your retained adjusters.
Thank you.
Reggie Warren
TWIA
One adjuster for TWIA recently told me that TWIA needs to hope he does Not get a subpeona, and that these adjusters will be the Policyholders' Best witnesses, especially after being told to do things they Know are not right or fair, and Then being thrown under the bus and abandoned like this, in some sort of 'plausible deniability' scenario.
Yes, they're expecting us to "take it badly", as storm victims & their PA's, attorneys and others involved on
(I love this, and not just because my non-profit senior advocacy and assistance agency is "Angel House")
Chip said at the conference & seminar in Houston the other day, that we work "on the side of Angels".... This is great, and the email I got shows that the Other side is in it for the Dollars and must be pretty well connected and in many ways, protected, at the state Capitol. I wish I'd known about the march in time - I'd have Particpated and I know a few of the insureds I have met would also have gone!
Having gone through all this in Florida decades ago, starting with Andrew there, I see Texas needs a lot of help and Angels. Power to the people.
Doreen,
I found it interesting how TWIA throws their help "under the bus" with that memo.
Following the initial filing of Katrina lawsuits, most of State Farm's vendors were provided counsel by State Farm--a very wise move by State Farm's management. They all remained "on the same page" with legal theories and coordination.
Thank you for your comment, and I hope you share more in the future.