I represent a high-end paint and body shop in Orlando, Fla. We’re having major issues with State Farm on a hail damage claim. Despite the fact that the insured has photos to prove the damage, plus hail reports indicating that there was a severe storm in the exact area where his vehicle was, State Farm is trying every tactic to keep from paying the claim. I need some advice as the repairer given my commitment to the customer, who is fully covered with comprehensive insurance.
Asked by Bryant Sanchez, Exotik Auto Werkz, Orlando, Fla.
Thank you for the inquiry, but since I’m no longer a licensed claims adjuster and not an attorney or a licensed insurance agent, I cannot and do not provide legal advice.
With that noted and understood, I can say that, if it were me in your situation, this is what I would do:
1. Have the policyholder place every communication in writing and send all communications by Certified Mail, Return Receipt Requested.
2. Demand that the insurer either provide confirmation that they will or will not honor the comprehensive claim…IN WRITING ONLY!
3. If the insurer agrees to accept the claim, afford coverage and provide for repair, then the vehicle owner should authorize (in writing as per FL 559 regulations) and request that the repairer (body shop) prepare a comprehensive assessment of the loss-related damages, detail each and every procedure and cost as needed for a proper and thorough repair (estimate/blueprint), and submit it to the insurer with a written notice to inspect the damaged vehicle within 72 hours, as repairs would begin at that time to mitigate further losses and costs.
4. Have the insurer authorize a rental vehicle, and have it billed to them during the necessary time for repair (up to the limits of the policy).
5. If the insurer denies the claim, they’re bound by Florida regulations to provide to the policyholder, IN WRITING, the reason for their denial within a certain timeframe. If they were going to deny it, they should have already sent a “Reservation of Rights Notice” to the policyholder.
6. I would then suggest that the owner seek a competent lawyer familiar with contract law to take the necessary action against the insurer for a cause of action (e.g. Breach of Contract).
7. Have the vehicle owner seek and obtain a copy of a weather service report with date and time to document the occurrence of the hail storm or applicable weather for that specific area/region.
Just my humble, non-legal opinion!
