HOA Insurance Claims
A community wide catastrophe claim was filed on behalf of all owners on February 19th. Princeton has just informed the board (March 8th) that they will accept the claim and will process the community as a single entity. The deductible will be $5,000 for the claim, community-wide (not $5,000 per unit).
The claim will be processed en-masse, like the roof claim in prior years. There will not be individualized service or an insurance agent or customer service person to work with each homeowner. Princeton will come out, assign a repair allowance for the repairs they are covering and send a check.
To participate, please complete the following form: <<link to form>> It is best to do this as soon as possible but not later than Friday March 12. The adjuster will be on site on March 16th.
Note: As we are seeing, some homeowners policies will just pay the full claim (e.g., Farmers, State Farm). All things equal, if your insurer will pay your full claim, you might be better served by opting out of working with Princeton.
See all articles about the "2021 freeze" here: <click here>.
Association insurance policy The Lakes of Bent Tree is insured by the Princeton Excess and Surplus Lines Insurance Company (New Jersey), policy CAUC100167-1. The Princeton coverage in a situation like this is limited and most likely will not cover all costs. The expectation is that the homeowners policy will cover the gaps in coverage and also cover personal property, lodging , etc. Princeton will reimburse based on market rates for repairs, which may be more or less than the owner's out-of-pocket expenses. The full policy is located here: <click here>.
One day for site inspection The
insurer has made it clear that they are not going to process this as 82
individual claims or take calls from or on the behalf of individual
owners. Essentially, they are handling this just as the roof claim
was handled 4 years ago. The plan is to have a team of estimators on the
property for one day to complete their entire damage assessment for the
community. To participate
all the information on the form (above) needs to be submitted and the your home
needs to be accessible on the day of the assessment.
On March 1 the adjuster explained that they are just getting paperwork
in from Princeton and are just now setting up "shop" and need a time to
get organized. On March 8, the Association was informed that the claim
will be assigned to the Dallas field office this week.
Dan Parker and his crew will be overseeing the damage surveys (photo
right).
Insurance fund distribution Julie Blend, the
Association's attorney, will oversee the release of payments and the
execution of release agreements. As required by the insurer, the claim
awards are paid to the Association (not the condo owner) to distribute
to the owners based on (1) proof that the
repairs specified in the adjuster's report were made and (2) less any payments made by the personal homeowners policy for the same repairs. The Association may have an engineering firm assess the proof of repairs.
Supplementing or disputing the adjuster's estimate Anyone who found additional damage after the estimators inspected can do so after the initial claim has been paid. Supplements will also be processed en masse. Davis-Dyer-Max will be involved in the supplement/dispute resolution process, if any.
Role of CMA, the Board, and Davis-Dyer-Max
- CMA
(Tim McConville) will consolidate the "forms" and get them to the
inspectors, be on site the day of the inspections, and distribute the
damage estimates and inform owners of the amount Princeton is offering to pay. CMA will also collect "proof of repair" and documents from the personal homeowners policy for each claim (e.g., adjuster reports, payments made, deductible, etc.).
- The board will report broadly on information they receive that may be helpful (as is being done here, now).
- Davis-Dyer-Max will consolidate any supplements or after the initial payout and send to the insurer.
I didn’t file a claim for my garage Sheetrock because it would be less than the deductible. Is it necessary to have filed a claim in order to join the community claim? SR
ReplyDeleteYes, you can join the claim .People who are under their Home policy deductible can file. It is the advantage of making a site wide claim.
ReplyDeleteUPDATE: The Princeton Adjusters have confirmed that they will be on site on Tuesdays March 16th to evaluate damages.
ReplyDeleteI was speaking with the subcontractor for Princeton Insurance to show them the damage to our unit and showed them the damage to _____ Westgrove as as none of our pipes were damaged and received damaged due to the Management Company not informing any in the Lakes that they needed to shut off the outside value in the ceiling of each shed as the only thing done was to put styrofoam covers over the outside of each outside facet.
ReplyDeleteI asked the two subcontractors that there if they wanted the documents that you requested each homeowner to provide the Princeton Insurance; they had no idea about this. Who do I give these picture of the damage to?
When will you be able to send me the adjusters report this week? I need to start fixing my unit ASAP and need this report? I understand that I should email you invoices, reports and pictures is that correct? Or would you prefer a one-drive (internet data vault)?
ReplyDeleteThe guys that were here today looking at the damage to the units indicated that I should send invoices from the plumber and other bills we have related to that damage to the HOA. That also includes any pictures of the water damage. Who should we send this to? Thanks so much
ReplyDeleteQUESTION: When will you be able to send me the adjusters report this week? The adjuster's are estimating 4 weeks before settlement reports are available - mid April. As stated above "Julie Blend, the Association's attorney will oversee the release of payments and the execution of release agreements. As required by the insurer, the claim awards are paid to the Association (not the condo owner) to distribute to the owners based on proof that the repairs specified in the adjuster's report were made. The Association will likely have an engineering firm assess the proof of repairs."
ReplyDeleteSTATEMENT: The guys that were here today looking at the damage to the units indicated that I should send invoices from the plumber and other bills we have related to that damage to the HOA. Hold on to your documentation until after the settlement reports are received from both Princeton and your homeowners policy. This is a change from what was originally requested. These documents will be needed, however, if you need to petition for additional funds (from both your insurers). Princeton has advised the Association that their settlements are based solely on a software program called Xactimate. It does not use owner input in its calculations. They are only using owner input in their contested settlements.
ReplyDeletewho is responsible for fixing the dry wall? Do we have HOA authorization to fix the drywall, floor, cabinets? My contractor asked?
ReplyDeleteEach owner is responsible to hire their own contractors to repair their home.
ReplyDeleteRepairs are funded by the owner, in whole or part, with insurance proceeds.
The amount of the insurance proceeds is dependent on the type of damages and on the coverage terms, limits, and exclusions in the insurance policy(ies). Some insurers pay out based on your actual expenses/receipts/quotes. Some insurers pay based on what their consultants tell them is that rate you should have paid be for your repairs.
Princeton has said that they pay based on the latter and have exclusions for improvements made since the original construction. For example, if they determine that a home was originally built with a 30 gallon hot water heater, they will pay the market rate for a new 30 gallon heater and not the 75 gallon hot water heater that was damaged in the storm. They would expect the homeowner or the homeowner's personal policy to pay for difference. They can apply this exclusion to floors, cabinetry, wall covering, fixtures, etc.
STATEMENT: [Damage is] due to the Management Company not informing any in the Lakes that they needed to shut off the outside value [valve]!
ReplyDeleteThe Board probably did its best (not perfect) to help owners prepare for the freeze and to help owners stop the flowing water. It was a neighbors helping neighbors effort more than an official function of the Asscoaition. Everyone involved wishes more could have been done. It was heartbreaking to see the damage.
It may be useful to know, for the future, that the Bylaws (Article IX, Section 4 ) identify the owner as having the primary maintenance responsibility for water, electric, sewer, and gas lines from the meter (or street) to their home and inside. Hopefully, after the recovery is complete, we can all educate ourselves on how to better protect and insure ourselves.
Note: "Maintenance obligations" lists in the governing documents and "insured property" lists are not the same. This is normal, but certainly not intuitive.
Hope that helps.
when will we receive HOA response. it has been approximalety weeks and we need to get started to repair? thanks
ReplyDeleteThe estimated timeline listed above is mid-April and that has not yet changed. The initial site inspection was completed 14 days ago.
ReplyDeleteDespite filling the claim on February 19th and the push to get all homes inspected on the 16th and 17th, we understand that none of that work has yet reached the senior adjuster. The data is still with the inspectors who are making drawing and itemizing damages.
We had 2 owners not report until March 22. We don't know at this time how the late reporters will be handled. We expect to find out soon and will post an update here.
ReplyDeleteIMPORTANT Anyone with remediation invoices (e.g., ServPro, etc.), please forward the invoices via email to the board.
ReplyDeletewhat is the stautus, when will we recive our estimate of payment to us?
ReplyDeletethanks
Yes, please update, even if the update is no news yet.
ReplyDeleteUnfortunately, the site survey report has still not yet been completed and sent to the adjuster. As such, the adjuster has revised the estimated date for the claim offer to be April 30th.
DeleteThree homeowners turned in late claims (as late as 22 days after the site inspection) and these homes have not yet been inspected. One of the claims came in this week.
It's not clear whether everyone's claims will be further held up pending site surveys on the 3 late claims or whether the 3 late claims will be handled as supplemental claims and pushed out into late May or June for resolution.
what is the latest update? thanks,
DeleteHave you heard anything about our claims?
DeleteWe received a call on Friday and the inspection team is coming out to this Thursday to assess the 3 homes who turned in late claims. The claim is now 18 days beyond the initial estimate completion time.
ReplyDeleteI have not been given a call and my home wasn’t inspected. 5136 Westgrove dr.,
ReplyDeleteNote: 5136 was inspected on the May 6 with the other late claims.
DeleteWe were initially told to expect claim information in mid-April. Unfortunately, all we have been able to learn in the last 5 weeks is that things are delayed with the estimators. The estimators, who had been communicating with us, have gone quite. We have learned that they are telling the adjuster to expect their report by mid-May.
ReplyDeleteWhat is happening?
To the insurer, this is a single claim and not 82 separate claims. Princeton (not unlike others) is using a third party claims support organization to adjust their claims for the mass catastrophe. That company is using a third party estimator to prepare damage reports for this event because they did not have enough staff. At this point, the full damage estimate for the LBT claim has not been completed by the estimator and sent to the adjuster.
Timeline:
Feb. 19: HOA files claim (same week as the "freeze")
Mar. 16: Estimators survey all known damaged units (26).
Mar. 22: A homeowner files a late claim.
Mar. 30: A second late claim is filed.
Mar. 30: Insurer requests remediation expenses
Apr. 04: A third late claim is filed.
May. 06: Estimators to survey the late claims (3)
After the 6th, the last 3 claims with photos, measurements and estimates will be added to the existing estimates and sent to the adjuster. The adjuster will then analyze the data and make a recommendation to the insurer on what to pay LBT. The insurer will review the adjuster report and send a payment to the HOA.
LBT's attorney will then provide the individual estimates to homeowners which can be used to finalize their claims on their homeowners policy. Based on the current timeline, this will happen during the last two weeks of May.
Thereafter, owners can submit reimbursement requests/receipts to the attorney for the covered expenses only. The attorney will then pay the homeowner what the insurer paid the HOA and the homeowners will sign a release.
Anyone wanting to make a supplemental claim will need to contact Davis-Dyer-Max who is consolidating the supplementals.
UPDATE: As of today, the insurer has not received the damage estimates being prepared by the third party estimator. The estimator who is working the claim for LBT is off this week.
ReplyDeleteSome other communities in the area who are insured by Princeton are just now getting feedback from the insurer suggesting that the end of this first phase of the claim is finally nearing completion for us. We consulted a third party insurance expert and the association attorney regarding the timeliness of the response and they both said that this is common in a catastrophe situation and within industry norms.
Timeline:
Feb. 19: HOA files claim (same week as the "freeze")
Mar. 08: Claim formally accepted by Princeton
Mar. 16: Estimators survey all known damaged units (26).
Mar. 22: A homeowner files a late claim.
Mar. 30: A second late claim is filed.
Mar. 30: Insurer requests remediation expenses
Apr. 04: A third late claim is filed.
May. 06: Estimators survey the late claims (3)
Feedback from the insurer was initially expected mid-April. The target date was reforecasted to mid-May and now late-May. This feedback/report will provide owners the information they need to settle their claims with their homeowners insurers in those cases not fully resolve by homeowners insurers.
The distribution of funds will be some weeks after that.
This is taking forever. Thank you for keeping me informed.
DeleteUPDATE: Sunday will be 100 days from when the claim was filed. The records from the estimators have still not reached the adjuster. The re-forecast is June 7th.
ReplyDeleteThe board has actively pursued this claim on a weekly basis in addition to the work being done by the primary contacts (CMA and Davis, Dyer, Max). Being that we're at 100 days, we were able to get the attention of the Vice President of Claims at CAU (top of the pyramid) who has agreed to investigate and expedite the matter.
The feedback we are getting is that people at all levels are overwhelmed and exhausted and that some claims a struggling to get through the myriad of consultants and subcontractors that were hired. There is also agreement that 100 days was enough to process this claim.
We will report more when we have it.
UPDATE: Senior management at Princeton/CAU are actively involved in expediting this claim and giving daily updates on their activity.
DeleteI just sent a message to USAA to see if they could help in any way. If I hear anything from them I will let you know Thanks for the information. Lillie Thomas
ReplyDeleteThanks for your help.
DeleteUPDATE:
ReplyDeleteFrom the Estimator (5/29/21), "Trying to have the estimates to the adjuster by 7-4-21".
From the Adjuster (5/30/21), "I have requested information from the estimators and they are not responding. I don't know what is holding this up. "
From the Vice President of Claims at the insurance company (6/1/21), "we'll get to the bottom of this".
From the Adjuster (6/7/21), "I don't know what is holding this up. I reported this to the insurer."
From the Director of Business Development at the insurance company (6/8/21), "This is not the kind of claims scenario our customers have come to expect from CAU over the years, so we need to find out what the hang-up is and get it addressed. I'll get back to you later today with an update."
Note: When the estimators report is complete, it will go to the adjuster for analysis (2-3 days), and the to the insurance company (7-14 days) to determine the award and begin the formal processing of the claim . That information will go to the Association’s Attorney who will then parse the reports for the owners.
Note: While we are putting as much pressure on the insurer as possible, we are being advised that it is in our best interests to not engage the association attorney at this time.
UPDATE: From the Vice President of Claims at the insurance company (6/8/21), "It was just explained to me that our consulting engineer had someone walk off the job in mid-May and delete his work product as well."
DeleteWe just received this information. We don't know yet it this means in terms of timing for our claim.There is a lot of visibility on resolving this. Will update when we know more.
Please explain further. Who advised the HOA to not engage the association attorney? Why is it not in our best interest to engage the association attorney? The update from the Vice President of Claims does not seem credible. Thanks.
ReplyDeleteThe frustration on this is significant for all involved. 100 days is too long.
DeleteQuestion: Who advised the HOA to not engage the association attorney?
Answer: The advice we are working with comes from the association attorney and the CEO of a large commercial insurance brokerage in Dallas (as mention above).
Question: Why is it not in our best interest to engage the association attorney?
Answer: There may be a time when engaging the association attorney or hiring a contingency lawyer for this claim is prudent. Doing it this week, however, is likely to create more problems than it solves.
Involving an attorney will likely delay the claim further, and may negatively impact the amount of the award (as the insurer has to pay its lawyers and our lawyers).
Once our attorney is involved, the management of the claim by the insurer will likely be taken over by their corporate lawyers and the priority will shift from processing the claim, to risk management.
Typically, in the case of catastrophic claims, the awards are often more generous in the interest of getting things done - the insurers don't have time to nit pick every detail and fight every claimant. However, once the corporate attorneys are involved, every detail will be scrutinized and all communication will be attorney to attorney.
Question: The update from the Vice President of Claims does not seem credible.
Answer: From the information the board has, it does seem plausible. The problem is clearly at the bottom on the ladder (third party estimators) and the message from higher up the processing chain has been critical of them and in one case, includes a written reprimand. Nothing in the information that we have seen suggests that there an effort to stall the processing of the claim by the insurer.
We are well networked with the people working this claim. That includes 3 different organizations involved in this claim, two departments at CAU (insurer) and we have information from other claimants like LBT. With the exception of the estimators who don't communicate well, we have cordial/open communications.
That said, we have scheduled a zoom meeting for Friday the 18th to discuss the matter and next steps if the estimators reports are not advanced to the adjuster by that time frame.
Topic: Insurance Claim Meeting - Zoom
Time: Jun 18, 2021 08:00 AM Central Time (US and Canada)
Link: https://bit.ly/3zg0Tul
Meeting ID:: 968 1818 1941
Passcode:: 50005000
The zoom meeting has been canceled as the estimator reports went to the adjuster on Tuesday June 15th at 3:00 PM.
Deletei agree with Lillie, should we engage our attorney or will HOA help? Thanks
ReplyDeleteQuestion: Should we engage our attorney?
DeleteAnswer: The board is not opposed to turning the matter over to a third party if that is the consensus of the 51 owners with claims. We can explore your recommendation with others on the 18th.
Question: Will [the] HOA help?
Answer: What help are you requesting?
UPDATE: An executive who is senior to the Vice President of claims has interceded on our behalf. His note this afternoon...
ReplyDelete"Mr. Bauer – Ben DiGiorgio [Vice President of claims] is making some calls and I believe will be back with you today. Please let me know if you get a call this afternoon. Thank you"
Realistically, Ben DiGiorgio is not going to recreate the missing claims report or recover the data that is lost, but he is now being held accountable for the failings of the subcontractors. That should, hopefully, bring significant priority to resolving our claim.
UPDATE: The VP of claims called an apologized profusely for what he termed a "perfect storm". He said there was no simple answer. The estimators are working through the weekend on the report. He volunteered to call daily (Monday to Friday) to keep us updated until the report is issued.
DeleteUPDATE: The VP of claims say that the report did not go to the adjuster today, but that they worked through the weekend on it as well as today.
DeleteUPDATE: The estimators reports went to the adjuster today at 3:00 PM. The next step in the process is for the adjuster to analyze the information, follow up with any additional information requests to the community, and then pass his recommendations to the insurer.
DeleteThe adjuster expects to finish his analysis by Friday.
The insurer issues payments from the adjuster reports.
thanks for the update. While we wait, Lillie and I are exploring our options. Ron Hebert
ReplyDeleteWhat is the process to protest the estimated payment?
DeleteThis is the best "working" explanation of how the HOA insurer and your personal homeowners insurance come together to cover all or part of your damages. https://lakesbenttree.blogspot.com/2020/10/ready-for-catastrophic-event.html#more
DeleteQuestion: What is the process to protest the estimated payment?
Answer: In short, your personal homeowner insurance is "gap insurance". The amount of the mitigation your insurer will do will depend on what coverage you purchased. That would be the place to start.
On the other hand, if something was missed or discovered after the estimators were here the Association can assemble and submit a supplemental claim for review. This would be one organized, site wide submission. For example, the swimming pool is covered but it appears to have been accidentally left off of the claim report. This process is being handled by Davis-Dyer-Max.
Thank you so much for the update. Do you know if the owners will receive funds via check in the mail?
ReplyDeleteCarmen
The best detailed explanation on how payments will be distributed is here: https://lakesbenttree.blogspot.com/2021/03/hoa-policy-claims.html#more
DeleteTo answer your question:
Question: Will [we] receive funds via check in the mail?
Answer: In short, yes.
1. Owner submits proof of repair and their personal homeowners policy information (i.e., adjusters report, information of any payments made and deductibles, etc.),
2. Owner receives a release to sign with the adjusted payment amount.
3. Payment is mailed.
I may be late to the game here... To whom do we submit proof of repairs to? What does that proof need to contain (invoices, photos, etc.), by when do we need to submit this by?
ReplyDeleteThank you!
I submitted one repair bill but have other repairs needed. Wanted to see how much would be covered before hiring anyone. How do we know how much we will get?
DeleteThe process is explained in the article above.
DeleteQuestion: To whom do we submit proof of repairs to?
Answer: To CMA with a copy to the board. The specific instructions are included in the email sent to you on June 20, 2021 8:55 PM.
Question: What does that proof need to contain (invoices, photos, etc.)?
Answer: Itemized invoice for work listed in the adjustment report and proof of completion as well as the adjustment report from your personal homeowners policy and any payments or pending payments from your personal homeowners policy
Question: When do we need to submit this by?
Answer: You can submit it when all the work has been completed.
Question: How do we know how much we will get?
Answer: For any repair adjusted by Princeton and repaired by an owner, the owner will receive that value assigned by Princeton (or the actual cost, whichever is less) minus what was paid for by their personal homeowner's policy.
Question: I submitted one repair bill but have other repairs needed. Wanted to see how much would be covered before hiring anyone.
Answer: Between the Princeton adjustment report and your personal homeowner's policy adjustment report, you should have clear information on what is covered and for how much. If the damage is for something that was not included in either the Princeton adjustment report or your personal homeowner's policy adjustment report at this time, then it would be best to file a supplemental claim with your personal homeowner's policy,
UPDATE: Funds have not been received by the HOA yet.
ReplyDeleteOwners are, however, encouraged to get all their paperwork in as soon as possible so that it can be processed and payments can be issued promptly.
what is the latest?
DeleteUPDATE: The HOA has started receiving insurance funds. The HOA will be in a position to process settlement agreements and pay out insurance funds by July 19th, possibly sooner. Claims are being handled in the order in which fully documented claims are received.
DeleteHow do we know what number we are in your list of payments? We have not received anything in the mail.
DeleteHello,
DeleteI did not receive the email regarding submission of work completion- Invoices, photos, etc. I have checked my spam folder.
To whom or how can I submit this information so that I can get reimbursed?
Thank you!
Kendall, 5068 Westgrove Dr
Question: I did not receive the email
DeleteAnswer: We are sending another copy to your "yahoo" address this morning. An email was sent to your university email address with a copy to your agent J. Brown on on June 25, 2021 8:55 PM. A second copy was send on July 2, 2021 at 10:35 AM. J. Brown responded on July 2, 2021 at 10:55 AM (with a copy to you).
Question:To whom or how can I submit this information?<
Answer: To CMA with a copy to the board. Send
1. itemized invoice for work listed in the adjustment report and
2. proof of completion as well as
3. the adjustment report from your personal homeowners policy and
4. Information on any payments or pending payments from your personal homeowners policy
Hope that helps.
All owners who submitted claims documentation have received release agreements (except for four owners who have been contacted regarding additional documentation needs). Reimbursement checks are being sent as signed releases are received.
ReplyDeleteWe commend everyone as a community for weathering this catastrophe and all the setbacks from the various insurers and contractors. From the day the storm blew in (February 17th), volunteers/neighbors were helping each other; first to winterize, then to cut of running water, and then to get qualified contractors on site. The adjustment process was 95% completed by the second week of March.
But after that, it was a long haul. There was an extremely long wait for the adjusters reports and even longer wait for insurance funds, along with months of construction inconveniences and out-of-pocket expenses. The process of owners submitting documented and volunteers processing them was daunting and time consuming - and it has taken months to repair the pool/pool-house damages as well as extensive landscape damages.
On behalf of everyone, thank you for your patience and positive attitude through it all.
Any updates on our claims?
ReplyDeleteQuestion: Any updates on our claims?
DeleteAnswer: Have you sent in the following. All fully filed claims have been paid.
1. itemized invoice for work listed in the adjustment report and
2. proof of completion as well as
3. the adjustment report from your personal homeowners policy and
4. Information on any payments or pending payments from your personal homeowners policy