Common Reasons Insurance Companies will deny your Claim
Here we will discuss the two most common negative responses you will run into with your insurance adjuster. It will be a great help to you to be prepared with logical responses to these denials.
#1 – “Bat, skunk or racoon are a pest control problem”
Most insurance companies will refuse to cover pest or vermin problems. One agent considering a bat exclusion claim said “I’ve had cases with rodents and termites that fall into this category.” But can bat, skunk or racoon be included in the term ‘vermin’ or even ‘pests’? The definition of ‘vermin’ in the American Heritage Dictionary reads “any of various small animals or insects that are destructive, annoying, or injurious to health.” At first glance it may seem easy to classify bat, skunk or racoon as vermin and feel defeated in your effort to have your exclusion work covered by your policy. However, there is much debate concerning whether or not bat, skunk or racoon can be considered vermin or pests. Here I will explain why bat, skunk or racoon are absolutely not vermin and do not come under the ‘pest control’ clause in your insurance policy. First, to classify bat or racoon with pests and vermin is to place them in a creature line up with rats, mice, cockroaches and fleas. When pests and vermin take over your home and you bring in a pest control specialist, typically the way the pest problem is handled is by exterminating the animals. That is the typical and generally accepted method of handling the issue with pests. Contrary to that, to handle a bat problem by destroying the animals is illegal. Many bat, skunk or racoon are protected under the law as endangered or as a ‘protected species’. Have you ever run into a protected species of cockroach or rat? Not likely. The Virtual University’s faculty members currently argue that bat or racoon cannot fall under the category of vermin. In an article written by Bill Wilson of VU he states “Dictionaries cannot agree on what types of creatures the word ‘vermin’ includes. Courts invariably conclude that if a term has more than one reasonable meaning then it’s ambiguous.” Legally any term that is considered to be ambiguous cannot be used to deny coverage. This is a legitimate argument that homeowners and attorneys can use to get the coverage you are owed. Not all animals are considered vermin under insurance policies. For example, damage from domestic animals generally is not covered, but the policy will leave room for damage done by wild animals. In fact, the HO-3 reads, “We do not insure for loss caused by animals owned or kept by an ‘insured.’” This makes a distinction between wild and domestic animals. For example, my father’s rental property was damaged when a wild bear entered into the kitchen. The insurance company covered the damage. This is because the bear damage was clearly not a result of maintenance or neglect. Obviously the bear was not considered a “vermin” and bat or racoon are no different. They are wild mammals that are protected by law.
#2 – “Bat or racoon are a maintenance problem”
Many insurance companies will also try to deny a claim saying that the bat infestation is a maintenance issue. An insurance agent said concerning this, “Compare a bat infestation to a roof problem. The homeowners let the roof wear out. If there is a hole in your house, it is your responsibility to fix it.” The claim that a bat infestation is a maintenance problem is completely false. One adjuster said that to determine how much the company would cover he would need to know how old the house was. He said this was the most serious issue in determining how much the policy would cover. This would suggest that an older home is more likely to have an infestation than newer homes because of the possible disrepair on an aged house. That is not true. Many times even brand new homes will have an infestation problem. This is because of home constructers being unaware of the risk of bat or racoon and knowing very little about how to protect the home they are building from developing a bat problem. Many houses are designed in ways that make them perfect for bat or racoon to find their way in. Roofs are a particular favorite doorway for bat or racoon. Tiny holes that can be unnoticeable from the ground, work as perfect pathways to the bat or racoon, and an easy entrance into your ceiling or attic. If you are having work done on your roof it is very useful to have your roofer sign off on a guarantee that the roof is bat proof. This can offer you future financial protection if you do develop a bat infestation. Another common house design issue that allows for bat or racoon to enter easily is the various vents throughout a home. These vents or openings are in place for ventilation purposes and are necessary to the health of the occupants, but without appropriate screens in place they are an easily missed way to invite a bat colony into your home. When we consider that even a new house can have a bat infestation it can reasonably be said that it cannot be called a maintenance issue. Bat or racoon like dark places to roost and they never want to be alone. Any home with walls, an attic or rafters looks like a roost to a bat. They are not picky about new construction or old, and when they choose your place for their home it is simply a case of your home being in the right place at the right time for them. Insurance companies need to understand this. Any home that has a bat infestation needs bat exclusion to handle the problem immediately and properly.
How Bat Exclusion Saves Insurance Company’s Money
Consider this example:
Windshield repair is one way in which insurance companies can save money by providing additional coverage. For many years, insurance companies did not repair cracked windshields. This was primarily because the repair costs exceeded the deductible. When windshield damage worsened, however, the insurance companies covered the replacement costs. As a result, they lost money. They spent more money replacing windshields than they would have repairing the damaged windshields. Nowadays, insurance companies generally cover smaller damages to windshields to prevent paying total replacement costs. This saves the insurance company money in the long run. The same concept should be applied to bat cases. Insurance companies will lose money in the long run by not covering the costs of bat exclusion. When the damage becomes worse, insurance companies will need to pay more to cover the incredible costs. Covering the basic costs of bat exclusion is beneficial to insurance companies.
Helpful Hints When Dealing with Insurance Companies
Stay Positive – Stay Professional
When you call your insurance company initially, keep a positive outlook in mind. You have a genuine reason to be concerned over the bat situation and you have every right to stand up for the coverage you deserve and need. Your determination should be obvious but it should be tempered with a professional manner. Assuming that you may have to fight to get the coverage that you want may make you feel as though you need to be aggressive or rude. Handling the situation calmly and positively will go much further in getting a good response. Remember too, that some insurance companies are fully willing to cover bat exclusion work. There would be no reason to approach the conversation with an agent aggressively if they are going to be agreeable to covering the claim from the beginning anyway.
Knowledge is your Greatest Tool
Once you have read this book you will be fully equipped with the knowledge that you need to approach your insurance company. Once again, your insurance agent is a sales person not a bat expert. Speak confidently to the agent remembering that you have become the more knowledgeable one on the facts surrounding bat exclusion.
Letters can be Powerful
A written statement is something that an insurance company must take seriously. It is something that will be filed in with your claim and cannot be disputed or misrepresented like a phone conversation could be. A well written letter can deliver a clear message to the agency concerning the liability risks the company could be facing if they refuse to cover costs. Again, when writing a letter, remember to be professional and knowledgeable. Never be threatening or use foul language to get your points across. Keep a copy of the letters you write.
Be Persistent
Persistence is more useful than aggression. Speak respectfully to the agent, and if you cannot seem to get anywhere, end the conversation and call again another day. Ask to speak to different employees; don’t get stuck with one person over and over again. Write your letter and then call to make sure they received it. Your agent can make it seem as though the case is closed and your claim has been denied. Your persistence will make sure they know the issue has not been settled. This can be frustrating, but succumbing to unprofessional behavior could damage your chances of receiving the coverage you are fighting so hard to get. On the other hand, well thought out persistence pays.
Summary
You now have all of the knowledge you need to be convinced and convincing when presenting your claim to the insurance agency. Now I will provide you with my successful step by step guide to convincing your insurance agency to pay for bat exclusion costs. By following these proven guidelines you can save yourself thousands of dollars and get the coverage that is rightfully yours.
