Homeowners are at a complete disadvantage when dealing with Insurance Companies.

There are three centuries-old concepts, ABC's, that guide the Insurance Industry. A stands for "Aleatory Agreement." B stands for "Be Indemnified." C stands for "Contract of Adhesion."

"Aleatory Agreement" means that consideration (i.e. money exchanged) is never expected to be equal. Insurance Companies have actuaries, underwriters, and complicated algorithms to figure out what to charge from whom and from how many in order not only to fulfill their contractual obligations but also to be exceptionally profitable in so doing. For instance, a homeowner can put a policy in force with an initial $100 monthly premium and then immediately suffer a $100,000+ loss which the Insurance Company must pay. The contract is binding on the Insurance Company despite only having received $100. That's what an Aleatory Agreement means.

"Be Indemnified" is the principle of restoring the insured to the condition that existed before the loss occurred. For example, a homeowner whose home has no prior repairs or patches to his or her roof (or whose roof is so old that repairs or patches are not feasible) is entitled to full replacement after suffering wind or hail damage even if only to small portions of his or her roof. Most Insurance Companies initially try to prescribe a repair or patch but will eventually agree to the terms of their contracts when presented with expert opinions and then will replace entire roofs.

"Contract of Adhesion," as previously mentioned on this site, means that since the Insurance Company wrote the policy and unilaterally dictated all of the terms, any less-than-exact, ambiguous, or even gray area is to be decided in favor of the insured. This concept is crucial when claims go to Appraisal or Litigation. (Appraisals and Litigation go through local County Common Pleas Courts and are handled by Magistrates, not Judges.)

This is how we level the playing field and get our clients that to which they are entitled, for which they are paying, and completely deserve. (And, it's also our passion to do so.)

 

The two types of property claims.

  1. At-Fault claims count against you. Most Insurance companies will drop coverage if you have 2 of these within a 7 year period. Switching Insurance Companies will not help you either since all claims get reported into the industry's CLUE report (Comprehensive Loss Underwriting Exchange.)
  2. Comprehensive claims do not count against you, if filed properly. You can have an unlimited number of these within any period without having premiums increased or having your coverage cancelled.

Examples of At-Fault claims include theft, vandalism, most water losses, and most fire damage (Gatlinburg in 2017 is an exception as are other wildfires.) Examples of Comprehensive claims include wind, hail, tornadoes, and most storm damage when filed on registered catastrophic loss dates.

All of the following examples violate the “Uniform in Appearance” standard adopted in 45 0f 50 states. The standard set by the courts is, "visible difference as noticed from the curb."