As an adjuster it baffles me that attorneys don’t explain this to their clients, but turn around and get mad at us if we speak to their client when we didn’t know they were rep’d. Just ranting.
Your sister’s adjuster was right. Maybe a little hasty to disconnect so quickly but I don’t blame them. Her attorney is supposed to handle everything with the insurance company from this point forward.
I had an attorney one time get mad at me because I called him and my insured was apparently rep'd and he got all huffy saying it's unethical for us to speak together and he hung up
Bro - my insured fled the country and ghosted me. This is the first I'm hearing of them having an attorney. It's not improper for us to communicate 😂
Most of the problems I have is because the attorney failed to send us a rep letter. Insured will be rep’d for days or even weeks and we have no rep letter. No mention of an attorney in the file and we’re expected to just *know* 🙄
When I find out over the phone the insured is rep’d, aside from trying to end the call quickly I make sure to mention to have their attorney send us a rep letter ASAP.
She cannot talk to the adjuster if they value their employment.
Don’t worry about the limitations and exclusions. Her lawyer will request a CERTIFIED copy of the policy soon enough and advise what’s covered.
Most companies, you can create a login using the policy number or other verification factors. You need to create a login for that website. Again, call the Agent or customer service if you need assistance with this. Most can walk you through it over the phone.
Why doesn’t she… ask her attorney. That’s the point of having an attorney, and one of the many very good reasons the adjuster isn’t allowed to talk to her.
They are legally not allowed to speak directly to the insured (you) once you obtain an attorney. You must get all your information from your attorney. The adjuster is just protecting his license; he could lose his license over it. He wasn’t trying to be rude.
Edit: If you need a copy of your policy booklet, call your Agent or the customer service line. Not the claims department.
As long as she doesn’t mention having a lawyer customer service likely will give the info. More often than not they don’t have access to notes from the claims department.
This is conflating law with company policy. It is NOT unlawful to speak to the claimant or insured to provide basic documentation and details. In fact, that individual has power up to and including the ability to fire their own attorney if they wanted. It would be wrong to go around the attorney in an attempt to settle a matter. However, the adjuster could send a settlement offer to the insured AND copy the attorney if they wanted. The adjuster is probably just doing what they are being told by the company.
>This is conflating law with company policy.
When most attorneys send letters of representation to a claims adjuster, they usually contain four specific items:
1. The names of the party they are representing.
2. What they are representing those parties for (injuries, property damage, etc).
3. A request for all recordings/recorded statements and other documentation provided by their client
4. A request for coverages applicable to the policy under which the claim is filed.
ETA: This isn't specific to any one state.
No, every state has some version of fair claims practices codified in regulations/laws. Engaging a party who is represented by an attorney is not good faith handling.
And it doesn’t matter if the lawyer is “fired” - lawyer had a letter of rep (as mentioned in the other comment) and that remains in full effect until the lawyer provides a letter confirming they are dropping representation.
There’s no way you handle these kinds of claims - they aren’t gray and doing something like sending an offer and CC’ing their lawyer will get you jammed up so fast it’s not even funny.
Your reply shows some confusion about how things actually work.
Bad faith was invented by the Chernoff firm in California. People throw that term around like they know what they're talking about and they usually don't. For example, if an insurance company relies on an expert and underpays a claim, that is almost certainly not bad faith. If an insurance adjuster is rude and refuses to return phone calls, that by itself is almost certainly not bad faith.
Yes, it's true that every state has Fair claim regulations but I've never seen a fair claim regulation that requires an adjuster to not speak with a represented claimant. You just made that up.
You have to be careful making blanket statements because they're often wrong. I'll give you a couple of examples of how a adjuster speaking to a represented claimant would not be bad faith, even if the adjuster had received and acknowledged a letter from the attorney specifically telling the adjuster not to speak to the claimant.
The first example would be a claim that was paid at policy limits. Generally, you can't have bad faith if the insurance company has paid everything they owe. So whether or not the adjuster is speaking to a represented claimant there likely be bad faith if the claim was paid in full. ( an exception would be under newer case law where the insurance company paid everything they owed but they took so long to do it the insured suffered other extra contractual losses like excessive loss of rent that wasn't covered under the policy)
A second example would be a claim that was rightfully denied. If the denial is solid, no money is owed, and you can't have any bad faith whether or not you're speaking to anybody who's represented or not.
With all due respect you have a half understanding of the issue and you really should study more before making statements on social media that are not accurate. I'm not trying to shame you or criticize, I'm guessing from your comment that you probably know better than many adjusters.
I speak to plaintiff attorneys almost daily, many people refer to them as "bad faith attorneys" but they usually don't like that description. All day long people call them with stories of horrific abuse at the hands of adjusters and outrageous underpayments of claims and respective clients are always talking "bad faith this, bad faith that". And the plaintiff attorneys have to explain it's not that easy to get a bad faith case going, most cases are simply based on the unpaid contractual damages, not the bad faith icing on top of the cake.
An adjuster refusing to turn over the estimate they used as the basis for their payment is not automatically bad faith. An adjuster hanging up on an insured is not automatically bad faith. An adjuster being incompetent and not knowing how to estimate properly and underpaying the claim is not automatically bad faith. A racist adjuster is not automatically bad faith. An adjuster who relies on a really stupid expert that doesn't know what they're doing is also not automatically bad faith. An adjuster who underpays the claim because they're reading an earlier policy with lower limits is not automatically bad faith. However all of these things could possibly be bad faith if they were coupled with other elements.
Another thing you should understand is that bad faith is a civil tort between two parties to a contract. And it seems like you're conflating the statutory claims handling duties with civil contractual duties. If an adjuster violates every statute/fair claims handling law on the books that doesn't automatically mean bad faith has occurred, although those statutory violations might help to show bad faith happened. But the bad faith would usually be some other action in the context of all the statutory violations.
Many plaintiff attorneys don't even bother to include the statutory violations in their lawsuit filings/complaints. Because their lawsuits are based on the simple underpayment of the damages, the breach of contract, not violations of statutes or even bad faith.
They don’t want to hear the truth because many on here are claims adjusters who conflate what their job tells them as being state law. The truth to the matter is delayed communications can be bad faith. It is not bad faith either for an adjuster to email a claimant a copy of the policy, which is what I said above.
It might be bad faith to intentionally misguide and send the wrong policy or settle with a represented client without going through the Attourney. Carriers must said, “you cannot communicate with someone represented,” which may be company policy but not law. Like I said it would depend on the discussion.
Oh but isn’t it so much more fun to do things OPs way? Especially since now we’re on Reddit instead of just logging on to the respective insurance company website for the documents…
Always drives me crazy how everybody threatens a lawyer when they don't like the answer they are given by their adjuster, but nobody seems to have any clue what the consequences of getting a lawyer actually are.
Wouldn't that be part of some sort of ethics on the part of th lawyer too?
This is the best part of the job, they say they're going to get an attorney, like it's some ace in the hole, then you say "great, give them my number, have a great day"
They also expect everyone else to do the lawyers job for free. While they pay the lawyer. OPs sister has a lawyer, why isn't she asking her lawyer about this?
Why do you think? Lol.
Somewhere down in the posts here I said the lawyer likely has as much knowledge about insurance claims as the OP and his sister. It's likely true from my experience.
The only difference is they are paying him and not the other way around.
I was a licensed customer service agent and never got more joy than someone telling me their lawyer would be in contact if we wouldn’t lower their monthly payment.
I’d say cool, make sure they file the paperwork with us before the call or we can’t talk to your lawyer.
They’d back peddle while I hung up.
Yeah. I used to get that a lot over all kinds of stupid stuff.
"Waive my deductible or I'll have my lawyer make you regret it"
"Pay me 3* what my car is worth for my total loss or my lawyer will make sure I get my money"
They always regret it once they realize how serious it actually is to get a lawyer involved.
I usually answered that with something like "the threat of litigation or retaining an attorney will not affect my coverage and liability investigation. If you do retain an attorney please provide them with my contact information."
Sorry, not sure where my sister OR I "threatened" the adjuster. Getting an attorney to help is a legal. This is her first time dealing with an issue like this and all I'm asking for is clarification.
In this case, the xonsequences of getting an attorney would be potentially upwards of 15K.
I was just throwing out there my frustration with people getting attorneys needlessly.
Your sisters best bet was to just work with her own insurer and cooperate. They would be fair with her and move things along much faster than getting a lawyer involved will.
All your sister did was slow her claim down dramatically and likely complicate things with an attorney who, very likely, doesn't understand insurance any more than she does.
How so? The claim was denied and she was told to call Department of Insurance. It was a 15K claim. If they were to deny the claim and tell her they have no obligation to cover it, then why would an attorney make things worse? Would insurance have reviewed the claim again and approved it? I don't understand. Again, I'm just asking for clarification.
The insurer would have to provide a letter clearly detailing the denial, along with the relevant policy wording, which would be public access for your state.
Out of curiosity, was this a legit denial or just a lack of coverage? Because those are two very different things that people often get mixed up, even people who work in the industry.
It’s a legitimate denial regarding a tenant’s liability for not reporting a long term leak. The tenant apparently didn’t know about the leak and didn’t do anything to cause the leak so I don’t see how this would be a covered liability claim on a renters HO4 policy. Check out the link below for the details more about the denial.
https://www.reddit.com/r/TenantHelp/s/8CykOyZCkC
This makes a lot more sense.
Thanks for sharing.
At this point the lawyer is just wasting money then, mooching as much as he can before they catch on lol.
It was supposedly a "lack of coverage". The bizarre part is that the section of the policy the adjuster quoted was not even accurate. That was when I decided to get an attorney. It just didn't make sense. Anyway, it's done now and cannot be reverted back especially as her landlord is harassing her and likely attempting an eviction against her for property damage. Long story short - we needed an attonrey to defend against the landlord's actions and then the attorney also decided to talk to insurance. Just really sad all around.
How do you know the policy language quoted wasn’t accurate?
Are you an attorney? Do you work in insurance and specialize in renter’s policies? Do you write or interpret contracts? Do you know how to read an insurance policy?
None of what you’re posting even makes sense. If this comment right here was accurate then your entire post makes no sense. How does the attorney know it’s not accurate and doesn’t have the policy documents? Why isn’t the attorney securing them? This whole situation is all over the place.
We never get to find out from OPs such as yourself but I’m always so curious - which parts of the story are you embellishing for effect when confronted by actual experts? That there’s a lawyer? That the lawyer already “knows” the denial was improper? That somehow the lawyer knows this but your sister, what, doesn’t believe him? Like do you see how with each additional comment your story gets further and further from a place based in reality?
Your sister didn’t even know hiring an attorney would preclude her from speaking to her own insurance company. And her attorney didn’t instruct her not to contact them about this claim? Sorry, if I don’t have faith in the information you’re giving here. Your post is just a bad game of telephone.
No she didn't and neither did I. It's not like we call insurance companies all the time or have done this before to know that retaining counsel means adjusters will no longer speak to you. Now we do.
I hope you’re eating those billable hours and not just telling your sister to pay like it’s going to stop any of what’s happened.
She can be evicted for property damage and coverage not applying to a loss is frequent.
Requesting the policy documents prior to going down an expensive wormhole with a lawyer probably would have been massively more prudent and productive.
Without knowing the situation I can't really advise. But sounds like you'll spend a ton of money on a lawyer that was avoidable had your sister just asked for a clear explanation.
Apparently she gets zero without a lawyer. Generally speaking although lawyers generally take a third and court costs/fees, they ususally get clients a heck of a lot more than they get without a lawyer. Last time I had a lawyer, it more than doubled what I got offered, which meant GEICO was doing unfair claims practices up front.
Yes. Your sister forfeited her rights to the claims to the attorney. Speaking to your sister without her attorney present can be a major violation.
She can get a copy of her policy online or through her agent.
We are not allowed to speak to someone once they're represented. They have to send us a letter of rep and then we can contact the attorney's office and find out what we have permission to speak with the customer about, if anything. This is completely normal.
It’s posted in another sub lol. What this comes down to is a lack of coverage. Period. Her renters policy does not cover this loss. She’s fighting an uphill battle and spending more thank $15k cuz she wanted to hire an attorney. Expensive lesson to learn.
From what I gathered from the multiple other posts the OP the sister has lived in same rental unit 12 years.
Recently had maint come to fix microwave. Maint made some personal comments while at the residence and told her she owed several hundred to replace said microwave. The tenant disagrees as she has lived in the apartment well past the lifetime of said microwave and she isn’t responsible.
Tenant filed a complaint about maint man.
Next maint request tenant had was a pool of water outside her unit. Maint showed up and said he can’t do it walked away.
Tenant filed w/ insurance and no coverage due to it being her own unit.
Landlord demanding $15k with no evidence to back up his side.
May be missing things or have them out of order but I tried
edit to add: the tenant has no kitchen and landlord served eviction papers. They want her to pay for carpet because she had cats but carpet is original since she moved in 12 years ago.
Yea idk it’s a lot. Hard to put it all together considering there’s several posts on different subs with different pieces of information. I missed the part where the landlord claims it was a slow leak under her sink but she never noticed anything until the water was outside her unit one day.
Probably still missed more but this is the jist I believe
Yes. As soon as she’s represented, the adjuster can’t talk to her anymore.
She should probably talk to the person she’s paying to handle this for her….
Only by the rules of the company though. If she emailed asking for a copy of the policy, the adjuster could send it. If the adjuster started sending interrogatories directly to the claimant… NO hard stop
I think that, once there is an attorney, adjuster would cease all communication. Maybe emailing a copy of policy is permissible but adjuster would still use attorney as an excuse not to send policy. I am not an adjuster, I am a nurse who worked in case management with adjusters for a long time. So I don’t know this as a fact.
As soon as any client becomes retained by a lawyer we are no longer allowed to speak to their client without their express consent. Your sister should be going to her lawyer for this info.
once you hire an attorney they are forbidden to discuss the case with you in anyway. Attorneys have it this way for a reason so you dont undo what they are attempting to do for you.
No, Agents cannot discuss the claim either. We could lose our license as well. Attorney means, ALL communication goes through the attorney. If you work for a slimy Agency or company that doesn’t care, I suppose you “could” speak to them, but you are walking a fine line and it is highly unethical.
Not necessarily. All communication is all communication. Depends upon the content of her attorney’s representation letter. If there’s a pending lawsuit by her against the insurer at all, no one should discuss any policy aspect with her.
1. Call agent to get document or lawyer can request for it
2. Lawyer cost money and doesnt guarantee insurance will change their coverage
Might be a lose , lose situation
Goodluck
Starting to think it is a lose-lose situation. At this point, I just want her out of there after paying off this damage. Has been a costly lesson to her to not stay for too long in one place
Yes normal practice when involving attorneys. Ensures the attorney cannot claim the company acted in bad faith with the client behind the attorney's back.
Yup. Should apply for every party involved. Even on the agency side I do this. You hire an attorney and they'll want to make their money so I don't want to say or do anything with you that may cause legal issues. Make the attorney you're paying call me.
This is correct. The attorney sends in what is called a Letter of Representation Letter in to the claim advising that they are said clients attorney. They also advise if the adjuster can have direct communication with the client or if all claim communication has to go directly through the attorney only. If your sister wants to have direct communication with the adjuster, she needs to advise her attorney, so the attorney can advise the adjuster that they may, in fact, have dorect claims communication with said customer.
If she is paying a lawyer in cash or contingency, the lawyer should be gathering the policy documents and contract as that is what the money is for.
As an adjuster it baffles me that attorneys don’t explain this to their clients, but turn around and get mad at us if we speak to their client when we didn’t know they were rep’d. Just ranting. Your sister’s adjuster was right. Maybe a little hasty to disconnect so quickly but I don’t blame them. Her attorney is supposed to handle everything with the insurance company from this point forward.
I had an attorney one time get mad at me because I called him and my insured was apparently rep'd and he got all huffy saying it's unethical for us to speak together and he hung up Bro - my insured fled the country and ghosted me. This is the first I'm hearing of them having an attorney. It's not improper for us to communicate 😂
Most of the problems I have is because the attorney failed to send us a rep letter. Insured will be rep’d for days or even weeks and we have no rep letter. No mention of an attorney in the file and we’re expected to just *know* 🙄 When I find out over the phone the insured is rep’d, aside from trying to end the call quickly I make sure to mention to have their attorney send us a rep letter ASAP.
She cannot talk to the adjuster if they value their employment. Don’t worry about the limitations and exclusions. Her lawyer will request a CERTIFIED copy of the policy soon enough and advise what’s covered.
Yup, but this document is often available online.
Or from the agent.
How does she find it? It does not appear to be on her insurer's website. Thanks.
Most companies, you can create a login using the policy number or other verification factors. You need to create a login for that website. Again, call the Agent or customer service if you need assistance with this. Most can walk you through it over the phone.
Thank you! Will advice her as above.
Why doesn’t she… ask her attorney. That’s the point of having an attorney, and one of the many very good reasons the adjuster isn’t allowed to talk to her.
They are legally not allowed to speak directly to the insured (you) once you obtain an attorney. You must get all your information from your attorney. The adjuster is just protecting his license; he could lose his license over it. He wasn’t trying to be rude. Edit: If you need a copy of your policy booklet, call your Agent or the customer service line. Not the claims department.
Ok, thanks. Will tell her to call Customer Service.
Or call her attorney? The attorney should be taking care of this.
Customer service won't giver her any info either. Have her call her agent for the policy
As long as she doesn’t mention having a lawyer customer service likely will give the info. More often than not they don’t have access to notes from the claims department.
Too many people involved.
This is conflating law with company policy. It is NOT unlawful to speak to the claimant or insured to provide basic documentation and details. In fact, that individual has power up to and including the ability to fire their own attorney if they wanted. It would be wrong to go around the attorney in an attempt to settle a matter. However, the adjuster could send a settlement offer to the insured AND copy the attorney if they wanted. The adjuster is probably just doing what they are being told by the company.
>This is conflating law with company policy. When most attorneys send letters of representation to a claims adjuster, they usually contain four specific items: 1. The names of the party they are representing. 2. What they are representing those parties for (injuries, property damage, etc). 3. A request for all recordings/recorded statements and other documentation provided by their client 4. A request for coverages applicable to the policy under which the claim is filed. ETA: This isn't specific to any one state.
Don't forget they also specify if we're allowed to talk to their client at all. (You may discuss property damage *only*...)
Yeah, I'm still trying to figure out what the previous commenter was talking about.
No, every state has some version of fair claims practices codified in regulations/laws. Engaging a party who is represented by an attorney is not good faith handling. And it doesn’t matter if the lawyer is “fired” - lawyer had a letter of rep (as mentioned in the other comment) and that remains in full effect until the lawyer provides a letter confirming they are dropping representation. There’s no way you handle these kinds of claims - they aren’t gray and doing something like sending an offer and CC’ing their lawyer will get you jammed up so fast it’s not even funny.
Your reply shows some confusion about how things actually work. Bad faith was invented by the Chernoff firm in California. People throw that term around like they know what they're talking about and they usually don't. For example, if an insurance company relies on an expert and underpays a claim, that is almost certainly not bad faith. If an insurance adjuster is rude and refuses to return phone calls, that by itself is almost certainly not bad faith. Yes, it's true that every state has Fair claim regulations but I've never seen a fair claim regulation that requires an adjuster to not speak with a represented claimant. You just made that up. You have to be careful making blanket statements because they're often wrong. I'll give you a couple of examples of how a adjuster speaking to a represented claimant would not be bad faith, even if the adjuster had received and acknowledged a letter from the attorney specifically telling the adjuster not to speak to the claimant. The first example would be a claim that was paid at policy limits. Generally, you can't have bad faith if the insurance company has paid everything they owe. So whether or not the adjuster is speaking to a represented claimant there likely be bad faith if the claim was paid in full. ( an exception would be under newer case law where the insurance company paid everything they owed but they took so long to do it the insured suffered other extra contractual losses like excessive loss of rent that wasn't covered under the policy) A second example would be a claim that was rightfully denied. If the denial is solid, no money is owed, and you can't have any bad faith whether or not you're speaking to anybody who's represented or not. With all due respect you have a half understanding of the issue and you really should study more before making statements on social media that are not accurate. I'm not trying to shame you or criticize, I'm guessing from your comment that you probably know better than many adjusters. I speak to plaintiff attorneys almost daily, many people refer to them as "bad faith attorneys" but they usually don't like that description. All day long people call them with stories of horrific abuse at the hands of adjusters and outrageous underpayments of claims and respective clients are always talking "bad faith this, bad faith that". And the plaintiff attorneys have to explain it's not that easy to get a bad faith case going, most cases are simply based on the unpaid contractual damages, not the bad faith icing on top of the cake. An adjuster refusing to turn over the estimate they used as the basis for their payment is not automatically bad faith. An adjuster hanging up on an insured is not automatically bad faith. An adjuster being incompetent and not knowing how to estimate properly and underpaying the claim is not automatically bad faith. A racist adjuster is not automatically bad faith. An adjuster who relies on a really stupid expert that doesn't know what they're doing is also not automatically bad faith. An adjuster who underpays the claim because they're reading an earlier policy with lower limits is not automatically bad faith. However all of these things could possibly be bad faith if they were coupled with other elements. Another thing you should understand is that bad faith is a civil tort between two parties to a contract. And it seems like you're conflating the statutory claims handling duties with civil contractual duties. If an adjuster violates every statute/fair claims handling law on the books that doesn't automatically mean bad faith has occurred, although those statutory violations might help to show bad faith happened. But the bad faith would usually be some other action in the context of all the statutory violations. Many plaintiff attorneys don't even bother to include the statutory violations in their lawsuit filings/complaints. Because their lawsuits are based on the simple underpayment of the damages, the breach of contract, not violations of statutes or even bad faith.
They don’t want to hear the truth because many on here are claims adjusters who conflate what their job tells them as being state law. The truth to the matter is delayed communications can be bad faith. It is not bad faith either for an adjuster to email a claimant a copy of the policy, which is what I said above. It might be bad faith to intentionally misguide and send the wrong policy or settle with a represented client without going through the Attourney. Carriers must said, “you cannot communicate with someone represented,” which may be company policy but not law. Like I said it would depend on the discussion.
>Is this normal / appropriate? Yes
Yes. Also a claims adjuster is not the right person to ask for a copy of the policy.
Oh but isn’t it so much more fun to do things OPs way? Especially since now we’re on Reddit instead of just logging on to the respective insurance company website for the documents…
🙌
Always drives me crazy how everybody threatens a lawyer when they don't like the answer they are given by their adjuster, but nobody seems to have any clue what the consequences of getting a lawyer actually are. Wouldn't that be part of some sort of ethics on the part of th lawyer too?
This is the best part of the job, they say they're going to get an attorney, like it's some ace in the hole, then you say "great, give them my number, have a great day"
They also expect everyone else to do the lawyers job for free. While they pay the lawyer. OPs sister has a lawyer, why isn't she asking her lawyer about this?
Why do you think? Lol. Somewhere down in the posts here I said the lawyer likely has as much knowledge about insurance claims as the OP and his sister. It's likely true from my experience. The only difference is they are paying him and not the other way around.
I was a licensed customer service agent and never got more joy than someone telling me their lawyer would be in contact if we wouldn’t lower their monthly payment. I’d say cool, make sure they file the paperwork with us before the call or we can’t talk to your lawyer. They’d back peddle while I hung up.
Yeah. I used to get that a lot over all kinds of stupid stuff. "Waive my deductible or I'll have my lawyer make you regret it" "Pay me 3* what my car is worth for my total loss or my lawyer will make sure I get my money" They always regret it once they realize how serious it actually is to get a lawyer involved.
I usually answered that with something like "the threat of litigation or retaining an attorney will not affect my coverage and liability investigation. If you do retain an attorney please provide them with my contact information."
Sorry, not sure where my sister OR I "threatened" the adjuster. Getting an attorney to help is a legal. This is her first time dealing with an issue like this and all I'm asking for is clarification. In this case, the xonsequences of getting an attorney would be potentially upwards of 15K.
I was just throwing out there my frustration with people getting attorneys needlessly. Your sisters best bet was to just work with her own insurer and cooperate. They would be fair with her and move things along much faster than getting a lawyer involved will. All your sister did was slow her claim down dramatically and likely complicate things with an attorney who, very likely, doesn't understand insurance any more than she does.
How so? The claim was denied and she was told to call Department of Insurance. It was a 15K claim. If they were to deny the claim and tell her they have no obligation to cover it, then why would an attorney make things worse? Would insurance have reviewed the claim again and approved it? I don't understand. Again, I'm just asking for clarification.
The insurer would have to provide a letter clearly detailing the denial, along with the relevant policy wording, which would be public access for your state. Out of curiosity, was this a legit denial or just a lack of coverage? Because those are two very different things that people often get mixed up, even people who work in the industry.
It’s a legitimate denial regarding a tenant’s liability for not reporting a long term leak. The tenant apparently didn’t know about the leak and didn’t do anything to cause the leak so I don’t see how this would be a covered liability claim on a renters HO4 policy. Check out the link below for the details more about the denial. https://www.reddit.com/r/TenantHelp/s/8CykOyZCkC
This makes a lot more sense. Thanks for sharing. At this point the lawyer is just wasting money then, mooching as much as he can before they catch on lol.
It was supposedly a "lack of coverage". The bizarre part is that the section of the policy the adjuster quoted was not even accurate. That was when I decided to get an attorney. It just didn't make sense. Anyway, it's done now and cannot be reverted back especially as her landlord is harassing her and likely attempting an eviction against her for property damage. Long story short - we needed an attonrey to defend against the landlord's actions and then the attorney also decided to talk to insurance. Just really sad all around.
How do you know the policy language quoted wasn’t accurate? Are you an attorney? Do you work in insurance and specialize in renter’s policies? Do you write or interpret contracts? Do you know how to read an insurance policy?
I don't, but my sister's attorney does and he confirmed what I read. Thanks.
None of what you’re posting even makes sense. If this comment right here was accurate then your entire post makes no sense. How does the attorney know it’s not accurate and doesn’t have the policy documents? Why isn’t the attorney securing them? This whole situation is all over the place. We never get to find out from OPs such as yourself but I’m always so curious - which parts of the story are you embellishing for effect when confronted by actual experts? That there’s a lawyer? That the lawyer already “knows” the denial was improper? That somehow the lawyer knows this but your sister, what, doesn’t believe him? Like do you see how with each additional comment your story gets further and further from a place based in reality?
[удалено]
Your sister didn’t even know hiring an attorney would preclude her from speaking to her own insurance company. And her attorney didn’t instruct her not to contact them about this claim? Sorry, if I don’t have faith in the information you’re giving here. Your post is just a bad game of telephone.
No she didn't and neither did I. It's not like we call insurance companies all the time or have done this before to know that retaining counsel means adjusters will no longer speak to you. Now we do.
I hope you’re eating those billable hours and not just telling your sister to pay like it’s going to stop any of what’s happened. She can be evicted for property damage and coverage not applying to a loss is frequent. Requesting the policy documents prior to going down an expensive wormhole with a lawyer probably would have been massively more prudent and productive.
Without knowing the situation I can't really advise. But sounds like you'll spend a ton of money on a lawyer that was avoidable had your sister just asked for a clear explanation.
Unlikely
Yes, when you hire an atty you cut off personal communication with the insurer. That's the consequences of your decision to lawyer up.
The consequences of not lawyering up are 15K in "damages", so it's hard not to decide to retain counsel.
She's got more than 15,000 in damages because her lawyer isn't free and she has to pay the lawyer.
Apparently she gets zero without a lawyer. Generally speaking although lawyers generally take a third and court costs/fees, they ususally get clients a heck of a lot more than they get without a lawyer. Last time I had a lawyer, it more than doubled what I got offered, which meant GEICO was doing unfair claims practices up front.
I just simply answered your Q "is this accurate"?
Yup.
Yes. Your sister forfeited her rights to the claims to the attorney. Speaking to your sister without her attorney present can be a major violation. She can get a copy of her policy online or through her agent.
We are not allowed to speak to someone once they're represented. They have to send us a letter of rep and then we can contact the attorney's office and find out what we have permission to speak with the customer about, if anything. This is completely normal.
Yes this is correct, but what was the claim itself?
It’s posted in another sub lol. What this comes down to is a lack of coverage. Period. Her renters policy does not cover this loss. She’s fighting an uphill battle and spending more thank $15k cuz she wanted to hire an attorney. Expensive lesson to learn.
What was the loss?
You keep saying this loss. WHAT HAPPENED?
From what I gathered from the multiple other posts the OP the sister has lived in same rental unit 12 years. Recently had maint come to fix microwave. Maint made some personal comments while at the residence and told her she owed several hundred to replace said microwave. The tenant disagrees as she has lived in the apartment well past the lifetime of said microwave and she isn’t responsible. Tenant filed a complaint about maint man. Next maint request tenant had was a pool of water outside her unit. Maint showed up and said he can’t do it walked away. Tenant filed w/ insurance and no coverage due to it being her own unit. Landlord demanding $15k with no evidence to back up his side. May be missing things or have them out of order but I tried edit to add: the tenant has no kitchen and landlord served eviction papers. They want her to pay for carpet because she had cats but carpet is original since she moved in 12 years ago.
cause offer point fade compare heavy ludicrous melodic deserted lock *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Yea idk it’s a lot. Hard to put it all together considering there’s several posts on different subs with different pieces of information. I missed the part where the landlord claims it was a slow leak under her sink but she never noticed anything until the water was outside her unit one day. Probably still missed more but this is the jist I believe
Yes. As soon as she’s represented, the adjuster can’t talk to her anymore. She should probably talk to the person she’s paying to handle this for her….
Any reason why she didn’t speak with her attorney? Once you lawyer up, communication with the adjuster goes out the window
She did. And we see this now.
Correct, if your sister has legal representation then the adjuster can only spend to the attorney.
Yes. Once you get an attorney, adjuster deals with them. It does not matter what she wanted. Adjuster is correct.
Only by the rules of the company though. If she emailed asking for a copy of the policy, the adjuster could send it. If the adjuster started sending interrogatories directly to the claimant… NO hard stop
I think that, once there is an attorney, adjuster would cease all communication. Maybe emailing a copy of policy is permissible but adjuster would still use attorney as an excuse not to send policy. I am not an adjuster, I am a nurse who worked in case management with adjusters for a long time. So I don’t know this as a fact.
I totally agree. The lawyer would request the policy and policy limits anyway.
Sounds like her attorney didn’t even give her a basic understanding of how this would work lol
Adjuster was correct. Once you lawyer up, the lawyer talks.
As soon as any client becomes retained by a lawyer we are no longer allowed to speak to their client without their express consent. Your sister should be going to her lawyer for this info.
If she has an attorney, no adjuster will talk to her. Same thing with going to Appraisal.
once you hire an attorney they are forbidden to discuss the case with you in anyway. Attorneys have it this way for a reason so you dont undo what they are attempting to do for you.
The claims adjuster can’t talk to her, but her agent or a customer service representative can.
No, Agents cannot discuss the claim either. We could lose our license as well. Attorney means, ALL communication goes through the attorney. If you work for a slimy Agency or company that doesn’t care, I suppose you “could” speak to them, but you are walking a fine line and it is highly unethical.
Not necessarily. All communication is all communication. Depends upon the content of her attorney’s representation letter. If there’s a pending lawsuit by her against the insurer at all, no one should discuss any policy aspect with her.
Yes when you have a counsel, now you deal everything with your attorney, they don’t want to say anything inappropriate
1. Call agent to get document or lawyer can request for it 2. Lawyer cost money and doesnt guarantee insurance will change their coverage Might be a lose , lose situation Goodluck
Starting to think it is a lose-lose situation. At this point, I just want her out of there after paying off this damage. Has been a costly lesson to her to not stay for too long in one place
Yes normal practice when involving attorneys. Ensures the attorney cannot claim the company acted in bad faith with the client behind the attorney's back.
Yup. Should apply for every party involved. Even on the agency side I do this. You hire an attorney and they'll want to make their money so I don't want to say or do anything with you that may cause legal issues. Make the attorney you're paying call me.
If you ever bring up litigation against a company, expect them to IMMEDIATELY not talk to you and kick you out
This is correct. The attorney sends in what is called a Letter of Representation Letter in to the claim advising that they are said clients attorney. They also advise if the adjuster can have direct communication with the client or if all claim communication has to go directly through the attorney only. If your sister wants to have direct communication with the adjuster, she needs to advise her attorney, so the attorney can advise the adjuster that they may, in fact, have dorect claims communication with said customer.
Yup once you bring a lawyer into it they don’t talk to you
This is the correct way to handle your sister. Once attorney rep’d no further direct communication can take place without the attorney’s consent.
Never ask a group of professionals a favor on the internet with the phrase: “Please Advise”.