Case Study: Overturning a Lowball Offer on a Hail Claim
Client: Mark P., commercial property owner Claim Type: Hail Damage (Commercial Roof) Initial Insurance Offer: $45,000
The Challenge
Mark's commercial building, a large warehouse with a flat, TPO membrane roof, was hit by a severe hail storm. He filed a claim, and his insurance company's adjuster came out and quickly issued an offer of $45,000. This low offer was based on a "repair" approach, suggesting only a few damaged sections of the roof needed to be patched. The adjuster's report failed to acknowledge:
Widespread damage: The hail impact had compromised the integrity of the entire TPO membrane, causing micro-fractures that would lead to future leaks across the whole roof, not just isolated spots.
Manufacturer warranty void: A partial repair would void the manufacturer’s warranty on the TPO roofing system, a critical detail not mentioned by the adjuster.
Building code compliance: Local building codes required a full tear-off and replacement if a certain percentage of the roof was damaged, a threshold the building clearly met.
Mark knew the offer was insufficient. The long-term risk of a voided warranty and future leaks made the repair option unacceptable. He realized he needed an independent expert to challenge the insurer's assessment.
L7 Claim Resolution's Role
Mark hired L7 Claim Resolution for our specialized expertise in commercial roofing claims. Our team immediately initiated a comprehensive, evidence-based process.
Detailed Scoping and Inspection: Our certified appraisers and estimators conducted a thorough, top-to-bottom inspection of the roof. We used photographic documentation, core samples, and impact analysis to prove the widespread nature of the damage. We also meticulously documented the pre-loss condition and the exact locations of hail strikes across the entire roof surface.
Expert Estimating and Documentation: We prepared a detailed, line-item estimate for a full roof replacement. Our report was based on industry-accepted pricing and standards and included costs for a full tear-off, new TPO membrane installation, insulation, and all associated labor and materials. Critically, our report also included an explicit section on the manufacturer's warranty and building code requirements, providing irrefutable evidence that a full replacement was the only valid solution. The total estimated replacement cost was $185,000.
Appraisal and Negotiation: We formally submitted our comprehensive report and estimate to the insurance company through the appraisal process. We prepared for a potential dispute by having all our documentation ready to present. During the appraisal, we were able to demonstrate to the insurance company's appraiser the long-term risk and liability associated with their initial repair plan, as well as the undeniable need for a full replacement to comply with codes and maintain the warranty.
The Outcome
Faced with our extensive documentation and expert analysis, the insurance company's appraiser acknowledged the deficiencies in their initial report. The appraisal process concluded with a final settlement of $178,000, a figure that was nearly four times the initial offer.
This settlement enabled Mark to fully replace the compromised roof with a brand new, warranted system, securing his asset and preventing future liabilities.
L7 Claim Resolution provided the expert appraisal, meticulous scoping, and strategic consulting needed to turn a frustrating and underpaid claim into a successful resolution. We ensured that Mark received the full value of his claim, protecting his investment and providing peace of mind.
Case Study: Getting Full Value for a Drunk Driver Impact Claim
Client: The Anderson Family, a family in Fort Worth, TX Claim Type: Vehicle Impact to Residential Home (Drunk Driving Incident) Initial Insurance Offer: $24,000
The Challenge
In the early hours of a Sunday morning, a drunk driver lost control of their vehicle and slammed into the front corner of the Anderson family's home. The impact was particularly devastating as it occurred directly into their young son's bedroom. The collision destroyed the exterior brick wall and frame, shattered the window, and caused extensive damage to the interior, including the collapse of a portion of the ceiling and significant damage to the walls, floor, and a closet. While their son was thankfully not in the room at the time, the emotional trauma and the damage to a child's sanctuary were immediate concerns for the family. The incident was a vivid and terrifying reminder of the danger of impaired driving.
The insurance company's initial assessment was a cursory one. The adjuster primarily focused on the most obvious, visible damage and offered a quick settlement of $24,000. This offer was based on a simple, low-cost repair of the exterior brick and a partial interior drywall replacement. It failed to account for several critical issues:
Structural Integrity: The adjuster's report did not include a structural engineer's assessment to evaluate the integrity of the home's framing and foundation, which had been compromised by the force of the impact.
Hidden Damage: The impact had caused unseen damage to the home's electrical wiring and insulation within the wall and ceiling, creating potential fire and safety hazards.
Building Code Compliance: The repairs needed to be brought up to current Fort Worth residential building codes, which included additional requirements for materials and construction methods that were not reflected in the initial estimate.
Emotional and Trauma-Related Costs: The family felt violated and deeply concerned about their son returning to a room that was once a source of comfort but now a symbol of a traumatic event. The insurer's offer did not include the full cost of a complete, high-quality restoration that would provide peace of mind and help them recover from the trauma.
Overwhelmed and distressed by the low offer and the insurer's failure to address the full scope of the damage, the Anderson family hired L7 Claim Resolution.
L7 Claim Resolution's Role
The Anderson family hired L7 Claim Resolution to provide a comprehensive, independent appraisal of the damages. Our team, with local expertise in Fort Worth construction and code requirements, took a multi-faceted and empathetic approach.
Comprehensive Scoping and Inspection: We immediately brought in a qualified structural engineer to perform a thorough analysis of the home's framing and foundation. Our appraisers used laser scanning and detailed measurements to document every aspect of the damage, both visible and hidden. We also meticulously documented the damage to interior systems, including electrical conduit and insulation, which the insurer had overlooked.
Expert Estimating and Documentation: We prepared a meticulous, line-item estimate using industry-standard software. Our estimate was far more comprehensive than the insurer's and included:
Costs for a structural engineer's full report and a plan for the repair of the structural frame.
The complete tear-down and rebuild of the damaged exterior and interior walls with materials and methods that met current Fort Worth building codes.
Full replacement of all damaged interior systems, including electrical, insulation, drywall, and custom finishes to restore the room to a comfortable and safe state for the family.
An allowance for professional cleaning and remediation of any potential unseen contaminants from the debris.
Our final estimate for the full scope of repairs totaled $115,500, supported by a thorough report, photographic evidence, and the engineer's findings.
Appraisal and Negotiation: We submitted our detailed report and estimate to the insurance company and initiated the formal appraisal process. During the appraisal, our expert appraiser was able to present irrefutable evidence of the structural damage and the full scope of work required. We demonstrated that their initial offer was based on an incomplete assessment that would have left the family with a structurally compromised and code-noncompliant home, and most importantly, a room that did not feel safe.
The Outcome
Faced with our professional, thoroughly documented, and evidence-based appraisal, the insurance company's appraiser agreed to a final settlement of $108,000. This settlement was more than four times the initial offer.
The additional funds enabled the Anderson family to perform a full and proper restoration of their home, including crucial structural repairs and code upgrades. The room was rebuilt with the highest standards of safety and care, allowing their son to return to a fully restored, safe, and comforting space.
L7 Claim Resolution provided the expert appraisal, meticulous scoping, and strategic consulting needed to turn a lowballed drunk driver claim into a successful resolution. We ensured that the Anderson family received the full value of their claim, protecting their most valuable asset and their peace of mind.
Case Study: Getting Full Value for a Water Damage Claim
Client: The Rodriguez Family, Homeowners in a Dallas, TX suburb Claim Type: Water Damage from a Burst Pipe Initial Insurance Offer: $35,854
The Challenge
The Rodriguez family discovered a major water leak in their home stemming from a burst pipe in their attic. Water had been leaking for several days, causing extensive damage to ceilings, drywall, flooring, and personal property in multiple rooms.
They filed a claim and their insurance company promptly sent an adjuster who quickly assessed the visible damage. The adjuster's report recommended a partial repair, suggesting a few sections of drywall and flooring needed replacement. The resulting offer of $35,854 was based on this limited scope and failed to account for several critical issues:
Hidden Damage and Microbial Growth: The adjuster did not fully investigate the extent of the water saturation within walls and behind cabinets, which had already led to the beginnings of mold growth.
Tear-out and Restoration: The estimate did not include the necessary costs for a full, professional tear-out of all damaged materials, as well as the specialized drying and dehumidification equipment required for proper mitigation.
Contamination and Code Upgrades: The offer did not account for the removal and replacement of contaminated materials and neglected to include costs for bringing electrical and plumbing systems up to current building codes.
Feeling overwhelmed and concerned about the low offer and potential for mold, the Rodriguez family sought professional help to ensure their home was properly restored.
L7 Claim Resolution's Role
The Rodriguez family hired L7 Claim Resolution to manage their claim, recognizing the need for an independent, expert assessment. Our team immediately initiated a detailed, step-by-step process.
Comprehensive Scoping and Inspection: Our certified appraisers conducted a thorough inspection of the property. Using moisture meters and thermal imaging cameras, we were able to map the full extent of the water intrusion, identifying saturated areas within the walls and subflooring that were not visible to the naked eye. We also documented early signs of microbial growth in a bathroom cabinet and behind the drywall.
Expert Estimating and Documentation: We prepared a comprehensive, line-item estimate using Xactimate, the same software used by most insurance companies. Our estimate was meticulous, including:
Costs for a professional mitigation company to perform a full tear-out of all wet materials and install drying equipment.
Line items for mold remediation and subsequent air quality testing.
Full replacement costs for all damaged flooring, drywall, cabinetry, and painting in the affected areas.
Necessary plumbing and electrical repairs, including code upgrades.
Our final estimate totaled $98,400, supported by extensive photos, moisture readings, and a detailed scope of work.
Appraisal and Negotiation: We submitted our detailed report and estimate to the insurance company and initiated the formal appraisal process. During the appraisal, our expert appraiser was able to present irrefutable evidence of the hidden damage and the full scope of work required. We demonstrated that their initial offer was based on an incomplete assessment and would not properly restore the home or protect the family's health and safety.
The Outcome
Faced with our professional and thoroughly documented claim, the insurance company's appraiser agreed to a final settlement of $92,587. This settlement was nearly three times the initial offer.
The additional funds allowed the Rodriguez family to hire a professional water damage restoration company to fully dry their home, remediate the mold, and complete all necessary repairs, ensuring their home was safe and restored to its pre-loss condition.
L7 Claim Resolution provided the expert appraisal, meticulous scoping, and strategic consulting needed to turn a lowballed water claim into a successful resolution. We ensured that the Rodriguez family received the full value of their claim, protecting their property and their well-being.
Case Study: Getting Full Value for an Upstairs Bathroom Water Backup Claim
Client: The Roberts Family, a family in Decatur, TX Claim Type: Sewer Backup from Upstairs Bathroom Initial Insurance Offer: $22,589
The Challenge
The Roberts family returned home to a devastating scene: a severe sewer backup from their upstairs master bathroom. The contaminated water flooded the bathroom and overflowed, causing extensive damage to the hardwood flooring on the second story. It then seeped through the ceiling, dripping down and causing significant damage to the drywall, carpet, and a sectional sofa in their first-floor living room.
They filed a claim, and the insurance company's adjuster quickly came to assess the damage. The adjuster's report recommended a basic cleaning and partial replacement of the affected areas, resulting in a lowball offer of $22,589. This offer was grossly insufficient and failed to account for several critical issues:
Biohazard Contamination: The contaminated water from the sewer backup is a biohazard. The adjuster's estimate treated the incident like a simple water leak, ignoring the need for professional biohazard cleanup, sanitization, and the safe disposal of contaminated materials. This poses a significant health risk.
Hidden Damage: The adjuster's assessment was superficial, missing the extent of the contamination that had soaked into the subflooring on the second floor and the internal structure of the ceiling and walls on the first floor. This could lead to long-term issues with mold and odor.
Loss of Contents and Living Space: The offer didn't adequately cover the cost of replacing the contaminated hardwood floors, furniture, and personal belongings. It also didn't include enough for "loss of use" to cover the family's stay in a hotel while the home was uninhabitable.
Complex Structural Repair: The damage spanned two stories. The prolonged exposure to moisture could have compromised the wooden joists and framing, requiring a more extensive and costly repair.
Feeling overwhelmed by the scope of the damage and the inadequate offer, the Roberts family hired L7 Claim Resolution to handle the complex claim on their behalf.
L7 Claim Resolution's Role
The Roberts family hired L7 Claim Resolution to provide a comprehensive, independent appraisal. Our team, with local expertise in North Texas, took a meticulous approach to ensure the family's home was fully restored and safe.
Comprehensive Scoping and Inspection: We immediately brought in a certified biohazard cleanup specialist to conduct a thorough inspection. We used specialized equipment, including moisture meters and thermal cameras, to map the full extent of the contamination. We meticulously documented every affected area on both floors, proving that the damage was far more widespread than the initial assessment.
Expert Estimating and Documentation: We prepared a comprehensive, line-item estimate using industry-standard software, including specific details for biohazard cleanup. Our estimate was far more detailed than the insurer's and included:
The full cost for a certified biohazard cleanup company to perform a professional tear-out of all contaminated materials on both floors.
Line items for professional sanitization, mold remediation, and deodorization.
Full replacement of all affected hardwood flooring on the second floor and carpet, drywall, and baseboards on the first floor.
A detailed itemization of all contaminated personal property with replacement values.
A proper calculation for "loss of use" to cover the family's temporary living expenses.
Our final estimate for the full scope of repairs and losses totaled $165,500, supported by extensive photos and a detailed report from the biohazard specialist.
Appraisal and Negotiation: We submitted our detailed report to the insurance company and initiated the formal appraisal process. During the appraisal, our expert appraiser was able to present irrefutable evidence of the biohazard and the full scope of work required. We demonstrated that their initial offer would have left the family with a contaminated and unsafe living environment, creating future health risks and legal liabilities.
The Outcome
Faced with our professional, thoroughly documented, and evidence-based appraisal, the insurance company's appraiser agreed to a final settlement of $158,154. This settlement was more than seven times the initial offer.
The additional funds allowed the Roberts family to hire a professional biohazard remediation company to perform a full and proper cleanup and restoration. They were able to replace their contaminated belongings and live comfortably in a hotel while the work was completed, with the peace of mind that their home was now safe.
L7 Claim Resolution provided the expert appraisal, meticulous scoping, and strategic consulting needed to turn a lowballed sewer backup claim into a successful resolution. We ensured that the Roberts family received the full value of their claim, protecting their property and their well-being.