Is it insurance fraud?

Anonymous · ‎09-08-2009

As a new homeowner, I have run into a question of legality and ethics with my homeowners' insurance. DH and I had a major plumbing issue, and filed a claim with insurance. They had an independent adjuster come out to get an estimate. It looks like his estimate will be much higher than our actual cost. What do we do? Do we just tell our insurance company exactly how much we had to spend, or do we accept the larger amount? This particular issue comes with a $5000 limit per year, so we know that if anything else came up, we would not be able to make a new claim, but we could use the remainder of the insurance for that. What is the right thing to do here?

Any advice?

MidnightVoice · ‎09-08-2009

Will they give you a check or do you submit the bill?

The slide from grace is really more like gliding
And I've found the trick is not to stop the sliding
But to find a graceful way of staying slid

Anonymous · ‎09-08-2009

I believe they will give us a check, as we have already submitted our estimates. We even told the insurance adjuster that we have spare floor tiles so that they will not have to cover retiling our entire house, but we are not sure what he will put in his estimate. We have been honest the entire time, but it still feels wrong if we get more than we paid.

Uborrow-Upay · ‎09-09-2009

Hi, mrscharlie! Congrats on the new home!

About three years ago, I had a similar situation, and I felt the same way then as you do now.

Maybe this is a rationalization, or maybe not. But not all of the costs of a claim appear on invoices, there are also the costs for your time and inconvenience, as well as for loss of use of your property while it was being repaired. From the time you discovered the plumbing issue, think of everything you've had to go through to get the problem fixed, including any time off from work, time spent waiting for contractors or estimators, obtaining the estimates, filing the claims, using other facilities while yours were being repaired, etc., etc.

If you take those factors into account, the check they'll send is probably less than you deserve.

Keep the check.

plasticman · ‎09-09-2009

@Uborrow-Upay wrote:
Hi, mrscharlie! Congrats on the new home!

About three years ago, I had a similar situation, and I felt the same way then as you do now.

Maybe this is a rationalization, or maybe not. But not all of the costs of a claim appear on invoices, there are also the costs for your time and inconvenience, as well as for loss of use of your property while it was being repaired. From the time you discovered the plumbing issue, think of everything you've had to go through to get the problem fixed, including any time off from work, time spent waiting for contractors or estimators, obtaining the estimates, filing the claims, using other facilities while yours were being repaired, etc., etc.

If you take those factors into account, the check they'll send is probably less than you deserve.

Keep the check.

+1

Excellent points Uborrow-Upay!

Anonymous · ‎09-18-2009

Thanks for your responses, and you are definitely correct that the money we (hope to) receive will not begin to cover our time, etc. We were home on bereavement after the loss of DH's stepmom when this happened. We were barely able to get out of bed that day, and then this... So I will agree NOT to feel guilty when/if we get a fat check!!

Thanks, all!

Message Edited by mrscharlie on 09-18-2009 08:43 AM

Uborrow-Upay · ‎09-18-2009

Very sorry to hear of your loss, you have my condolences.

I hope all works out well for you and your family in the future.

Take care.