Title: Homeowner’s Insurance Nightmares | What You Need to Know
Downloaded: 2026-04-10 14:51:56

[Music] welcome back everybody to the auto accident attorneys podcast I'm your host attorney Ali the podcast as always is sponsored by the auto accident attorneys group where we take care of you today like most days I've got my sister with me attorney Holly Cole hello and again we have our favorite return in-house guest attorney Rishi patney thanks so much for having me absolutely it's good to be back I love having you guys I wanted to even though this is an auto accident podcast we do deal with insurance generally and because the theme of the podcast is consumer facing and helping take care of people with information through the podcast I wanted to today talk about insurance but on instead of the auto side the homeowner side and the reason for that is I got a call from the office from Jamie that our roof was coming down and it turns out that my older daughter meline had started to draw a bath in the master bathroom and it was taking so long to fill the tub up that she wanted to go lay down and and take a nap or rest she didn't mean to take a nap she wanted to rest so she went to go lay down and fell asleep for about 90 minutes or so oh my God and Jamie just heard what sounded like rain coming from the garage so when she went to the garage oh wow she saw the ceiling coming down water flooding the entire garage her car was soaked and uh she ran upstairs and the entire m master bath was flooded so man I found myself in the situation where I needed to rely on insurance and I'm always out here proz oh you don't know anything about your auto insurance I realized I don't know if my homeowner's insurance covers this yeah so I thought homeowners insurance would be a great topic uh selfishly for me to talk about so that I might be able to learn a couple things today I remember Holly you had a similar situation when you were living in Midtown and your condo I did my I woke up the morning after a birthday celebration for myself so I wasn't feeling too hot and I just hear like this pouring water a similar sound and I was like what does that sound and I go into the kitchen and it's just like a waterfall coming out of the island where my sink and dishwasher were housed and it was just nonstop and I'm trying with buckets to get it to like you know I don't think I knew that it was coming out of the sink yeah I mean it was coming out of every like orice of that island and uh and you're hung over dealing with it and I was hung over and I the entire condo flooded a good three in I would say all my furniture was damaged it started to leak out into the like common area so and our the hallways of that Condo building were carpeted so of course the immediate concern is mold and how it affects other units and do you have units below you I had units below I was on the eighth floor so I was sandwiched between oh wow um and this is like a 20 story building and um turns out I didn't have homeowners insurance somehow when we were getting the mortgage it slipped through the cracks did you not have homeowners insurance or did you have homeowners insurance and the coverage didn't apply because it the cause came out from no it was no homeowners insurance oh that's someone screwed up someone screwed up on the mortgage l side that's crazy yeah that's like a like a Porsche dealership letting you drive off financing the vehicle M with no Gap coverage MH that's insane I didn't I don't think I remembered that yeah so I was out of that unit for at least a month and we had to come out of pocket to pay for that and in that moment I realized how important insurance is all right so if you're listening well it's a pretty rare occurrence because part of the closing you know what what the lenders absolutely require is that you have a homeowner's policy in place with you know a certain reputable company and it's got to meet certain standards and you have to have certain you know kind of minimum coverage uh to make sure that they because your your home is actually the security for for the loan right the mortgage so they would they in you know they absolutely insist that that you know they not only do you have a policy but that the mortgage like the lender also be named on the policy so that you know when they send you like a you know property damage check uh it has to go through you know it's it's made out to you the homeowner as well as your mortgage company yeah 100% And I realized that after the fact I'd never thought about those things and then I was like there's some somebody messed up big time was it was this back in the days when uh when when they were you know going through loans so fast they you know they basically have those Robo signs um not then it was uh 2013 I believe when I purchased the condo okay so that was after the subprime yeah but Rei's right it's it's technically that you were living in it but it was the bank's condo right it's their money that that they need to protect so it's wild that they weren't running audits to make sure that their asset was protected right they do that with with this building actually when it's coming up for Renewal I don't even have to remember cuz my bank will send a notice like hey if you don't renew it we're going to put in Insurance in place and there's a premium for it yeah at least there's coverage well and and a lot of lenders they actually they just to make sure you don't accidentally Laps on your policy or forget to make a premium payment um they'll they'll actually make sure that you know a part of your mortgage payment goes into an escrow account and then they pay the premium for you just to make sure that there's no laps like that I'm also familiar with that U my bank just overcharge me uh they tried to tell me that my property insurance or my property tax went up to $52,000 oh wow and it's actually $8,600 but someone again mes maybe it's me someone keeps messing up when it comes to my finances common denominator is you it is me but it's not me actually screwing up it's just some energy I must be putting off but yeah they tried to it it all had to do with the escrow and it reminded me of the fact that I do have homeowners insurance because I pay into SC every month to pay for that coverage did they ever fix that by the way they did okay so did you get the money back that they not all the money but we can get into that later real quick side note I think this is helpful for listener so you're careful about what you're doing with your own finances the mistake was on the bank side and they because your mortgage is set up on an automatic draft it was what 5x what it was supposed to be they just went ahead and took the money out of your account yeah that's the craziest thing so the money's gone it's their mistake but you don't have the money until they fix their own mistake yeah and by the way 14 business days to fix to refund their mistake that's not even including the process it takes to send it up top to make sure we could do another episode on that when we learn some things that we could actually share so I I think this is perfect because I remember Rishi you actually the I remember it is because you got attorney's fees yeah out of it but you had a homeowner's issue that you represented a client on just a couple weeks ago yeah it was actually helping out a neighbor of mine um and it was a it was a roof damage claim um his his roof was damaged by hail and um and his insurer um you know he he had a roofer that told you know had the roof inspected found you know several spots where you know there's very clear hail damage um and so so when they the the roofer created an NE like a repair estimate they sent it off to his insurance company um and the insurance company's response was no there's no hail damage it it's all wear and tear uh no sign of no actual signs of hail damage um so they appealed it and they they did a more detailed um you know I guess a revised line item repair estimate um and it same response they said no there there's no there's there's no heal damage um but then they asked for an engineer to come out so they they they had their own engineer come out inspect it and um this was this was right around the time that I got involved in the case and um and I'd said a letter of rep to to his insurer and basically laid out why um it was such a ridiculous position um and so then they came back and said we we've revised our analysis and said that um there there ishal damage but there's only hail damage to like SE six or seven tiles and so we're only going to cover you know about 15 square feet of roof as opposed to the entire roof and uh it's amazing how uh focused the sky can be right exactly it only hit th those few spots and it wasn't enough to to Warrant a roof replacement so then we ended up getting in an engineer like a forensic engineer out of Colorado to come in Oh my he inspected the roof um and he actually does this for a living he he actually used to do it for the insurance companies um and he was in house an inspector um and so he so he knows exactly what they're looking for in terms of um you know what would be their justification he photographed it documented it and had an entire report and so we sent that with a final demand um that was above what the roofers estimate was they initially denied it and they fought back and so we said okay well I mean you know that's bad faith um you know on the on the coverage side they had absolutely no basis to to continue to refuse the fact that there was hail damage and it was you know enough hail damage to Warrant replacement of the entire roof and uh and then we finally ended up settling above the the am of the the roof damage and we' got attorney fees and and expenses I just want to point out that clearly these people pay for homeowners insurance this is what they have it for and they had to go so far as hiring an attorney and getting a forensic roof inspector to come out from Colorado yeah to finally get the insurance company yeah to pay for the service that they're paying him to on a monthly basis or I guess really annually and the insurance company paid more on that particular claim than had they just done their job exactly and and that that's that's really where um it's it's a little bit you know this is where it's a little bit unique when you are the insured party it's it's called a first part party claim the reason why it's first party claim is it's between there there you know your insurance you know your insurance policy is a contractual agreement between you the the policy holder and your insurance company and so that that contract you know when when they violate it um and the claim is for you as the the first party beneficiary under that contract um you know it automatically triggers the you know the bad faith and the contractual breach and all those things that um you know that come up from from contracts class but it's uh but it's all those classic damages um it makes it a tough case typically for for just a property damage case but in this one it was so egregious that because there was absolutely no justification for this constant delay other than they were hoping that at some point the homeowner just gets tired of fighting and just accepts you know what you know what few scraps they wanted to to throw his way um to resolve it and I think that's worth noting is that you know we don't have to say the name of the insurance company But whichever insurance company it is it's not if I have to venture a guess it's not as if this particular insured is the one that they denied they're doing this they know that if they get popped they're going to have to pay more but it's still in their best business interest imagine how many claims they deny that people don't pursue where it makes it financially justifiable for them to be like okay we can work in the possibility of of getting popped one or two times but we can if we deny a hundred and just pay more on one right it's still financially beneficial yeah well and what happens when they you know when that's their approach is that sometimes they stick out like the sore thumb so um so in my client's neighborhood um out of 151 homes um 65 of them had their roofs replaced due to to hail damage um and this one insur was the only outlier to deny the existence of hail damage every single 65 other homes in that neighborhood within you know like like literally within walking distance of of my client's home all had their roofs replaced um and and none of those other insurers had any problems um accepting that yes there's clearly roof damage here it's within your policy and um and we're going to cover the claim um they you know they might they might fight on you know the the amount of of of the repair costs or the overall but but they don't deny that you know the existence of of the actual damage right so that that's the part that's like clear as day that you there's clear damage um and and you you're getting it from your own engineer you're getting it from the roofer um and and you've got you know photos you've got the actual um you know it's it's very detailed way that they describe like um sample areas of each slope of the roof and they just flat out denied what's clearly obvious from pictures from descriptions what's so impressive about insurance companies is how much specialized knowledge they have right they're doctors they're Engineers that's exactly where I was going they're making judgment calls on structural damage to roofs these adjusters are call making those judgment calls and in another division in the same company they've they've got adjusters saying the way that that roof damage was denied they've got people with B suffered bodily injury saying oh this treatment was unnecessary oh don't get me started on health insurance well we have a a mutual who was diagnosed with cancer and had to have surgery a very invasive surgery she had have her tongue removed and replaced and skin graphs and had to go through physical therapy to learn how to use certain body parts where they had to use take graphs from and the insurance company said that her Hospital the health insurance company said that the hospital stay her overnight stay was medically unnecessary after this incredibly mind you she was there for a week in the hospital yeah and they're like ah you should have been out after like a day and it's insurance companies making this call The Physician her her attending physician her surgeon I'm assuming likely recommended the stay absolutely right it's not like she was asking to stay yeah yeah and I know that the insurance company is going to frame it as if the attending physicians are biased they're like well yeah of course they want them to stay because they get to earn money off of the hospital stay but they're forgetting the fact that this is It's medical treatment right they're in such a better position in reality yes there may be some some theoretical you know truth to that that bias but here's the reality that attending physician is not you know is also got to listen to his patient there's no patient that just enjoys staying in a hospital setting so much that they just like I don't want to go home get doct you please extend my stay right you know it's it's not you know it's not a five star resort it's not an all-inclusive it's a it's not a vacation it's it's a miserable place and people want to get out of there as soon as possible so even their patients are pushing to get out of there I mean I think the notion that um that that Physicians and and hospitalists are um are keeping patients longer than they you know that they need um that the more than medically necessary it I think it's a ridiculous proposition I mean and it's it's it's not only it's not only the fact that the patients are push you back but there's a need I mean in most places thankfully Atlanta is not that bad but when you get outside of Atlanta and you get to rural places there's a desperate need um for that space somebody else needs that bed somebody else needs that room somebody needs that ER space so the the notion that the doctors are going to just keep everybody else waiting while they you know while while they overcharge or or overuse um you the the space for this one patient I think is ridiculous they they're under tremendous pressure to to keep people moving and as soon as they're they're well enough and ready to be discharged they get them out of there y the premise is is ludicrous they it's funnier to me how the insurance Lobby has done such a great job of playing the victim of course poor us and and but they always they also shift it because they know where the pain point is like this this is coming back to Tor reform now they're like oh Georgia consumers and Georgia businesses have to pay more like poor consumers excuse my language who the [ __ ] is charging them more exactly it's you and they're publicly traded companies we can see how much shareholder return you have every quarter and CEO compensation that has never gone the other way it's only gone up um that's right by you know several fold um you know and it it's it's constantly the the notion that a poor little insurance company is fighting you know it is up against this unmatched you know this you know they can't fight against this Behemoth that is the the plaintiff's barns that that's ridiculous right um they yeah that is really U it's actually astounding that that's the the the side that they take or the the argument that they take my knee-jerk reaction is to find out who the CEOs are I'm just kidding there's a reason the Luigi's of the world exist on bringing it back to the homeowners claims uh I think I'm in the midst of the repair right now they're going through the remediation they have to take all the drywall out they took the ceiling out obviously there's insulation between so it's all empty well you know uh water damage to to your home it is it is crazy how nuanced and how specific the policy gets in terms of coverages right the one thing that you don't have to worry about is the the water um originated inside your home and um and that's going to almost always be covered right um but the the real question um or or or the the the real problem that that gives homeowner sticker shock when they go to file a claim on their homeowner's policy is when water comes from the outside because it really depends on what caused that um is it uh is it basically um a breakdown of the exterior barriers that's allowing regular natural like like rainwater or uh or is it a is it like a flooding storm like you know is is it due to storm water or is it discharged from a neighboring property but based on on each one of those different stereos there may or may not be coverage under under those depending on various types of coverages that that you have under a homeowners policy um and I only know this because I've had friend uh deal with um his neighbors they changed something in their backyard and changed the way the water was flowing and so it was basically water discharged from his neighbor's property onto his property running up against the side which finally gave way through the vapor barrier um on on the I guess the first like the basement level and um and water was was there was water intrusion at the basement level but they said that that is because the water was not originating off of his property it was not natural water um on his property it was actually water being discharged off of his neighbor's property it wasn't CED and they fought him like for a while wow the funniest thing about insurance is if you don't need it it's fine and you think you're covered it's it's that security blanket that false security blanket like everything's okay the moment something goes wrong is when you really find out what you have it reminds me of the people that are drive around being like I've I've got full coverage there's no such thing is full coverage right what what do you you mean full garbage we're laughing at it I'm sure like somebody listening to this Mom hi Mom she's like what mean I have full coverage but there is no specific policy there's all these different things that will happen like uh if your car is out of flooding flooding of a car it was in North Carolina full coverage doesn't necessarily cover that Collision wouldn't necessarily cover that it would have to be comprehensive coverage like there's these very specific types of coverage that apply when it comes to any insurance whether it's Auto or home and even then you have to read the fine print because they will find their exclusions oh yeah yeah to rishi's point oh it's not all flooding well the the the my favorite is um almost you see this in almost all policies there are certain things that we just can't explain how it happened we're going to call that act of God there you go right um and that is open to some pretty wide interpretation um arguably you know depending on on where you fall on the face Spectrum I mean everything is an act of not at the end of the day that's a good point re actually never thought about car Rex could be an act of God even though it's due to the negligence of another motorist oh my God reishi just gave the insurance carriers another way out what watch that come back and bite me yeah I think that uh this is worth a part two even like I said mostly this was selfish for me to review some of the homeowner stuff uh I want to see what what I go through uh we had uh a water remediation company I forget the name of the company I was going to give them a shout out Integrity all right shout out Integrity um if you don't do well by me I'm coming come back on part two and blast you that but no they've been great guys uh Shane is Shane or Shawn is from Integrity young guy uh knows what he's doing though this is pretty much all he's been doing his entire life uh but he's young he started right out of high school uh they started the remediation process and he's like this will always get covered but I also have a feeling that he's saying that this will always get covered because it's going to be within the deductible anyways so he's like well yeah no we'll always get paid on on the ration portion sure but next week There's fans everywhere in the house right now drawing everything out next week our insurance company is going to come out we have Handover I actually do really like Handover um there's not many insurance companies that I like but I like the people at Handover they they've treated us well we've had a couple we had a an electrical strike here at the office they took care of us there sorry I'm laughing I always have to throw in a joke especially upon pun as soon as you said Handover I just want to be like do you think they're making money Handover fist well played well played on thank you I've seen our premiums yes yeah I think they are I think maybe that's why they don't mind paying out on claims every two three years they're swimming in the cash they're like here you go well great investors they they' they've got good financials um I see you Handover uh they're going to send an adjuster out to check everything out so the Reconstruction is going to be another Spiel alog together so that's what I want to do I just came up with another one they're just coming to me well don't set them up just say it I was just going to say they're not in the business of handovers no that's not as good unlike auto insurance I don't have much input to be like this is what you need to look for it's I I think it's a little bit different because it is so varied with homeowner you know and property policies um you know there's the overall evaluation the value of the property and that has to constantly be updated based on the market value of your home and and you know that affects your premium but there are so many different types of risks when when it comes to home owners policy that I I think it would be impossible to to I mean you can cover the you know the broad ones the ones that are most common but you know depending on your locality uh you're going to have completely different I mean you know Florida homeowners policies are totally different here in fact some insurance companies they've siloed off their Florida um Underwriters and and operations so that if there is ever like catastrophic thing that that that that would otherwise tank or would you know really affect you know overall profits for the for a whole company they can at least limit that just to this one Florida company to re she's point I agree I homes are one of those things where like down to the region you're located it probably covers based on like what what kind of structure your home is built out of or how it's built I should say materials used like Florida homes are going to be much different than homes in Georgia they're all going to be on SS not all you know what I mean um versus the weather in that particular area whereas with automobiles or health insurance for the most part you can kind of uh predict what's going to be necessary but I think with homes yeah the rishi's point there's so much Nuance geography matters yeah anecdotally I heard about um some policies from the Palisades fires in California yeah that they had not update because the your statement just reminded me Rishi about updating the value so these guys had Insurance in place from the 80s and they never updated the home's value so the replacement cost of their home was based off like the 1980s numbers yeah oh wow yeah so I this is anecdotal so I haven't actually now sound like President Trump you know a lot of people have been saying so I I don't know the facts behind it but I can see that being an issue where if you don't go back I I actually I've got a 19 you've seen it the the 78 Bronco that I have yeah um on paper the market value of the 78 Bronco is fairly low but it was like a classic vehicle that I bought from an auction site so I actually had to call in and readjust I had to get oh man now I don't remember the name of that insurance company but they specifically do classic cars so I went and I readjusted the replacement value of the car based on it being a classic 78 as opposed to just a 1978 Bronco go yeah you know so they had to adjust it and I actually I did try to to push it up they only they only insured it for what I paid for it they wouldn't go further that makes sense which is okay because I think I could it would be diff if something did happen to it I I could find a comparable one probably in that same range but you never know yeah with these like classic cars or or one-offs it's tough to find replacement cost and and get an insurance company degree yeah yeah buy or beware Act of God no I don't know what that is in Latin all right everybody um if you got any information that was useful from this podcast Please Subscribe whatever platform you're listening to drop us a like leave a comment it would really help us out mom just ask Holly how to leave a comment she'll D to take it care for you we look forward to talk to you next time and as always I look forward to taking care of you take care