How Do I Help My Customer When the Insurer Refuses to Pay? - BodyShop Business

How Do I Help My Customer When the Insurer Refuses to Pay?

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.

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!

You May Also Like

The Digital Blitz

We talk so much about how much collision repair is changing, but so is the world of media!

We talk so much in the pages of BodyShop Business about how rapidly the collision repair industry is changing, but the world of BodyShop Business is changing drastically too — the world of media, that is. Change is everywhere! Is there anything that is not changing? Change, as they say, is inevitable. I liken it to a freight train that will steamroll you unless you get on board.

Auto Body Shops: Building a Foundation for the New Year

For the new year, it’s important to conduct a thorough audit of your finances to look for areas of opportunity and things to change.

Auto Body Consolidation Update: There’s a New Buyer in Town

The good news for shops that want to sell but do not fit a consolidator’s
profile is that there is a fresh pool of new buyers.

Is Your Auto Body Shop a Hobby … or a Business?

So you want to provide safe and properly repair vehicles to your customers … even at a financial loss?

BodyShop Business 2023 Executives of the Year

Greg Solesbee was named the Single-Shop Executive of the Year, and Charlie Drake was named the Multi-Shop Executive of the Year.

Other Posts

This Could Be Your Last Text

A sign I saw on the highway that said “This Could Be Your Last Text” reminded me of my son’s recent car wreck.

SUNY Morrisville Auto Body Program Makes Students, Cars Shine 

A 1997 Mustang Cobra is getting the chance to shine again, thanks to students in Alexander Graf’s auto body technology classes.

3 Strategies to Improve Your Insurance Protection

If you’re looking to improve your shop operations and set yourself up for success in 2024, remember these three insurance strategies.

A Scary Moment Reminds Us of the Importance of Proper Collision Repairs

My son’s car wreck reminded me that we literally hold people’s lives in our hands in the collision repair business.