This is your Smart Claim Tip of the Week, “But It Won’t Match!”
I hear this every single day.
Most people are under the impression that the insurance company owes to put it back and matching condition. And matching is sort of a thing of the patch or the past, however you want to pronounce it.
Matching used to be pretty easy…
The insurance company’s policy had language that was pretty clear on what was due. And it’s became a very difficult or more aggressive position of the carrier not to match, like the gentleman staying there with two different shoes.
There are policies out there that consider that completely acceptable.
But it won’t match…
So, look at that roof, are they going to leave it like that?
Believe it or not, there are policies out there that consider that completely acceptable. As long as the roof can maintain its function and to keep the water from entering inside the building. The color, the appearance have no considering factors in the adjustment of loss.
…. That can be really difficult position because there’s an economic loss to that, the meaning of that house was right next door to a house with a brand-new roof, or …
… a roof even aged that was very similar in appearance, meaning had no distinct differences or visible patches, that house would probably be worth more money.
So if your policy does not address matching in a way, and I use that term “matching” kind of to describe the arguments, if it doesn’t address it in a way that leaves your property reasonable, and that’s the new terms, you may be left with something much like that.
Policies today pretty much have an exclusion on matching
Did you know, policies today pretty much have an exclusion on matching, meaning you can’t argue it, it doesn’t exist, and we don’t owe for it. So they use other terms, they use the word “reasonable” a lot. So, is it reasonable to do this?
So reasonable is a very subjective term, and to be indemnified under reasonable, means you have to argue or put positions forward that have more value, or more strength than their defensive position.
They use terms like repairable.
What the F*** is Repairability?
So if the roof is still repairable, they say, ‘We don’t really care if it doesn’t match, we don’t owe for that, we owe for the repairability.” Now, there are factors in repairability that actually make it easier to get a roof replaced, rather than color issues, which most people focus on as the primary problem.
Being uniform. So we’ll have a uniform appearance language. StateFarm is big for a uniform appearance. So uniform doesn’t mean perfect, right? You’ve seen the uniform where the top and the bottom are different. So again, these are subjective terms that are difficult to argue or difficult to process in the claims world. And that’s what we do as adjusters, we take the policy at hand, we take the limited language that’s built into the contract and we work around those restrictive terms, we try and find the ones that work best for your situation or your property.
USAA Case Example
So, I’ll give you an example.
There’s a Superior Court ruling called Green versus USAA. And it says in a roofing case that if the roofing is damaged, the insurance company owes for substantially similar size, color and texture, all three. It’s a pretty big hurdle. I say this side of matching, it’s actually a state USAA case. But in that case, the shingle was available. And they said they owe for at least replacing the slopes to that level of repairability/matching.
Matching is not a good argument. In fact, it’s a horrible argument
But I can tell you, this can be a really tough thing for people to understand when they say ‘but it won’t match.’ And guess what, that’s not an argument we can even use anymore. So it’s really bad if you have a policy that says we don’t even owe for repairability, we don’t care, we don’t care if the roof’s not fixable.
I’m not going to name them or call them out. You’ve probably seen this guy advertising before. That policy is ridiculously difficult to win on what is called matching uniform repairability and things like that, it’s very restrictive.
- even though they advertise and market real strongly
- even though the policy is pretty clear on what they owe.
Getting paid for “matching” is quite a bit of challenge with that policy. Not impossible, but quite a bit of a challenge.
I hope you enjoyed our tip today. Hope you enjoyed the tip. Or you can send me a question directly at email@example.com. Thanks everybody.
Article transcribe from the video, But it Won’t Match https://youtu.be/odZebD_s8Ws