Two wks ago, Our homeowners insurance denied our claim after our entire kitchen was torn out and gutted by contractors.

Question

The restoration company led us to believe that our insurance policy included coverage for damages.  We called our insurance co and a plumber when we noted the leak.  Insurance co. was there within hrs. and asked to see insurance policy.  He began quoting dollar figures that we would be compensated for even down to receipts for food, etc.  Owner signed the work authorization on a tablet but didn't receive a paper copy.  Contractors started work the next day.  A week later, we were informed by insurance that they were sending a letter that our claim was denied due to the damage being long term.   Plumbers Report stated damage due to short term.  We are elderly and live on fixed income.  We have no means to pay for what was done.

Delaram Keshvarian · Answer

You need to have a lawyer write a demand letter to the insurance co. The attorney needs to see if the repair was covered and if there is a bad faith in rejecting the request.  
 
The attorneys can work on contingency or hourly rate.

James L. Arrasmith · Answer

This is a complex situation that involves multiple areas of law, including insurance, contract, and potentially elder law. Here's a breakdown of the key issues and some potential steps you might consider: 
 
1. Insurance Claim Denial: 
   - Review your insurance policy carefully to understand your coverage. 
   - Request a detailed explanation of the denial in writing from your insurance company. 
   - Compare the plumber's report (indicating short-term damage) with the insurance company's reasoning for denial (long-term damage). 
 
2. Potential Bad Faith Claim: 
   - The insurance company's initial behavior (quoting compensation figures) followed by denial could potentially be grounds for a bad faith claim. 
   - Document all communications with the insurance company, including dates, times, and content of conversations. 
 
3. Contract with Restoration Company: 
   - Request a copy of the work authorization you signed. 
   - Review the terms carefully, especially regarding payment responsibility. 
   - Determine if the restoration company misrepresented your insurance coverage. 
 
4. Elder Law Considerations: 
   - As elderly individuals, you may have additional protections under California law. 
   - Consider if there was any exploitation or undue influence in the contracting process. 
 
5. Potential Next Steps: 
   - File a complaint with the California Department of Insurance. 
   - Consult with an attorney specializing in insurance bad faith and/or elder law. 
   - Consider mediation or arbitration with the insurance company and/or restoration company. 
   - If necessary, explore legal action against the insurance company or restoration company. 
 
6. Financial Considerations: 
   - Explore options for financial assistance or payment plans with the restoration company. 
   - Consider seeking help from local elder services organizations. 
 
Given the complexity of your situation and the potential financial impact, it would be advisable to consult with an attorney who specializes in insurance bad faith and elder law. They can provide more specific guidance based on the details of your case and help protect your rights.

Q: Two wks ago, Our homeowners insurance denied our claim after our entire kitchen was torn out and gutted by contractors.