For over 20 years, I’ve represented homeowners in front of large insurance companies. I spend my days assisting my clients in the preparation, presentation, negotiation, and adjustment of their insurance claims. Today, I’m sharing an experience I had while handling a theft loss claim in Encino:
How did you first become involved with this claim?
I was contacted directly by the homeowners. They had a family friend who had worked with me before, and the friend referred them to me. This couple returned from vacation and discovered someone had broken into their Encino home. The house was located near Tarzana, and the neighborhood was experiencing a series of thefts at that time.
What was stolen from the property?
The couple was missing valuable pieces of jewelry and a handful of collectible items. Unfortunately, the damage to their home far exceeded the value of the stolen items. This happens frequently in theft claims. Burglars often break windows or doors to gain entry to the home.
How did the thieves enter the home in this case?
In order to break in, they dismantled a large French door at the back of the house. They tried to pick the lock and bent the frame of the door. Eventually, they just broke the glass and reached through to unlock the door from the outside. Once they entered the house, they started searching for valuables. They dropped vanity drawers on the flooring, which dented the tile.
Did the insurance company replace the jewelry?
Your insurance provider will always try to limit their liability. It doesn’t mean the company is evil, but that’s how they stay in business. My clients did not have enough coverage for their jewelry, so we weren’t able to replace all of the items. However, they did have property insurance that should have covered the damage to the home. This led to a few weeks of negotiations with the insurance company’s adjuster.
Was the insurance company unwilling to repair the damage?
Insurance companies prefer to repair things, rather than replacing them. In this case, we had to negotiate for a full replacement of the tile and the broken door. Although only portions of the tile were dented, we couldn’t cut out and replace pieces of it because the original tile was no longer available. Moreover, when you’re working with tile, you still need to redo all the grout so that the color is uniform.
We brought in a contractor to assess the damage. He discovered that the kitchen had been built ON TOP of the tile. This further complicated our claim because there was no way to fully repair the tile without dismantling the kitchen. Eventually, we determined that it would be cheapest to remove the kitchen, replace the tile, and then rebuild.
Were there complications with replacing the door as well?
Before I was brought on to handle the claim, the couple had paid to have the broken glass replaced in the back door. The homeowners didn’t know that the door frame was bent, and even with the new glass, the door would not lock properly. When we presented this information to the insurance company, they were reluctant to replace the door completely because it looked fine at the surface level.
How did you argue your case for replacement?
The insurance provider was initially unwilling to replace the door because it would be very expensive. The broken back door was part of a set of three doors around the home. After doing a bit of research, we found that the exact model and style of the door was no longer in circulation. This meant that the insurance company would be required to replace three sets of doors with newer, matching models in order to return the property to a pre-loss condition. They knew that would be costly, and insisted we exhaust all avenues for repair.
When we reached an impasse with the insurance company’s independent adjuster, we turned to the manufacturer of the doors. He helped us prove that the door needed to be replaced and could not be repaired. These doors are typically assembled in a controlled environment. There are two panes of glass that must be sealed together to block out noise and moisture. Due to the unique manufacturing process, there was no way to repair the damage.
Did the adjuster agree with the manufacturer’s assessment?
After we presented the evidence to the independent adjuster, he agreed that replacement fell within the scope of work. However, when the insurance provider sent their settlement estimate, we saw that the adjuster had recommended that the company only pay a portion of the costs. We were unsure why this happened, but when we started digging, we discovered that the independent adjuster was hired as a contractor. This was his first project with that specific insurance provider, and he wanted to show that he had minimized the company’s liability by undervaluing the damage.
Were you able to resolve the case with the adjuster?
That adjuster managed the homeowners claim from start to finish. Eventually, we negotiated a settlement for twice the amount he originally offered. Although we couldn’t recover the full cost of the stolen jewelry, we were able to secure part of the cost using the content coverage provision in the homeowners’ policy.
In the end, my clients were very happy with their new kitchen, and they were a pleasure to work with. I’m grateful that I had the opportunity to advocate for them. Since finalizing their settlement, I’ve received two referrals from them.