Complaints

• Initial Complaint

  06/06/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  We called are insurance company about a roof replacement after hell damage and strong winds knocked our ridge cap off. We just ask for an estimate. We received a check in the mail for damages but we didn't file the claim. They took it upon there selves to do that. We have had insurance with this company for about 30 years. They revised are policy from replacement cost to depreciation cost. We had no knowledge of this. The replacement cost is around $8000 more than we received on the check that we didn't even ask for. We have been paying for this policy for full replacement cost. They switched it right before we tried to file a claim. They also sent an adjuster to our home when we weren't there. They didn't even bring there own ladder They used are that was under our deck. This is not acceptable we should have been notified They were coming. You don't send strangers to someone's home to climb around on there roof without permission from the owner. I would like help with this matter of getting the full replacement cost that we thought we were paying for. We never gave them permission to change this on our policy. I appreciate any help you can give us. The agents name is ***** ****** ************* ***** *** ** ******* *** **** ***** **** ****** ************

  Business response

  06/28/2023

  I am writing to you today to address complaint ID ******** dated June 5, 2023.

   

  Mrs. ******'s complaint addressed several items that I will respond to individually on behalf of Missouri Heritage Mutual Company.  

   

  You should understand that Missouri Heritage Mutual Insurance Company uses independent insurance agents to sell its policies. These independent agents are also empowered to file claims on behalf of the customers.

   

  The customer’s statement indicates that the customer only wanted an estimate but did not wish to file a claim.  However, we received a written loss notice for a claim from the customer’s agent on 10-23-22. The written loss notice stated that while a roofing contractor was at the home to inspect/review a damaged ridge cap, the roofing contract found hail damage on the roof. Specifically, the loss notice from the agent said:

    

  "Mr. ****** called 10/21/2022. He said a number of houses had sustained hail damage this spring. He had a roofer repair a ridge cap at that time and the roofer said that there was hail damage ."

   

  The loss notice noted the date reported as 10-23-22. This loss notice indicated that a decision was made to file a claim with an unexact date of loss from earlier this spring. The agent has a strong record of providing good customer service. Our company has no reason to believe that this agent would have ever filed a claim without the customer’s knowledge or consent.

   

  The customer complaint also stated that an adjuster showed up without the customer’s knowledge and without advance notice.  That is inconsistent with our records. Instead, the insured was contacted by our contracted independent adjuster on 10-24-22 to discuss the loss. During that contact, the adjuster made arrangements to visit the home and review the loss on 10-27-22.  The customer’s contractor met the independent adjuster at the home while the customer was at work. This was not an unannounced visit.

   

  The adjuster did find hail damage to the roof of the entire structure, and wrote an estimate as such. 

   

  The customer’s policy included “replacement cost” but included an endorsement that provided that once the roof reached 10 years of age, the roof was then protected to actual cash value. This is consistent with all of our company’s replacement cost policies. The customer received this endorsement (endorsement ML5510) on the renewal date.  A disclosure notice, along with a copy of the endorsement, were included in the 2019 renewal of the policy that was mailed to the insured (customer). There was also a notice regarding this endorsement included on the 2019 declaration page, and each renewal since of this endorsement was added.  Actual cash value of roof claims is common among many homeowners insurance carriers.  The roof was noted in the application to be put on in 2005 and the same note was in the adjuster's report. Therefore, the roof was 17 years old.  It also noted the shingle was a 30 year shingle, so more than half the life expectancy has passed with the age of the roof.  The non recoverable depreciation was 44 percent. 

   

  The adjuster estimate was sent to us and the insured (customer) for the damage found on 11-1-22. Our supporting check was issued and sent out to the customer on 11-2-22.

  
  

  
  

  Thank you,
  

  
  

  Missouri Heritage Mutual Insurance Co.

  
  
  

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