Here’s how an aggressive fire insurance claim attorney might respond to an insurance adjuster to protect the homeowner’s rights in Palisades, Altadena and Los Angeles fires and push for a fair settlement
Conversation 1: Denying Coverage Due to Policy Exclusions
Adjuster: “We’ve reviewed your claim, and unfortunately, the damage appears to fall under the ‘act of God’ exclusion in your policy, so we can’t cover it.”
Attorney’s Response: “Wildfires are a covered peril under this policy, and the ‘act of God’ exclusion does not apply here. Please provide a detailed explanation of how you believe this exclusion applies to this specific wildfire event. We will be reviewing the policy’s language and, if necessary, will involve regulatory authorities to ensure compliance with California insurance laws.”
Conversation 2: Lowballing the Settlement Offer
Adjuster: “Our evaluation came to a different figure. We’re offering $150,000, which should be sufficient based on our calculations.”
Attorney’s Response: “We have reviewed the contractor’s estimate and find it reasonable and necessary to return the property to its pre-loss condition. We request a detailed breakdown of your calculations. If the insurer’s valuation remains insufficient, we are prepared to seek an independent appraisal or escalate the matter through legal channels.”
Conversation 3: Refusing to Cover Smoke Damage
Adjuster: “Smoke damage isn’t always covered under fire damage. Our assessment shows the structure is intact, so we’re not covering the smoke-related issues.”
Attorney’s Response: “The policy clearly covers damages resulting from fire, which includes smoke damage. Smoke has rendered the home uninhabitable, and failing to cover these damages would be a breach of the policy terms. We demand a reassessment or we will proceed with filing a complaint with the California Department of Insurance and potentially pursuing litigation.”
Conversation 4: Partial Denial Based on Pre-existing Conditions
Adjuster: “We can’t cover those damages because they weren’t caused by the wildfire.”
Attorney’s Response: “We dispute your assessment of pre-existing conditions. The roof’s current state is directly attributable to the wildfire. We request that a third-party expert be brought in to provide an unbiased assessment. If necessary, we will present our case in court to ensure our client receives the coverage they are entitled to.”
Conversation 5: Delay Tactics and Conditional Offers
Adjuster: “In the meantime, we can offer an initial payment of $50,000, but this will be our final settlement.”
Attorney’s Response: “This offer is inadequate and fails to reflect the full extent of the damages. The continued delay in processing this claim is causing undue hardship to our client. We demand the full settlement amount be paid promptly, and any further delays may result in us seeking penalties for bad faith practices under California law, as well as additional damages for the inconvenience caused.”
EXPERIENCED FIRE INSURANCE CLAIM ATTORNEYS
In each situation, an attorney would respond by:
- Demanding Detailed Explanations: Ensuring the insurer justifies their decisions with clear, documented reasoning.
- Challenging Incorrect Denials: Pointing out inaccuracies or misinterpretations in the insurer’s assessment.
- Escalating the Matter: Threatening to involve regulatory bodies or pursue legal action if the insurer does not comply.
- Protecting the Homeowner’s Rights: Ensuring the homeowner receives the full benefits of their policy without unfair reductions or denials.
“CALL NOW” for a Free Consultation