Skip to content
Final Settlement: $30,000
Initial Incident
Our client believed she purchased a homeowners policy with strong Coverage A (dwelling) protection — only to find out too late that the coverage was riddled with hidden limitations. After discovering a water leak, she did what most insureds do: trusted her carrier and used their “preferred vendor” for leak detection.
The insurance company’s vendor reported the upstairs toilet was leaking. Following that advice, the insured spent hundreds of dollars replacing the toilet. But the leak didn’t stop.
Frustrated, she paid out-of-pocket for another leak detection company, which correctly identified the true source: a leaking tub, not the toilet. By then, she had spent over $1,500 on unnecessary costs, including a toilet replacement that was never needed.
The Insurance Company’s Response
The carrier not only refused to reimburse the insured for the second (correct) leak detection, they:
- Paid their preferred vendor despite a misdiagnosis
- Wrongly directed the insured to replace a perfectly good toilet
- Denied reimbursement for the vendor who correctly identified the leak
- Wrote a repair estimate under the deductible, effectively paying $0 for repairs
- Ignored the mold that developed because of delays and misdiagnosis
How Coast 2 Coast Helped
When Coast 2 Coast Adjusters was called in, we immediately:
- Performed a full inspection and prepared a comprehensive estimate
- Submitted our estimate and began direct negotiations with the carrier
- Invoked appraisal, taking the claim out of the carrier’s control since they insisted the loss was under deductible
- Documented and added damages for mold, caused by delays from the carrier’s preferred vendor misdiagnosis
- Ensured all damages were properly valued so repairs could be made by a contractor working for the insured, not the insurance company
The Final Result
Settlement Achieved: $30,000
This included $20,000 for water damage repairs and an additional $10,000 for mold remediation — turning what the insurance company tried to dismiss as “under deductible” into a fair recovery for the homeowner.
Conclusion
This case is a cautionary tale about hidden policy limitations and carrier-preferred vendors. Our client was left paying out-of-pocket, misled into unnecessary repairs, and offered nothing for the actual loss. With Coast 2 Coast Adjusters on her side, she received $30,000 — and hired her own contractor to restore her home the right way.
Initial Offer: $0 (under deductible)
Final Settlement: $30,000
Total Increase: $30,000
Percentage Increase: N/A (Claim initially denied as under deductible)
