Four roofs replaced in the last year or so due to hail damage. One left to go.

Two related situations bother me. Both related to the coverage spelled out in my policy.

It is something you might want to keep in mind. The issue is "Code Compliance".

My roofer first brought it to my attention a few years ago. One of my houses in Garland got hammered by hail and he asked me if my policy was "Code Compliant". I called the owner of the insurance agency and asked for their clarification. They told me my policy was NOT "code compliant". My roofer asked for my permission to go around him, on up-structure in the insurance company's bureaucracy. The end result? They confirmed to him that the policy did stipulate "code compliance", and the result was an additional $3,000 to me.

Now we've been battling another insurance company on another house. This time in Plano It's been going on for about four months. It got even more interesting than the other controversy.

This insurance company said the policy was "code compliant" and their proposed settlement did adhere to the 2012 construction code. My roofer asked them why they weren't adhering to the updated code as revised in 2015. They said the City of Plano said it didn't apply to existing homes. We called the City of Plano. They said they made a "mistake" when speaking to the insurance company. The 2015 code did apply. We went back to the insurance company. They said they were sticking with what they were originally told. We gave them the contact information to speak to the department manager for the City of Plano, or email him. They declined to follow-through. We asked the City of Plano to send the insurance company something in writing, email or otherwise, so we could get this resolved. They said they would not put anything in writing, but if the insurance company would call them they would explain the applicability of the 2015 code verbally to them.

That's how third-world countries operate.

The issue had to do with attic ventilation. It was a $2,400 issue if I had to do the code upgrade myself.

My roofer recommended I file a complaint / claim with the State of Texas Department of Insurance, Consumer Protection. I did.

A few weeks later the insurance company called and advised me that they had changed their mind and wanted to be friends. They offered over $4,000. I passed the new estimate by my roofer so he could determine whether the ventilation solution was acceptable, or not. He noticed their solution would not result in a balanced system, and he advised the insurance company of the problem. The insurance company responded with a new proposal that gives us about $6,000 to meet the 2015 code.

I find the whole situation disturbing. Why did two different insurance companies basically try to lie to me about the coverage in my policy, and why would the City be willing to say something verbally, but not put it in writing?

City governments and large insurance companies appear to be in bed together to the detriment of you and I.

Keep your eye on them. You've been paying their premiums. Get what you are entitled to.

Insurance company's represent the best interests of one entity.
Themselves.
After that they will do what they feel is represented in the policy.

Don't get me started on Insurance companies.I have had nightmares in both homeowners + health.Their ONLY objective is to take money in,never out.Besides it always chaps my ass when every year there is an increase even though I have made no claim.Of course their response is the same as the tax appraisal district,"well that's just the way it is."

They have whole departments whose only function is to figure out how to welsh on claims. Their biggest problem is finding enough investments for the cash they place.

Insurance companies are nothing more than bottom line corporations that would trade your last breath for a dollar 7 days a week.

Interesting article re the evolution of the health insurance industry:

http://stanmed.stanford.edu/20...-seeking-profit.html

If it's such a terrible money grubbing business, well, hell, just put your money where you mouth is and start an insurance company.

Sorry,I can't do that. My folks were married.

What's your point Gato? You do realize the private health insurers in this country get $9 billion of our tax dollars each year in subsidies while their CEOs make between $20-100 million per year correct?

We all realize how corrupt politics is but we still vote right? We can still scoff at the obscene profits insurance companies make yet we still purchase it right? I think the crux is when you find out that BC/BS (and others) have lost multiple class action lawsuits for "internal company policy of denial".....meaning just deny everything regardless of merit with the understanding that a percentage won't have the means or stamina to pursue appeals, etc.

I'm a believer in capitalism 100% but when it's corrupted by lobbied/legislated greed it can be unrecognizable.

quote:

Originally posted by Gatogordo:
If it's such a terrible money grubbing business, well, hell, just put your money where you mouth is and start an insurance company.

Good point. It's so much easier to complain than to fix a complicated mess. I don't think I have the patience to even research the laws that are supposed to regulate the business. For what it's worth, Kaiser Permanente has their own hospitals and seems to be a reasonable alternative.

On a separate insurance nightmare, I bought a life insurance policy in 1972 when my first child was born. Over the years the name of the insurance company changed as the company evolved, merged, bought-out, etc. The company finally became Reassure Insurance. Yeah right.

As I got into my sixties they started trying to cancel my life insurance policy, Twice I reported them to the Attorney General of Texas. Twice they reinstated my policy. A third time they failed to notify me that I was into their thirty day grace period for premium payment before cancelling the policy. They had to reinstate the policy again. They finally got their wish in about 2010. I had relocated from Jakarta to Singapore to Australia and their notice for the premium coming due, and grace period got lost in my employer's mail distribution network, and I failed to make a payment. They cancelled the policy.

I have a very low opinion of insurance companies and carry no life insurance.

I hold grudges. Aetna screwed me in 1971 on a stolen car claim that amounted to them needing only to replace my gear shift knob, and replace the clutch and battery. They didn't accomplish any of those tasks correctly. For the last 46 years when an Aetna salesman wants to talk to me about insurance, I tell them my story from 1971 and then tell them they have no chance in hell.

Sorry that you have had trouble. My Son and I have our homes with Germania. He had a severe fire, $200,000, and Germania took care of everything including a rent house. I lost a hot heater a few years ago and ruined all of the hardwood floors on the bottom floor. They took care of it and a repaint of the walls on the lower level. Year before last they replaced the roof. Roofer sent in a supplement and they paid promptly. My rates have not changed.
My insurance will probably go up this year as the evaluation on our house has increased about 30%.
I couldn't ask for better service from an insurance company.

Can someone tell me what the problem is? This is America isn't it? This is a capitalistic society isn't it? The theory is that if everyone is looking after their own best interests, then everything is better. Right?
Of course the insurance companies are there to make money! Thats exactly why they are in business! They will do what the law requires and ONLY what the law requires. That's what makes America great!
Now, as to the city, same thing! That clerk does NOT want the insurance company calling the city manager and saying "we won't write policies in your city any more because of your over enthusiastic clerk! He will lose his job.
The fact that YOU have made no claims, does not matter. Others have made claims, and premiums are based on the net of premium income and claims paid, taking into account other expenses like salaries, executive bonuses, shareholder dividends etc.
Having said all that what exactly is the impact of "code compliance"? I assume it means that any repairs made must be compliant with the current code, as opposed to being grandfathered in? Local laws may not allow this. If something is to be replaced then many local ordinances require compliance with current codes, and i assume that means that you must make up the difference, correct? This seems to me to be the fault of the insurance AGENT who sold you the policy. he may or may not be an employee of the company, but is certainly an agent. That is a good point, however, and something I will certainly bear in mind. I have always used State Farm for mu homeowners and auto insurance. I have had one claim on my homeowners insurance which they paid without any issues. I think that price shopping may not be a good idea when it comes to insurance.
Peter

Kensco, I am puzzled by your experience. Was your policy a whole life or a term life policy. A term policy has no residual value. I was under the impression that a whole life policy automatically went into a loan situation whereby the company took out a loan to pay the premium, thus reducing your death benefit or surrender value, but keeping the policy in force. Not sure whether this is compnay policy or state law. I have two old policies on my wife that are basically money makers, as the increase in surrender value is greater than the premium I pay.
peter.

When I had Blue Cross,my son (3 at the time) had stabismus (lazy eye) + needed surgery.After all was said + done the ins, co. thought his rates were too high so refused to pay.(like you're going to take your kid to a low level eye doctor) The Dr.s office came back on me wanting full payment.I told them to piss up a rope but my credit score was screwed for 7 years.But by God Blue Cross wanted their premium next month.

quote:

Originally posted by NormanConquest:
When I had Blue Cross,my son (3 at the time) had stabismus (lazy eye) + needed surgery.After all was said + done the ins, co. thought his rates were too high so refused to pay.(like you're going to take your kid to a low level eye doctor) The Dr.s office came back on me wanting full payment.I told them to piss up a rope but my credit score was screwed for 7 years.But by God Blue Cross wanted their premium next month.

Read the link I posted above about blue cross.

quote:

Originally posted by Norton:
What's your point Gato? You do realize the private health insurers in this country get $9 billion of our tax dollars each year in subsidies while their CEOs make between $20-100 million per year correct?

We all realize how corrupt politics is but we still vote right? We can still scoff at the obscene profits insurance companies make yet we still purchase it right? I think the crux is when you find out that BC/BS (and others) have lost multiple class action lawsuits for "internal company policy of denial".....meaning just deny everything regardless of merit with the understanding that a percentage won't have the means or stamina to pursue appeals, etc.

I'm a believer in capitalism 100% but when it's corrupted by lobbied/legislated greed it can be unrecognizable.

My point is that if the insurance business was nearly as profitable as the posters in here make it out to be, then many, many companies or rich individuals would be lining up to start new insurance companies. AFAIK, they ain't.

So, now the fact that insurance co. CEOs make too much money bothers you? Hell, in general, I think doctors make too much money. Should we cut back on all those who make too much money to suit our tastes?

It's been shown over our history that capitalism in its raw form is harmful to society in general without adequate regulation. Think cigarettes as a prime example. So do you believe 100% in raw capitalism or 100% in government regulated capitalism?

As mentioned above, it's a free damn society, hate insurance, self-insure, can't afford the risk, Hell, buy insurance. Or take your chances.

Understood, but perhaps other than your family what is the most important thing in your life? Your health important? How much should the guy that puts a clamp on your aorta make a year? Is 1/20th of a corporate CEO's salary fair? How many years did that CEO go to school to get where he is? As many as we subspecialty surgeons? I personally did 4 college, 4 med school and 8 years residency for the privilege of wielding a scalpel safely every day on you and your loved ones, and I won't make in my career what those insurance CEOs make in one year. I wouldn't trade places with any suit and feel that I'm perfectly compensated.

I think you misunderstood my take.....I don't begrudge anyone from making what the market allows BUT when you receive tax dollar subsidies, and being found guilty of cheating your clients resulting in huge fines is nothing more than a cost of doing business it irks me a bit.

Ironically, I'm insured to the hilt fwiw. You can't fight city hall.

quote:

How much should the guy that puts a clamp on your aorta make a year? Is 1/20th of a corporate CEO's salary fair? How many years did that CEO go to school to get where he is? As many as we subspecialty surgeons?

Find me a school that can turn out CEOs consistently and we'll see how much schooling it takes to lead a major company.

quote:

Originally posted by Norton:
Understood, but perhaps other than your family what is the most important thing in your life? Your health important? How much should the guy that puts a clamp on your aorta make a year? Is 1/20th of a corporate CEO's salary fair? How many years did that CEO go to school to get where he is? As many as we subspecialty surgeons? I personally did 4 college, 4 med school and 8 years residency for the privilege of wielding a scalpel safely every day on you and your loved ones, and I won't make in my career what those insurance CEOs make in one year. I wouldn't trade places with any suit and feel that I'm perfectly compensated.

I think you misunderstood my take.....I don't begrudge anyone from making what the market allows BUT when you receive tax dollar subsidies, and being found guilty of cheating your clients resulting in huge fines is nothing more than a cost of doing business it irks me a bit.

Ironically, I'm insured to the hilt fwiw. You can't fight city hall.

. I get what you are saying. My wife is a surgeon after all. The reality is that the people running these insurance companies are running incredibly large complex businesses. The money they take, while large in absolute dollars, is not great relative to the money flowing through the companies.

A wise man once told me that ones position on any issue depends on the chair they are sitting in. The insurance companies have their own concerns.

I consider the Insurance Business much like the Gambling Business. Insurance is like going to Vegas. The house has all the odds in their favor. If over time they don't see the profits they expected, they change the game so their odds improve.

quote:

Originally posted by Kensco:
I consider the Insurance Business much like the Gambling Business. Insurance is like going to Vegas. The house has all the odds in their favor. If over time they don't see the profits they expected, they change the game so their odds improve.

Lots of insurance carriers lose their ass. It is by no means a guaranteed road to riches.

Here in Austin (the live music capital of the world) e have started up an organization called HAAM (health alliance for Austin musisians),This started about 10 years ago when John D, Gramaam's son was diagonisd w/ leucemia.He had insurance but the company filed bankruptcy + now he could not get coverage because it was a "pre existing condition". So the community set up this service. I donate regurly.

A stunning program on Frontline (PBS) last night regarding government lack of oversight, and obscene insurance company profits off Superstorm Sandy.

https://www.npr.org/2016/05/24...-million-after-sandy

The one point that blew me away was that the government even paid the insurance company legal fees to fight against the homeowners that lost their homes during the storm when the homeowners had to sue to get their insurance companies to pay the coverage they were entitled to. Unbelievable?!?!