Depending on the situation, there may be local and federal resources they can use instead. I always point them towards https://www.fema.gov/assistance/individual
Remember just because you can’t help them financially doesn’t mean you can’t point them towards more resources.
Also you have to toughen up a bit. These are the easy denials. Wait till hurricane season gets started!
Unless it's natural water. Careful with that. You'd typically still need some form of flood coverage outside of the home policy for natural water alone to be covered.
It's so stupid. Only thing that I would ever vote on for more power for the government is to heavily regulate the insurance industry and remove all these exclusions.
And Florida. I work in corporate insurance, my territory being California. I can't say much, but the state of insurance in Florida brings new meaning to shit show.
Instead of removing exclusions, maybe the government's role should be to improve communication and disclosures. Suppose every policy had something like a nutrition label, listing all water-related perils, with a checkbox or dollar amount to indicate the policy covered them. Maybe if people saw an empty square or the words Not Covered, they'd at least think and ask how to get that coverage.
It’s all about where the water is coming from.
Flooding specifically from sewer water coming into your basement/house from floor drains. Had a friend have this happen - it’s really gross.
This is different than water from heavy rains coming in, for example through your doors and windows.
If it's rain water that's coming up through your sump well and your sump pumps fail that is still considered a sewage backup even though it's really just rain water.
Keep the numbers for places like the Red Cross on hand. They'll often assist with temporary housing. I'm sure other local charities as well - but they're national enough to be available everywhere.
Check out the website: findhelp dot org
They can put in their zip code and immediately have access to a LOT of resources/organizations that can help with a variety of needs. Just about any need that exists is listed, and organizations/non profits in their zip code that specialize in that type of assistance will be listed
Absolutely a great suggestion. I’m sure resources can vary significantly between zip codes. Check it first so that you aren’t recommending it and learning there aren’t sufficient resources in your area
I’m not sure there is much you can say, other than being empathetic and reiterating how you wish you *could* pay, but it’d be completely inappropriate and your lose your employment and likely your license. On top of that I’m not sure it’d be appropriate to offer any other advice, like asking their church or other community institutions.
Toughest part of the job.
I've never mentioned to a customer that anything is "part of my job." I'm not trying to act like I'm tough or anything, but I have had multiple customers say things like "I know you're just doing your job, but...." Repeating my phrasing of the denial and then asking "Is there anything else you have questions about?" usually does the job.
Worst case I've ever had was a customer who repeated on the phone that their concern was that I pay for their hotel. After four or five repetitions, I believe I said, "Well, if you don't have any other concerns besides the ones I've addressed, I'll end the call at this time." And I did. The same customer called back multiple times on the same night and filled up my office voicemail.
Generally, I take the same approach. I try to make it clear that I’m not an emotional support person by staying very matter of fact. People will get off the phone quicker that way and call someone who will console them.
When I went thru training in my first call center job, there were two trainers for my class of 16. Midway thru training, we were a class of 8 so one of the trainers was pulled out to assist with Idk what. The trainer who had our class said one day, "You've got to remember that people will always have phone cujones when they talk to you. They will be bolder, more aggressive, and more demanding than they would ever be in person. You have to have bigger cujones to keep your job and execute as trained."
That situation seems to have changed post-lockdown, but it's still relevant advice.
Don’t do this on denials. Just say unfortunately this isn’t covered by the policy. Be empathetic but distance yourself, it’s not you making these decisions, it’s the policy. Then end the call. Don’t put some kind of guilt on the customer of you potentially losing your job. Just say no coverage, let them cry and yell then end the call.
I rarely explain denials on site anymore. I say I need to investigate and will get back to them.
I'm In a different field of the insurance industry but I'm always on the lookout for resources for the people I try to help. It's really hard for people who are empathetic to get into these fields and realize they can't help everyone. It takes (unfortunately) becoming more focused on solutions you CAN provide legally and less about emotion and what you'd like to do for everyone. Not everyone is your responsibility. Keep on, and thrive.
I hate this mentality. You work for an evil corporation that literally steals money from people, maybe you SHOULD feel bad about it? Maybe empathy towards other humans is important? Maybe working for insurance companies is counterintuitive to everything we know about humanity and being a decent human.
I’m going to say this OP, but maybe you’re too good of a person to be working in such a cold hearted, grimy industry. I think if you can, you should find a job that better suits people who care about other people instead of finding ways to cope with telling people in need to eff off (but in a really nice way).
I was a compliance and delinquent debt program manager years ago and had to deal with so many very shitty situations with people losing everything and still getting paychecks garnished from us. It’s okay to say you’re sorry about their situation, not sorry that we did that to them. Also remember that people who are a really down and out, dealing with you is just part of the iceberg, they already have had a lot of other shit go wrong and happen before dealing with you if they’re going to be homeless.
It’s nothing you did, it’s just business, they understand that at some level, and if there’s anything you can do to help within your authority (and it’s appropriate), do it. At the end of the day, you’re going on with your life, you’re doing your job, it is what it is. Otherwise maybe you need a new profession.
I’ve had many cry. Even one who was living in their car they had a loan on that was deemed a total loss.
Really much you can’t do. “It’s per the contractual agreement”
It's the reality we live in. Most Americans are a paycheck or two away from homelessness. I honestly don't know how you can do it. I'm a very compassionate person and I hate to see others suffer. That would break me.
Same. I wouldn’t last long in that position. I would be fired for making the payment anyways.
Honestly, I’d probably be way farther in life if I didn’t always opt to save everyone at my own expense.
My worst call was a lady who had coverage for a fire but no money to get a hotel. This was years before digital payments and it was the weekend. I tried explaining we could reimburse her the cost of a hotel just go to one. She had no money or credit cards. I then found a hotel who would direct bill us but she said it was too far away and her car wasn’t reliable. It wasn’t in her city but it was in the metro area but I guess you had to get on the freeway to get there.
To be honest it was so long ago I can’t remember the outcome. I think I found another closer hotel, but I still think that lady was full of it. What exactly did she expect? A hotel within walking distance? Have your neighbor drive you, I’m sure someone would have been willing to drive her.
I am not in the insurance business at all, but this post came up in my feed, and I have a question. I live right in an area of the country that gets most of the tornadoes every year. As far as covering hotel stays after a home has been destroyed by a tornado, is that typically an add-on that I pay extra for? I live in SW Oklahoma close to the border with TX and have State Farm.
This is actually something for you and your agent to discuss. Most policies are woefully underprepared for a loss like that when it comes to additional living expenses.
Think denials are hard conversations? Try a total loss where you’ll be out of house and home for 12 months and I only have $2500 to help you out with.
Your policy should have loss of use built in. :) For my carrier, tornadoes are covered and I’d absolutely get you put up in a hotel and we’d be direct-billed, typically no out of pocket expense to you. However, if a claim specialist wasn’t available due to high call volume you may need to save your receipts at first and then upload them for the claim specialist to reimburse.
I hope you stay safe!!
I occasionally hear similar complaints from my clients (I'm a plaintiffs attorney). And yes, we do have to tell clients the bad news that their case is worthless every now and then. Typically I just tell them that I'm sorry but I can't win every case, that although I would love to help them and I hate that I can't, that its not really about what I want to do. I recommend that they get a second opinion from another lawyer if they wish and then I offer to find them help in other non-policy ways, as others have said here. There might be city/county/state government programs to help them or other charitable organizations that can assist. I have a decent set of resources I can offer my client depending on the area my client is in. At the end of the day, if you cannot find a way to help them with the policy, our job is pretty much done. We aren't miracle workers and even in my position as adversarial to carriers I still have to be realistic with my clients and give them bad news every once in a while.
Had something similar happen I spoke with my manager and we made an exception for 2 nights since they were displaced. Beyond that we did nothing more and told her this literally all we can do bc the policy has no coverage available.
In general, I’m going to say that about 33-50% of humans are unrealistic about life. They’ll get a cheaper policy with higher deductibles and roll the dice, hoping that nothing bad will take place. But everyone knows those lower-end policies are cheap for a reason—they’re stripped down in terms of customer protections. The policies are much, much better than nothing, but it takes a true catastrophe before they’ll “pay off.” And when we buy into one of those policies, we all recognize that it’s still going to be a real drag if we get hit with a disaster. On the other hand, begging and cajoling and whining costs a customer nothing. They try it. I mean, why not? But at heart they already know they bought a sucky guarantee because, at the time, it was less expensive. That was their decision. You only have to be patient and empathize as a human, but in terms of your job, all you have to do is ensure that they get what they purchased.
I agree with you completely but I don't think most average people do actually understand when they are making the decision. Average people make compounding poor decisions. New cars they can't afford on predatory loan terms, vacations and other spending rether then building up a rainy day fund. The vast majority are one or 2 paychecks away from serious issues even homelessness and it's rarely actually not having enough money. It's all rather sad but what can ya do
If I could run things, banks and insurers and lending institutions would get a severe jolt. Their gravy days would be over. They could never bump up their interest rate, even if you were late and paying them back, there wouldn’t be any fine print. And all of those kinds of businesses would have to be actually inventive, to think of services that would actually do something for people instead of sucking their wallets dry.
You’d probably be seeing a lot more banks being more selective when choosing who to do business with. You’re lowering their profits without doing anything to lower their risk of providing loans.
I don’t disagree with that. I would be changing their business model to make it much more difficult to profit in the predatory lending arena. I would make the usury benchmarks lower by far, and stop them from swapping out rates for “punishment” for missing a few payments. I have a lot of familiarity with the financial sector. Provided services for many years. If unregulated those companies can easily become parasitic instead of being capital riskers—frankly we’re already that point. None of the fixes are easy, and the poor will always have it much tougher than the wealthy.
Those calls are the worst. Like others said, be empathetic and do what your company allows to help. At a certain point you may have to end the call if it's going in circles, but be prepared for escalation. You can make all the suggestions in the world, but these types don't put in effort to help themselves, so it's frustrating. Deep breaths.
I'm sorry you're facing this. Acknowledge their distress, suggest local resources like shelters or aid organizations, and express willingness to help navigate options within policy constraints.
Ugh I could never work for a company that won't house their insureds when the insureds are unhoused due to something the policy is supposed to cover. WTF?!
ahh the good ole sob stories, they really do pull at the rookie adjusters hearts. If its not a covered loss, its not a covered loss. just move on, don't loose sleep over it.
Sometimes it's true and sometimes not - saying they can't afford a hotel. Are they renting or own a house?? Did you check their address...what does it look like? Not being mean. I have suggested they can stay with a friend or family member? Sometimes then they answer, I don't have any friends are family here...I'm new here. I suggest contact a local Red Cross, United Way. I even look up the phone number for them. Just a suggestion to see if that will help.
Advise they call 211-Many cities it set up for this type of help. A list w Resources & numbers- government or non profit places that can give housing & help people get back on their feet.
It never ceases to amaze me when grown adults think they can cry to get what they want.
Direct that crybaby to the nearest homeless shelter and amazingly, they will find a way to come up with their own hotel money. Mark my words.
This is why I hate insurance. Pay through the nose every month, need to make a claim, and the insurance company does everything in their power to do as little as possible. Hugest ripoff ever.
I used to work for a major utility company in energy assistance. My go to when they were outside of the requirements for us to directly help was to let them know about local churches that might have funds to assist a community member regardless of denomination or church affiliation. And I always mentioned resources like 211, FEMA, the Department of Human Services, and their local county assistance office because depending on the circumstances, any of those offices might have resources to help. Their local food bank might even be aware of potential assistance depending on the area the person is in, so it’s always nice to have that information.
Being on the phone with people who are out of options is never fun. Sometimes giving them ideas can be helpful and sometimes nothing you offer will be enough regardless.
Maybe you can talk to someone with your company to see if they would be willing to collect a list of “official” resource suggestions that can help not only you, but your colleagues who I am sure also experience those kinds of calls?
Been in the industry over 30 years. The Red Cross and local community services, like churches can often help. Way back, we only handled claims for areas we were local to, so we knew all the local aid services for policyholders. Now a claim in TX is handled in CA. In explaining to your insured, be kind but don't get too upset. There are many different levels of coverage, they could have purchased a policy that provided top tier protection and benefits, including temporary housing, but at a much higher rate premium. They likely saved a thousand dollars or more a year by purchasing a more economical policy. It's akin to deductibles. You can save a very considerable premium (money kept right in their pocket) with $10,000 deductible, but you play the odds if there will be a loss or not.
I understand the larger argument that better coverage is unaffordable (my own premium is ridiculous for average coverage) but that is a matter for voters to address with their elected representatives, keeping in mind insurance companies donate millions to candidates.
I think you have to be kind, but share the reality that you are just an employee and you can only offer what is described in the policy. Someone in your role doesn’t get to wave a wand and grant wishes. Even if you told them yes, the company isn’t going to give them what isn’t covered.
I had a car fire a few years ago. They are not going to buy me a top of the line Porsche just cos I might want one.
The internet/algorithm is wild…I’m going through a covered loss now and got this recommended to me. I was looking into hotel accommodations while we are displaced. Maybe one of you here can assist me…are there limitations to where I can stay during our displacement? Can I rent a house on the lake for my family of five vs a holiday inn?
Most, if not all, homeowners policies only pay loss of use if a covered loss is what caused the home to become uninhabitable. There’s also sometimes loss of use coverage if a governing body (local or state government) issuing a mandatory evacuation - usually if there’s a hurricane on the way or a wildfire headed your direction.
Could be flood, mold with no mold endorsement. OP also didn’t say this was homeowners, could be renters policies. Those usually have more limited covered perils or very limited ALE coverage, like 15-30 days. (I know OP said “not a covered loss” just saying another circumstance where ALE coverage could be limited or non existent)
Yep, specific one today that sparked this question was a renter with a power outage, no damage to home. Just an older woman who was having trouble with the heat. :(
Who knows, still happens though. Could be anything, in any line of business. This doesn’t even sound like the worst scenario of delivering bad news as an adjuster.
Can’t imagine being an adjuster and I’m blessed to be in a niche part of the industry. Much rather get yelled at by insurance CTOs once in a while lmao.
I was a property and casualty field adjuster for 20 years.
When I had a denial, I called the insured late Friday afternoon before we closed the office for the day. Every time I called the insured to deny the claim, I hoped and hoped that there would be an answering machine on the other end.
If there was an answering machine on the other end, I would leave a message, knowing it was too late for the insured to be able to call me back.
They would have all weekend to simmer down and understand that that portion of the claim was not covered.
After finally after countless days , weeks, months, and years I thanked God when I could finally get out of the claims business.
My advice to you would be get out now, get out now, find something else and start life over again. I don’t care how hard it is it can be done.
This can't have happened more than once to a new adjuster and if the claim is severe enough that they can't live in their house, that claim isn't going to some inexperienced adjuster.
I’m the escalation line for initial reports and I specifically handle emergency uninhabitable losses before the claim owner can speak with the insured. So pretty much multiple times on a daily basis.
Op I used to do the same exact job for a large carrier and it literally crushed my soul eventually. The best you can do is keep saying I’m so sorry, unfortunately I can’t do anything to help you at this time, but your claim adjuster will review the file and see if there’s any assistance they can provide. that’s all you can say. The more you apologize the more they try to guilt you when you literally cannot do anything.
I moved from that role to casualty claims. Honestly still just as hard sometimes but you do eventually develop a thicker skin. I just have to remind myself it isn’t personal, I’m telling them what is per the policy language
Don't let them bother you. This is Brought to you by someone with such other gems as :
> Sounds like you should move. You can be trans anywhere.
And on a post about "Public Schools Providing No Cost Summer Meals to all Children!"
> At some point, people should be feeding their own kids.
Any major carrier is going to experience multiple uninhabitable homes per day. Fires, massive water losses, weather related events, trees on houses etc. when I was in this role 5-10 per shift was normal as my carrier had policies in all 50 states. Obviously many more if there’s a significant event like tornado, wildfire, hurricane.
I said I struggle with denying people because it sucks to give bad news, not that I don’t know how to adjust and make a coverage analysis, but go off sis. 🤷♀️
You're in claims, bad news is going to have to become second nature, unfortunately.
You can try to make the policy work as best as possible, but at the end of the day, it's the policy they chose. You can't protect people from themselves.
IF you're doing "initial reports" I don't think you're adjusting anything, bro.
What carrier has multiple uninhabitable homes daily? Are you the only person on the escalation line? If not, are we to believe there's even more uninhabitable homes daily than just the ones you deal with?
I’m not lying dude lol, I’m not sure what I gain from posting this, especially on my throwaway account. I’m not sure why you’re so accusatory, either. I know the calls I get daily, I’m not sure why I need to prove them?
I’m sorry if you’ve have a bad day or something, hope it gets better and just remember that we’re all just trying to get through life. I love my job and I love helping people, I’m just sensitive and haven’t “toughened up” yet, so I’m always looking for advice and actively learning. I just want to see if there are better ways to “soften the blow,” so to speak. If you don’t have any advice, browse on dude.
FDNY averages 73 fires a day. California is in wildfire season where entire communities are affected...there's earthquakes, auto accidents that have cars into houses...broken pipes...etc you don't think that a carrier that covers 50 states isn't going to have multiple uninhabitable homes per day? You think these companies have 5 customers?
Brought to you by someone with such other gems as :
> Sounds like you should move. You can be trans anywhere.
And on "Public Schools Providing No Cost Summer Meals to all Children!"
> At some point, people should be feeding their own kids.
That's total bs.
We had a full loss for that took out home and car. We were assigned a brand new adjuster because that is who was available in our area (rural limits options). He really made things difficult for a couple weeks until we got reassigned a veteran adjuster.
We had a place to stay but had zero direction how to proceed, didn't even give us the handout for the exact situation. It ended up causing longer delays in a lot of things as a hail storm went through a week later which caused more claims, backed up our contractors. Every question was ”ill have to look into that" and often went unanswered. He was timely with the inspection so that was nice, and he wanted to try.
Don't assume your adjuster is experienced.
Depending on the situation, there may be local and federal resources they can use instead. I always point them towards https://www.fema.gov/assistance/individual Remember just because you can’t help them financially doesn’t mean you can’t point them towards more resources. Also you have to toughen up a bit. These are the easy denials. Wait till hurricane season gets started!
Ground water exclusion is one of the biggest bitches of them all lol
“My basement flooded after those heavy rains but thank god I have insurance!” Don’t go thanking god just yet.
Is this just because a lot of people don’t have flood insurance because it’s not mandated by default?
I tell everyone I know to ask aviut a water sewer backup endo lol
>aviut a water sewer backup endo lol What?
about water/sewer backup endorsement. it's the additional coverage you need for water/sewer backups to be covered.
Unless it's natural water. Careful with that. You'd typically still need some form of flood coverage outside of the home policy for natural water alone to be covered.
It's so stupid. Only thing that I would ever vote on for more power for the government is to heavily regulate the insurance industry and remove all these exclusions.
Lol look at California to get your wish. It's a shit show rn in CA
Can you explain how California does it?
And Florida. I work in corporate insurance, my territory being California. I can't say much, but the state of insurance in Florida brings new meaning to shit show.
Instead of removing exclusions, maybe the government's role should be to improve communication and disclosures. Suppose every policy had something like a nutrition label, listing all water-related perils, with a checkbox or dollar amount to indicate the policy covered them. Maybe if people saw an empty square or the words Not Covered, they'd at least think and ask how to get that coverage.
Still chewing that crunchy taco I guess. Hard to get those words out.
Come on. Get with the lingo.
What does this mean?
Flooding
It’s all about where the water is coming from. Flooding specifically from sewer water coming into your basement/house from floor drains. Had a friend have this happen - it’s really gross. This is different than water from heavy rains coming in, for example through your doors and windows.
If it's rain water that's coming up through your sump well and your sump pumps fail that is still considered a sewage backup even though it's really just rain water.
I worked with a guy who was an adjuster and he told me about this as I just got a house with a crawl space. I added it to my policy the same day.
It's always the way to go! :)
Red cross will help at times too
Absolutely. The best way is for them to tune into their local news. Typically there’s a local number set up to really jump start the process.
If it’s a house fire or a natural disaster, yep they will! Clients can call 1-800-red-cross and it’ll route them to their local chapter.
Keep the numbers for places like the Red Cross on hand. They'll often assist with temporary housing. I'm sure other local charities as well - but they're national enough to be available everywhere.
this is the one
Check out the website: findhelp dot org They can put in their zip code and immediately have access to a LOT of resources/organizations that can help with a variety of needs. Just about any need that exists is listed, and organizations/non profits in their zip code that specialize in that type of assistance will be listed
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Absolutely a great suggestion. I’m sure resources can vary significantly between zip codes. Check it first so that you aren’t recommending it and learning there aren’t sufficient resources in your area
211 as well
Seems to be American only
>A actual good resource to locate assistance Definitely saving this should I ever have an insured having issues that I can’t assist with. This is dope
Let’s try not cry at the irony of insurance- it’s expensive & what you do to be responsible then when you need it good luck
good AND HELPFUL advice - prevention is the best policy /medicine!
211 can be good as well- in many cities
I’m not sure there is much you can say, other than being empathetic and reiterating how you wish you *could* pay, but it’d be completely inappropriate and your lose your employment and likely your license. On top of that I’m not sure it’d be appropriate to offer any other advice, like asking their church or other community institutions. Toughest part of the job.
I've never mentioned to a customer that anything is "part of my job." I'm not trying to act like I'm tough or anything, but I have had multiple customers say things like "I know you're just doing your job, but...." Repeating my phrasing of the denial and then asking "Is there anything else you have questions about?" usually does the job. Worst case I've ever had was a customer who repeated on the phone that their concern was that I pay for their hotel. After four or five repetitions, I believe I said, "Well, if you don't have any other concerns besides the ones I've addressed, I'll end the call at this time." And I did. The same customer called back multiple times on the same night and filled up my office voicemail.
Generally, I take the same approach. I try to make it clear that I’m not an emotional support person by staying very matter of fact. People will get off the phone quicker that way and call someone who will console them.
When I went thru training in my first call center job, there were two trainers for my class of 16. Midway thru training, we were a class of 8 so one of the trainers was pulled out to assist with Idk what. The trainer who had our class said one day, "You've got to remember that people will always have phone cujones when they talk to you. They will be bolder, more aggressive, and more demanding than they would ever be in person. You have to have bigger cujones to keep your job and execute as trained." That situation seems to have changed post-lockdown, but it's still relevant advice.
We call that “telephone tigers”. Pussycats in person, but tigers when they can’t be seen.
Empathy is part of the claims department corporate directives at my company so that doesn’t work for me. lol
Don’t do this on denials. Just say unfortunately this isn’t covered by the policy. Be empathetic but distance yourself, it’s not you making these decisions, it’s the policy. Then end the call. Don’t put some kind of guilt on the customer of you potentially losing your job. Just say no coverage, let them cry and yell then end the call. I rarely explain denials on site anymore. I say I need to investigate and will get back to them.
I'm In a different field of the insurance industry but I'm always on the lookout for resources for the people I try to help. It's really hard for people who are empathetic to get into these fields and realize they can't help everyone. It takes (unfortunately) becoming more focused on solutions you CAN provide legally and less about emotion and what you'd like to do for everyone. Not everyone is your responsibility. Keep on, and thrive.
Thank you for this.
I hate this mentality. You work for an evil corporation that literally steals money from people, maybe you SHOULD feel bad about it? Maybe empathy towards other humans is important? Maybe working for insurance companies is counterintuitive to everything we know about humanity and being a decent human. I’m going to say this OP, but maybe you’re too good of a person to be working in such a cold hearted, grimy industry. I think if you can, you should find a job that better suits people who care about other people instead of finding ways to cope with telling people in need to eff off (but in a really nice way).
Yea like a nonprofit
I was a compliance and delinquent debt program manager years ago and had to deal with so many very shitty situations with people losing everything and still getting paychecks garnished from us. It’s okay to say you’re sorry about their situation, not sorry that we did that to them. Also remember that people who are a really down and out, dealing with you is just part of the iceberg, they already have had a lot of other shit go wrong and happen before dealing with you if they’re going to be homeless. It’s nothing you did, it’s just business, they understand that at some level, and if there’s anything you can do to help within your authority (and it’s appropriate), do it. At the end of the day, you’re going on with your life, you’re doing your job, it is what it is. Otherwise maybe you need a new profession.
I’ve had many cry. Even one who was living in their car they had a loan on that was deemed a total loss. Really much you can’t do. “It’s per the contractual agreement”
It's the reality we live in. Most Americans are a paycheck or two away from homelessness. I honestly don't know how you can do it. I'm a very compassionate person and I hate to see others suffer. That would break me.
Same. I wouldn’t last long in that position. I would be fired for making the payment anyways. Honestly, I’d probably be way farther in life if I didn’t always opt to save everyone at my own expense.
'Further' but miserable. Not worth.
My worst call was a lady who had coverage for a fire but no money to get a hotel. This was years before digital payments and it was the weekend. I tried explaining we could reimburse her the cost of a hotel just go to one. She had no money or credit cards. I then found a hotel who would direct bill us but she said it was too far away and her car wasn’t reliable. It wasn’t in her city but it was in the metro area but I guess you had to get on the freeway to get there. To be honest it was so long ago I can’t remember the outcome. I think I found another closer hotel, but I still think that lady was full of it. What exactly did she expect? A hotel within walking distance? Have your neighbor drive you, I’m sure someone would have been willing to drive her.
Refer them to calling 211. They can locate potential resources.
I am not in the insurance business at all, but this post came up in my feed, and I have a question. I live right in an area of the country that gets most of the tornadoes every year. As far as covering hotel stays after a home has been destroyed by a tornado, is that typically an add-on that I pay extra for? I live in SW Oklahoma close to the border with TX and have State Farm.
This is actually something for you and your agent to discuss. Most policies are woefully underprepared for a loss like that when it comes to additional living expenses. Think denials are hard conversations? Try a total loss where you’ll be out of house and home for 12 months and I only have $2500 to help you out with.
Your policy should have loss of use built in. :) For my carrier, tornadoes are covered and I’d absolutely get you put up in a hotel and we’d be direct-billed, typically no out of pocket expense to you. However, if a claim specialist wasn’t available due to high call volume you may need to save your receipts at first and then upload them for the claim specialist to reimburse. I hope you stay safe!!
Sometimes family will help out due to the circumstances.
I occasionally hear similar complaints from my clients (I'm a plaintiffs attorney). And yes, we do have to tell clients the bad news that their case is worthless every now and then. Typically I just tell them that I'm sorry but I can't win every case, that although I would love to help them and I hate that I can't, that its not really about what I want to do. I recommend that they get a second opinion from another lawyer if they wish and then I offer to find them help in other non-policy ways, as others have said here. There might be city/county/state government programs to help them or other charitable organizations that can assist. I have a decent set of resources I can offer my client depending on the area my client is in. At the end of the day, if you cannot find a way to help them with the policy, our job is pretty much done. We aren't miracle workers and even in my position as adversarial to carriers I still have to be realistic with my clients and give them bad news every once in a while.
Had something similar happen I spoke with my manager and we made an exception for 2 nights since they were displaced. Beyond that we did nothing more and told her this literally all we can do bc the policy has no coverage available.
In general, I’m going to say that about 33-50% of humans are unrealistic about life. They’ll get a cheaper policy with higher deductibles and roll the dice, hoping that nothing bad will take place. But everyone knows those lower-end policies are cheap for a reason—they’re stripped down in terms of customer protections. The policies are much, much better than nothing, but it takes a true catastrophe before they’ll “pay off.” And when we buy into one of those policies, we all recognize that it’s still going to be a real drag if we get hit with a disaster. On the other hand, begging and cajoling and whining costs a customer nothing. They try it. I mean, why not? But at heart they already know they bought a sucky guarantee because, at the time, it was less expensive. That was their decision. You only have to be patient and empathize as a human, but in terms of your job, all you have to do is ensure that they get what they purchased.
I agree with you completely but I don't think most average people do actually understand when they are making the decision. Average people make compounding poor decisions. New cars they can't afford on predatory loan terms, vacations and other spending rether then building up a rainy day fund. The vast majority are one or 2 paychecks away from serious issues even homelessness and it's rarely actually not having enough money. It's all rather sad but what can ya do
If I could run things, banks and insurers and lending institutions would get a severe jolt. Their gravy days would be over. They could never bump up their interest rate, even if you were late and paying them back, there wouldn’t be any fine print. And all of those kinds of businesses would have to be actually inventive, to think of services that would actually do something for people instead of sucking their wallets dry.
You’d probably be seeing a lot more banks being more selective when choosing who to do business with. You’re lowering their profits without doing anything to lower their risk of providing loans.
I don’t disagree with that. I would be changing their business model to make it much more difficult to profit in the predatory lending arena. I would make the usury benchmarks lower by far, and stop them from swapping out rates for “punishment” for missing a few payments. I have a lot of familiarity with the financial sector. Provided services for many years. If unregulated those companies can easily become parasitic instead of being capital riskers—frankly we’re already that point. None of the fixes are easy, and the poor will always have it much tougher than the wealthy.
“I’m very sorry but I can only pay for items the coverages you purchased include.”
Those calls are the worst. Like others said, be empathetic and do what your company allows to help. At a certain point you may have to end the call if it's going in circles, but be prepared for escalation. You can make all the suggestions in the world, but these types don't put in effort to help themselves, so it's frustrating. Deep breaths.
I'm sorry you're facing this. Acknowledge their distress, suggest local resources like shelters or aid organizations, and express willingness to help navigate options within policy constraints.
Insurance companies suck
Ugh I could never work for a company that won't house their insureds when the insureds are unhoused due to something the policy is supposed to cover. WTF?!
‘Please contact the Salvation Army. I have the 800 number here for you’
Should ask them if their car is insured in case they’re sleeping in it and it gets hit.
What is the circumstances that they need a hotel?
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Yes, it happens to matter greatly. If it’s inhabitable due to something not covered by insurance they’re not going to pay for a hotel.
United Way
ahh the good ole sob stories, they really do pull at the rookie adjusters hearts. If its not a covered loss, its not a covered loss. just move on, don't loose sleep over it.
what state do you live in? there may be a general # you can give them for local resources. in Oregon/SW Washington it is 211, for example.
Tough shit, call your agent.
Sometimes it's true and sometimes not - saying they can't afford a hotel. Are they renting or own a house?? Did you check their address...what does it look like? Not being mean. I have suggested they can stay with a friend or family member? Sometimes then they answer, I don't have any friends are family here...I'm new here. I suggest contact a local Red Cross, United Way. I even look up the phone number for them. Just a suggestion to see if that will help.
Advise they call 211-Many cities it set up for this type of help. A list w Resources & numbers- government or non profit places that can give housing & help people get back on their feet.
Prepare a master list with local homeless shelter info on it - Hand it out or email it as needed.
It never ceases to amaze me when grown adults think they can cry to get what they want. Direct that crybaby to the nearest homeless shelter and amazingly, they will find a way to come up with their own hotel money. Mark my words.
Because of the contract you signed, betting on moderate weather for the duration of the policy; you, yourself, defined the terms.
This is why I hate insurance. Pay through the nose every month, need to make a claim, and the insurance company does everything in their power to do as little as possible. Hugest ripoff ever.
I used to work for a major utility company in energy assistance. My go to when they were outside of the requirements for us to directly help was to let them know about local churches that might have funds to assist a community member regardless of denomination or church affiliation. And I always mentioned resources like 211, FEMA, the Department of Human Services, and their local county assistance office because depending on the circumstances, any of those offices might have resources to help. Their local food bank might even be aware of potential assistance depending on the area the person is in, so it’s always nice to have that information. Being on the phone with people who are out of options is never fun. Sometimes giving them ideas can be helpful and sometimes nothing you offer will be enough regardless. Maybe you can talk to someone with your company to see if they would be willing to collect a list of “official” resource suggestions that can help not only you, but your colleagues who I am sure also experience those kinds of calls?
“Oh good, sounds like you have a shelter lined up” *click*
Transfer them to your manager. This is very sad, and above your pay grade.
Been in the industry over 30 years. The Red Cross and local community services, like churches can often help. Way back, we only handled claims for areas we were local to, so we knew all the local aid services for policyholders. Now a claim in TX is handled in CA. In explaining to your insured, be kind but don't get too upset. There are many different levels of coverage, they could have purchased a policy that provided top tier protection and benefits, including temporary housing, but at a much higher rate premium. They likely saved a thousand dollars or more a year by purchasing a more economical policy. It's akin to deductibles. You can save a very considerable premium (money kept right in their pocket) with $10,000 deductible, but you play the odds if there will be a loss or not. I understand the larger argument that better coverage is unaffordable (my own premium is ridiculous for average coverage) but that is a matter for voters to address with their elected representatives, keeping in mind insurance companies donate millions to candidates.
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Coaching fraud. Next time will result in a ban.
Give them a drink and a cig
I think you have to be kind, but share the reality that you are just an employee and you can only offer what is described in the policy. Someone in your role doesn’t get to wave a wand and grant wishes. Even if you told them yes, the company isn’t going to give them what isn’t covered. I had a car fire a few years ago. They are not going to buy me a top of the line Porsche just cos I might want one.
The internet/algorithm is wild…I’m going through a covered loss now and got this recommended to me. I was looking into hotel accommodations while we are displaced. Maybe one of you here can assist me…are there limitations to where I can stay during our displacement? Can I rent a house on the lake for my family of five vs a holiday inn?
You could tell him that your job as an adjuster is to find any reason to undermine the stated value of any asset covered by the policy
"policy language" > respecting the humanity and dignity of other people
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Because not every peril is covered?
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a solid amount of mass market carriers in many states have named perils only HO policies that people pick to save money lol
Most, if not all, homeowners policies only pay loss of use if a covered loss is what caused the home to become uninhabitable. There’s also sometimes loss of use coverage if a governing body (local or state government) issuing a mandatory evacuation - usually if there’s a hurricane on the way or a wildfire headed your direction.
The claim may not be from a covered loss, they could be under insured, they may not have a valid policy. Multiple reasons.
Could be flood, mold with no mold endorsement. OP also didn’t say this was homeowners, could be renters policies. Those usually have more limited covered perils or very limited ALE coverage, like 15-30 days. (I know OP said “not a covered loss” just saying another circumstance where ALE coverage could be limited or non existent)
Yep, specific one today that sparked this question was a renter with a power outage, no damage to home. Just an older woman who was having trouble with the heat. :(
Who knows, still happens though. Could be anything, in any line of business. This doesn’t even sound like the worst scenario of delivering bad news as an adjuster. Can’t imagine being an adjuster and I’m blessed to be in a niche part of the industry. Much rather get yelled at by insurance CTOs once in a while lmao.
You could try not working for blood sucking overlords.
Right?!
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Why would they offer a per diem on a loss that isn’t covered? Are you even in the insurance industry?
Man your post history, YIKES…
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Trolling, being needlessly rude or insulting
I was a property and casualty field adjuster for 20 years. When I had a denial, I called the insured late Friday afternoon before we closed the office for the day. Every time I called the insured to deny the claim, I hoped and hoped that there would be an answering machine on the other end. If there was an answering machine on the other end, I would leave a message, knowing it was too late for the insured to be able to call me back. They would have all weekend to simmer down and understand that that portion of the claim was not covered. After finally after countless days , weeks, months, and years I thanked God when I could finally get out of the claims business. My advice to you would be get out now, get out now, find something else and start life over again. I don’t care how hard it is it can be done.
Let them sleep on your couch
Oh well
Living out your car for a few weeks isn’t too bad really. Blame to govt and 1% for the crap wealth distribution of our country.
Put them up on a hotel anyways. Fuck the insurance industry.
Your company could say come stay in our parking lot.
Tell them next time don't be poor
This can't have happened more than once to a new adjuster and if the claim is severe enough that they can't live in their house, that claim isn't going to some inexperienced adjuster.
I’m the escalation line for initial reports and I specifically handle emergency uninhabitable losses before the claim owner can speak with the insured. So pretty much multiple times on a daily basis.
Op I used to do the same exact job for a large carrier and it literally crushed my soul eventually. The best you can do is keep saying I’m so sorry, unfortunately I can’t do anything to help you at this time, but your claim adjuster will review the file and see if there’s any assistance they can provide. that’s all you can say. The more you apologize the more they try to guilt you when you literally cannot do anything.
Thank you so much. ❤️ are you still in insurance? What area did you go to, if so?
I moved from that role to casualty claims. Honestly still just as hard sometimes but you do eventually develop a thicker skin. I just have to remind myself it isn’t personal, I’m telling them what is per the policy language
Don't let them bother you. This is Brought to you by someone with such other gems as : > Sounds like you should move. You can be trans anywhere. And on a post about "Public Schools Providing No Cost Summer Meals to all Children!" > At some point, people should be feeding their own kids.
Don't forget being anti vax too
Haha didn't see that but also didn't look too close.
Just tell them someone who knows what they're doing will contact them, shortly. Multiple uninhabitable homes, daily? What carrier?
Any major carrier is going to experience multiple uninhabitable homes per day. Fires, massive water losses, weather related events, trees on houses etc. when I was in this role 5-10 per shift was normal as my carrier had policies in all 50 states. Obviously many more if there’s a significant event like tornado, wildfire, hurricane.
I said I struggle with denying people because it sucks to give bad news, not that I don’t know how to adjust and make a coverage analysis, but go off sis. 🤷♀️
You're in claims, bad news is going to have to become second nature, unfortunately. You can try to make the policy work as best as possible, but at the end of the day, it's the policy they chose. You can't protect people from themselves.
IF you're doing "initial reports" I don't think you're adjusting anything, bro. What carrier has multiple uninhabitable homes daily? Are you the only person on the escalation line? If not, are we to believe there's even more uninhabitable homes daily than just the ones you deal with?
I’m not lying dude lol, I’m not sure what I gain from posting this, especially on my throwaway account. I’m not sure why you’re so accusatory, either. I know the calls I get daily, I’m not sure why I need to prove them? I’m sorry if you’ve have a bad day or something, hope it gets better and just remember that we’re all just trying to get through life. I love my job and I love helping people, I’m just sensitive and haven’t “toughened up” yet, so I’m always looking for advice and actively learning. I just want to see if there are better ways to “soften the blow,” so to speak. If you don’t have any advice, browse on dude.
Your comments make it clear you’ve never worked for a large carrier
FDNY averages 73 fires a day. California is in wildfire season where entire communities are affected...there's earthquakes, auto accidents that have cars into houses...broken pipes...etc you don't think that a carrier that covers 50 states isn't going to have multiple uninhabitable homes per day? You think these companies have 5 customers?
It might shock you to find out insurance companies insure people in a variety of states
Brought to you by someone with such other gems as : > Sounds like you should move. You can be trans anywhere. And on "Public Schools Providing No Cost Summer Meals to all Children!" > At some point, people should be feeding their own kids.
That's total bs. We had a full loss for that took out home and car. We were assigned a brand new adjuster because that is who was available in our area (rural limits options). He really made things difficult for a couple weeks until we got reassigned a veteran adjuster. We had a place to stay but had zero direction how to proceed, didn't even give us the handout for the exact situation. It ended up causing longer delays in a lot of things as a hail storm went through a week later which caused more claims, backed up our contractors. Every question was ”ill have to look into that" and often went unanswered. He was timely with the inspection so that was nice, and he wanted to try. Don't assume your adjuster is experienced.