I apologize in advance for the long post, but there is a lot to unpack here.
I am at a point where I am frustrated enough to reach out to the collective that is the OB for an insurance issue we are currently dealing with in hopes that someone has some experience or expertise with third-party insurance.
Back in January, we purchased new appliances for our kitchen from Costco. Several weeks after having them installed we observed a weird stain at the bottom base of the cabinet next to the dishwasher. At first, it appeared like something our kids had spilled so we wiped it up and went about our business. A week later we observed the same stain in the same spot and wondered if we had a water leak from the dishwasher. We hadn't observed any water coming out from the bottom of the dishwasher.
We contacted Costco and they sent the company that installed it to verify the leak. He determined that the leak was due to a crack in the basket of our brand-new dishwasher. Costco then sent a GE service technician out to confirm, and he was able to determine it was a manufacturing defect.
At this point, GE initiated a damage claim and instructed us to proceed with getting water damage remediation, as well as finding a contractor that could perform the repairs. Based on recommendations from some friends and neighbors, as well as posters here on the OB we settled on Austin Hi-Tech Restoration. They came out quickly identified the damage and began the water remediation. They then sent out their adjuster to assess the damage and what would need to be repaired or replaced. This all went smoothly with no issues.
GE is using a third-party company called Sedgwick based in NC. They let us know if the estimate exceeded $15K that they would need to send a separate independent adjuster out to confirm the damages included in the estimate provided by Austin Hi-Tech Restoration. When this adjuster came out he agreed with the prior assessment, with one exception. He said he could only quote the damages that he could visibly confirm. Austin Hi-Tech Restoration included repairing our flooring where several wood panels were removed, the drywall, baseboards, and full cabinet replacement, as our cabinets are 17 years old and can't be matched. He mentioned that during the demo and removal of our old cabinets, there is a good chance that our quartz countertops and kitchen backsplash will be damaged.
In a normal first-party home insurance situation we would proceed with the initial estimate and include replacement of the countertops and backsplash in a supplemental if they are damaged. Sedgwick sent us their final estimate which includes cabinet replacement and repairing the flooring, drywall, and baseboards. It also included a letter for us to sign and notarize releasing GE/Haier of any future liability. If we sign this letter to release the check for the repairs included in the estimate and our countertops or backsplash are damaged removing the old cabinets we would be on the hook for that cost. We asked Sedgwick about supplemental payments to cover this and they stressed they would make one payment only, with no possibility of a supplemental amount to cover anything that comes up not included in the estimate. She then clarified that they would cover all of these costs if we wanted to wait until all of the work was completed and receive reimbursement on the back end. This isn't possible, as Austin Hi-Tech Restoration would work on the draws from the insurance company. They won't just do all the work upfront and take final payment when the work is completed. This means we would have to front all the repair costs and wait to be reimbursed when all of the work has been completed.
For anyone who has worked with a third-party insurance in a situation like this, or happens to be an insurance adjuster, is this standard practice? Again, sorry for the long post, but there was a lot to cover.
I am at a point where I am frustrated enough to reach out to the collective that is the OB for an insurance issue we are currently dealing with in hopes that someone has some experience or expertise with third-party insurance.
Back in January, we purchased new appliances for our kitchen from Costco. Several weeks after having them installed we observed a weird stain at the bottom base of the cabinet next to the dishwasher. At first, it appeared like something our kids had spilled so we wiped it up and went about our business. A week later we observed the same stain in the same spot and wondered if we had a water leak from the dishwasher. We hadn't observed any water coming out from the bottom of the dishwasher.
We contacted Costco and they sent the company that installed it to verify the leak. He determined that the leak was due to a crack in the basket of our brand-new dishwasher. Costco then sent a GE service technician out to confirm, and he was able to determine it was a manufacturing defect.
At this point, GE initiated a damage claim and instructed us to proceed with getting water damage remediation, as well as finding a contractor that could perform the repairs. Based on recommendations from some friends and neighbors, as well as posters here on the OB we settled on Austin Hi-Tech Restoration. They came out quickly identified the damage and began the water remediation. They then sent out their adjuster to assess the damage and what would need to be repaired or replaced. This all went smoothly with no issues.
GE is using a third-party company called Sedgwick based in NC. They let us know if the estimate exceeded $15K that they would need to send a separate independent adjuster out to confirm the damages included in the estimate provided by Austin Hi-Tech Restoration. When this adjuster came out he agreed with the prior assessment, with one exception. He said he could only quote the damages that he could visibly confirm. Austin Hi-Tech Restoration included repairing our flooring where several wood panels were removed, the drywall, baseboards, and full cabinet replacement, as our cabinets are 17 years old and can't be matched. He mentioned that during the demo and removal of our old cabinets, there is a good chance that our quartz countertops and kitchen backsplash will be damaged.
In a normal first-party home insurance situation we would proceed with the initial estimate and include replacement of the countertops and backsplash in a supplemental if they are damaged. Sedgwick sent us their final estimate which includes cabinet replacement and repairing the flooring, drywall, and baseboards. It also included a letter for us to sign and notarize releasing GE/Haier of any future liability. If we sign this letter to release the check for the repairs included in the estimate and our countertops or backsplash are damaged removing the old cabinets we would be on the hook for that cost. We asked Sedgwick about supplemental payments to cover this and they stressed they would make one payment only, with no possibility of a supplemental amount to cover anything that comes up not included in the estimate. She then clarified that they would cover all of these costs if we wanted to wait until all of the work was completed and receive reimbursement on the back end. This isn't possible, as Austin Hi-Tech Restoration would work on the draws from the insurance company. They won't just do all the work upfront and take final payment when the work is completed. This means we would have to front all the repair costs and wait to be reimbursed when all of the work has been completed.
For anyone who has worked with a third-party insurance in a situation like this, or happens to be an insurance adjuster, is this standard practice? Again, sorry for the long post, but there was a lot to cover.
