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Insurance Question HELP please

Kaos

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Insurance Question HELP please
« on: March 07, 2016, 09:12:10 PM »
Ok. Here's the situation. 

Friend had some roof damage.  Adjuster looked at it.  Estimated repairs at 11,500 incliding new roof and some interior painting.  So she got a check for like $3750. There's a recoverable depreciation amount of $2000 listed in their report.  Her deductible is 5900. 

Got a roofing guy to look at the house.  He said he'd do the roof for $9500 cash.   No paint work. 

He comes over tonight to get her to sign the contract and I just happened to be there.  He starts double talking (I think).  Says she's just $150 from meeting her deductible. So he says if she'll give him $150 more he will do all the painting too (which is honestly probably a $300 job, its not much) and he will handle all the paperwork with the insurance company.  He will bill the insurance company the entire $11,500 and when she gets the recoverable depreciation check she can just sign it right on over to him.

She was about to do it until I told him to hold on a blue fucking minute  Wasn't that recoverable depreciation hers?  He says yeah but the insurance company doesn't like to give it back and he knows he can get it.  He will just take care of it.  No worries.  And he shoved a contract in front of her again. Said he was an honest guy and was trying to help. Would really hate to see her come that close to her deductible and not make it.   

I told him I'd hate for him to get 2150 for a 300 paint job.   He said I wasn't understanding. I told him she wasn't signing a damn thing until we had time to check it out. So he left mad. 

Since he left he called and texted my friend three or four times.  Sorry if he was confusing. Look, if the extra $150 is a problem, he can convince the company to just eat that and call it even.  They'll still do the paint work, no hard feelings.  Just sign that recoverable check over whenever it comes. No rush, they will do the work even before it comes in. He's sure he can make that happen.

I don't know all of the deal with the recoverable. 

If she does the job for less (and does it all, paint included with another outfit) will she get some or all of that recovered back to HER?  Everything I've read so far says that money belongs to the homeowner, not some roofing outfit that's trying to run a shell game on somebody.

I felt like he was trying to hustle her for the extra $2000. 

Modified: 

Here's how I think it works.  The insurance company estimated $11,500.  They sent her a check for $3750. She's responsible for her deductible -- $5900.   But that's only $9650.  There's still an approximately $2000 gap in there, which is recoverable AFTER the repairs are done.  So she spends her $5900 and their $3750.  And the gets the painting done for $400.  She can claim that $400 against the $2000.  Basically anything she spends above the deductible (and their first check) she can claim and be reimbursed.  But she CAN'T request the whole amount back or it's insurance fraud, right?  If that's the case, she's just keeping this roofing guy from screwing the insurance company over for the $2000.
« Last Edit: March 07, 2016, 09:44:02 PM by Kaos »
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Godfather

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Re: Insurance Question HELP please
« Reply #1 on: March 08, 2016, 10:14:03 AM »
Modified: 

Here's how I think it works.  The insurance company estimated $11,500.  They sent her a check for $3750. She's responsible for her deductible -- $5900.   But that's only $9650.  There's still an approximately $2000 gap in there, which is recoverable AFTER the repairs are done.  So she spends her $5900 and their $3750.  And the gets the painting done for $400.  She can claim that $400 against the $2000.  Basically anything she spends above the deductible (and their first check) she can claim and be reimbursed.  But she CAN'T request the whole amount back or it's insurance fraud, right?  If that's the case, she's just keeping this roofing guy from screwing the insurance company over for the $2000.

This is correct.  He is trying to make an extra 2 grand. Of course it also depends on how he bills her.  If he is billing the insurance company 11,500 and is only going to bill her 9,500.  But I don't know that I would trust him.

In a perfect world  you want to have a company come in and give you a cost of $11,500 the deductible is $5,900 and the insurance company gives you a check for $5,600 the difference.  Then you go and have the roof repaired for $9,500 and you are only out of pocket $3,900.

What you need is a roofing friend.  Also I hope you get some pussy from all these desperate female friends you try to help out.
« Last Edit: March 08, 2016, 10:20:23 AM by Godfather »
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Kaos

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Re: Insurance Question HELP please
« Reply #2 on: March 08, 2016, 10:18:50 AM »
This is correct.  He is trying to make an extra 2 grand.

But there's no way that money is coming back to her except as invoiced expenses for work done no matter what we do.  Is that also correct? 

He made it sound like it was "her" money and he was just going to take it. 
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Godfather

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Re: Insurance Question HELP please
« Reply #3 on: March 08, 2016, 10:23:49 AM »
But there's no way that money is coming back to her except as invoiced expenses for work done no matter what we do.  Is that also correct? 

He made it sound like it was "her" money and he was just going to take it.

Well yes and no, it depends on whether you trust the guy or not.  I appended my previous reply.

If he bills the insurance company/her $11,500 but really only wants $9,500 then in theory he would be fake invoicing her 11,500 so that she would get whatever was over the 9,650 so.

Invoice to insurance -11,500
Insurance deductible -5,900 (she pays)
Insurance pays - 3,750
Insurance overage - 1,850

If you trust him in reality her bill is 9500
He bills her 7,650
And she signs over the check to him. Out of pocket to her is 3,900

My biggest problem with this is again if you trust the guy. He could potentially renig and say she owes him the full 11,500 and you wouldn't really have much recourse.
« Last Edit: March 08, 2016, 10:41:40 AM by Godfather »
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Pell City Tiger

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Re: Insurance Question HELP please
« Reply #4 on: March 08, 2016, 10:54:40 AM »
My biggest problem with this is again if you trust the guy. He could potentially renig and say she owes him the full 11,500 and you wouldn't really have much recourse.
This! My wife's niece was recently clipped in such a manner by a roofing guy she has known practically all her life. To top it off, he fucked her roof up which resulted in a leak and subsequent mold issue.

If the proposal caused your spidey senses to tingle, I would heed them and recommend to your friend to find someone else.
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Kaos

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Re: Insurance Question HELP please
« Reply #5 on: March 08, 2016, 10:59:30 AM »
Well yes and no, it depends on whether you trust the guy or not.  I appended my previous reply.

If he bills the insurance company/her $11,500 but really only wants $9,500 then in theory he would be fake invoicing her 11,500 so that she would get whatever was over the 9,650 so.

Invoice to insurance -11,500
Insurance deductible -5,900 (she pays)
Insurance pays - 3,750
Insurance overage - 1,850

If you trust him in reality her bill is 9500
He bills her 7,650
And she signs over the check to him. Out of pocket to her is 3,900

My biggest problem with this is again if you trust the guy. He could potentially renig and say she owes him the full 11,500 and you wouldn't really have much recourse.

The two options he presented to her:

1) Do the roof only for $9500, OR,

2) She gives him $9650 and signs the recoverable check over to him. Then she gets the roof and the paint work. 

He kept saying, "you're not going to get this ceiling painted for $150, I can tell you that for sure."   

He's already called me this morning with the same line of shit.  He's just an honest guy trying to help her out and have her avoid some paperwork.  When she can get the ceiling painted for just $150?  That's a steal and she'd be a fool not to let him do it. 

I called him a motherfucker and said it would be a shame for him to get $2150 to paint a ceiling.  He wasn't happy with me at all. 

Maybe I'm being a dick, but that seems shady to me.  She definitely doesn't want him or anybody else turning in an $11,500 bill for work that was quoted at $9500.  She is an honest person.   

I'd rather get a legit estimate to have the roof and painting done separately than let him scam  $2150, no matter whether he's scamming her or the insurance company. 

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Godfather

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Re: Insurance Question HELP please
« Reply #6 on: March 08, 2016, 11:31:01 AM »
The two options he presented to her:

1) Do the roof only for $9500, OR,

2) She gives him $9650 and signs the recoverable check over to him. Then she gets the roof and the paint work. 

He kept saying, "you're not going to get this ceiling painted for $150, I can tell you that for sure."   

He's already called me this morning with the same line of shit.  He's just an honest guy trying to help her out and have her avoid some paperwork.  When she can get the ceiling painted for just $150?  That's a steal and she'd be a fool not to let him do it. 

I called him a motherfucker and said it would be a shame for him to get $2150 to paint a ceiling.  He wasn't happy with me at all. 

Maybe I'm being a dick, but that seems shady to me.  She definitely doesn't want him or anybody else turning in an $11,500 bill for work that was quoted at $9500.  She is an honest person.   

I'd rather get a legit estimate to have the roof and painting done separately than let him scam  $2150, no matter whether he's scamming her or the insurance company.
I don't disagree.  That's why I said:

Quote
In a perfect world  you want to have a company come in and give you a cost of $11,500 the deductible is $5,900 and the insurance company gives you a check for $5,600 the difference.  Then you go and have the roof repaired for $9,500 and you are only out of pocket $3,900.

Because to me the above isn't scamming, you got a quote for 11,500 you just got a better price.
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Godfather

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Re: Insurance Question HELP please
« Reply #7 on: March 08, 2016, 11:50:25 AM »
I don't know all of the deal with the recoverable. 

If she does the job for less (and does it all, paint included with another outfit) will she get some or all of that recovered back to HER?  Everything I've read so far says that money belongs to the homeowner, not some roofing outfit that's trying to run a shell game on somebody.

I felt like he was trying to hustle her for the extra $2000. 

Modified: 

Here's how I think it works.  The insurance company estimated $11,500.  They sent her a check for $3750. She's responsible for her deductible -- $5900.   But that's only $9650.  There's still an approximately $2000 gap in there, which is recoverable AFTER the repairs are done.  So she spends her $5900 and their $3750.  And the gets the painting done for $400.  She can claim that $400 against the $2000.  Basically anything she spends above the deductible (and their first check) she can claim and be reimbursed.  But she CAN'T request the whole amount back or it's insurance fraud, right?  If that's the case, she's just keeping this roofing guy from screwing the insurance company over for the $2000.

I also went back and re-read your entire post again, because I glossed over the part of the recoverable.  I also thought you got a quote of 11,500 not the adjuster.  So the Adjuster said Actual Cash Value was 11,500, but they only gave her 3,750 and she has a deductible of 5,900 means that they depreciated the roof by the sum of 1,850.

My understanding is if she has a recoverable depreciation clause in her contract in order to get that 1,850 she would have to have the roof fixed at the adjusters amount or over.  So he was trying to scam her big time.

Here is an example:
A home is insured for $100,000 and has completely damaged its roof due to a tornado. The cost to replace the roof (Replacement Cost Value) is $10,000. Let’s say the roof is 20 years old and the policy owner’s deductible is $1,000.

The insurance adjuster is going to depreciate the roof based on age, so let’s say 20%, making the Actual Cash Value of the roof $10,000 – $2,000 depreciation = $8,000

The recoverable depreciation would be the Replacement Cost Value – Actual Cash Value = $7,000 after the deductible is applied.

The insurance company will make a payment to the policy owner for $7,000 actual cash value towards replacing the roof.

After the roof has been replaced for the full Replacement Cost Value of $10,000 and the insurance company receives the invoice, they will release the recoverable depreciation of $2,000 to be reimbursed to you.
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Snaggletiger

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Re: Insurance Question HELP please
« Reply #8 on: March 08, 2016, 12:05:37 PM »
What GF said.  Especially the part about him trying to scam her and the insurance company.
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Re: Insurance Question HELP please
« Reply #9 on: March 08, 2016, 12:15:36 PM »
What GF said.  Especially the part about him trying to scam her and the insurance company.
He stays awake worrying about this, so he knows.
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Kaos

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Re: Insurance Question HELP please
« Reply #10 on: March 08, 2016, 12:29:34 PM »
I also went back and re-read your entire post again, because I glossed over the part of the recoverable.  I also thought you got a quote of 11,500 not the adjuster.  So the Adjuster said Actual Cash Value was 11,500, but they only gave her 3,750 and she has a deductible of 5,900 means that they depreciated the roof by the sum of 1,850.

My understanding is if she has a recoverable depreciation clause in her contract in order to get that 1,850 she would have to have the roof fixed at the adjusters amount or over.  So he was trying to scam her big time.

Here is an example:
A home is insured for $100,000 and has completely damaged its roof due to a tornado. The cost to replace the roof (Replacement Cost Value) is $10,000. Let’s say the roof is 20 years old and the policy owner’s deductible is $1,000.

The insurance adjuster is going to depreciate the roof based on age, so let’s say 20%, making the Actual Cash Value of the roof $10,000 – $2,000 depreciation = $8,000

The recoverable depreciation would be the Replacement Cost Value – Actual Cash Value = $7,000 after the deductible is applied.

The insurance company will make a payment to the policy owner for $7,000 actual cash value towards replacing the roof.

After the roof has been replaced for the full Replacement Cost Value of $10,000 and the insurance company receives the invoice, they will release the recoverable depreciation of $2,000 to be reimbursed to you.

See, this is where I'm getting lost. 

She has a quote to have the roof done for $9500 by this roofing company.   
Adjuster said the cost of the repairs (including painting) should be $11,500. 
They depreciated it by about $2000 and are holding that.  They paid her $3750. 
She's come up with $5750 in cash.

So if she pays her $5750 plus the $3750 from the insurance company and gets the roof done for $9500 and then she gets another painting company to come do the ceiling paining for $500 which of the following would apply:

1) The insurance company releases the entire (approx) $2000 to her once they inspect the repairs

2) The insurance company gives her $350 of the $500 she spent on the painting (which deducts the $150 she still lacks to meet her deductible)

3) The insurance company rebates her the difference between what she actually spent ($10,000) and what they estimated the repairs to cost ($11,500) and she gets a check for $1500. 

« Last Edit: March 08, 2016, 12:34:16 PM by Kaos »
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CCTAU

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Re: Insurance Question HELP please
« Reply #11 on: March 08, 2016, 12:30:41 PM »
but truthfully, if you get the roof replaced and the deductible is included in the roof replacement price by the roofer, why do you care? You got a new roof for no out of pocket.
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2. What one person receives without working for, another person must work for without receiving.
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5. When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that my dear friends, is the beginning of the end of any nation.

Snaggletiger

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Re: Insurance Question HELP please
« Reply #12 on: March 08, 2016, 12:30:53 PM »
He stays awake worrying about this, so he knows.

Actually, I worked for an insurance company in claims for 15 years.  But, I do worry....about your worries.
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Kaos

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Re: Insurance Question HELP please
« Reply #13 on: March 08, 2016, 12:32:18 PM »
but truthfully, if you get the roof replaced and the deductible is included in the roof replacement price by the roofer, why do you care? You got a new roof for no out of pocket.

Nope. Not the case at all. 
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Kaos

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Re: Insurance Question HELP please
« Reply #14 on: March 08, 2016, 12:33:06 PM »
Actually, I worked for an insurance company in claims for 15 years.  But, I do worry....about your worries.

So can you and GF review the scenario options above?  Because all my nerve fibers are telling me this guy is trying to get over on her. 
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Re: Insurance Question HELP please
« Reply #15 on: March 08, 2016, 12:40:56 PM »
Nope. Not the case at all.

OK. I see where her deductible is $5900.

So yes, whatever money is paid extra by the insurance company should go back to her since her deductible has not be covered.

Who the hell has a $5900 deductible?
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Five statements of WISDOM
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2. What one person receives without working for, another person must work for without receiving.
3. The government cannot give to anybody anything that the government does not first take from somebody else.
4. You cannot multiply wealth by dividing it.
5. When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that my dear friends, is the beginning of the end of any nation.

Godfather

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Re: Insurance Question HELP please
« Reply #16 on: March 08, 2016, 12:44:22 PM »
See, this is where I'm getting lost. 

She has a quote to have the roof done for $9500 by this roofing company.   
Adjuster said the cost of the repairs (including painting) should be $11,500. 
They depreciated it by about $2000 and are holding that.  They paid her $3750. 
She's come up with $5750 in cash.

So if she pays her $5750 plus the $3750 from the insurance company and gets the roof done for $9500 and then she gets another painting company to come do the ceiling paining for $500 which of the following would apply:

1) The insurance company releases the entire (approx) $2000 to her once they inspect the repairs

2) The insurance company gives her $350 of the $500 she spent on the painting (which deducts the $150 she still lacks to meet her deductible)

3) The insurance company rebates her the difference between what she actually spent ($10,000) and what they estimated the repairs to cost ($11,500) and she gets a check for $1500.

She needs to look at her policy or call the insurance company.  My understanding is in order to get the 2,000 she would have to spend 11,500. 

I am about 95% sure #1 & #3 don't apply, if you pay less and don't get the money at the beginning.. without a modified invoice, insurance is not going to give you more money, for something you paid less for. 

I am not sure if with a recoverable depreciation clause they give you money spent over the deductible and payment (option #2)
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Re: Insurance Question HELP please
« Reply #17 on: March 08, 2016, 12:52:14 PM »
So can you and GF review the scenario options above?  Because all my nerve fibers are telling me this guy is trying to get over on her. 

Like I said he was going to bill the insurance company 11,500 (of that I have no doubt).  The question is whether or not he intended to only bill her 9,650. 

Like I said he was either going to:
Option 1-  only charge her 7,650 and then have her sign the check over (which is dishonest but obviously would help her) or
Option 2- he was planning on charging her 9,650 and then signing the check over, which obviously gigs her for an additional 2,000.

I believe he was trying to do option 1, however you have that whole fraud thing and he could also come back and sue her saying that she owes him 11,500 and only paid 9,650 and she really wouldn't have any recourse.
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Kaos

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Re: Insurance Question HELP please
« Reply #18 on: March 08, 2016, 01:11:02 PM »
She needs to look at her policy or call the insurance company.  My understanding is in order to get the 2,000 she would have to spend 11,500. 

I am about 95% sure #1 & #3 don't apply, if you pay less and don't get the money at the beginning.. without a modified invoice, insurance is not going to give you more money, for something you paid less for. 

I am not sure if with a recoverable depreciation clause they give you money spent over the deductible and payment (option #2)

Yeah.  That's what I figured.  I've got the policy, but it's vague (intentionally perhaps).

So her options are:
a) Get this guy to do it all and he rakes up the $2k

b) tell him to go fuck himself and see if she can find somebody to do the roof for less than he estimated and keep the difference

c) let him do the roof for what he quoted, pay for the painting herself and file a claim against the recoverable depreciation herself expecting to get some portion of that back

d) Get this guy to do the roof and somebody else to bogus up the painting invoices (do it for $300 bill for $2500 and then split the money). 

Just because of the way this guy tried to handle it, I'm inclined to tell him he lost the job and can suck it.

Apex Roofing.  Just so you know. 
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« Last Edit: March 08, 2016, 01:26:51 PM by Godfather »
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