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A senior citizen living on a fixed income suffered a shower pan leak in her manufactured home. Acting quickly, she:
- Called a local restoration company to dry out her home and prevent mold growth.
- Contacted her insurance company to start the claims process.
Her field adjuster visited her home, inspected the damage, and confirmed that the water damage was covered under her policy. However, when her claim reached a desk adjuster located in another state, things took a turn for the worse.
The Insurance Company’s Deceptive Tactics
- The cause of loss had already been confirmed by the insurance company’s own leak detection company—the shower pan failed and caused the damage.
- Despite this, the insurance company ignored their own findings and falsely claimed that the damage was due to grout failure, which is not covered under the policy.
- They used this false reasoning to deny the claim, leaving our client with a damaged home and no way to afford repairs.
How We Fought Back and Won
When the insured realized she was being taken advantage of, she reached out to us. We immediately:
- Reopened the claim and demanded accountability, refusing to let the insurance company get away with their deceptive denial.
- Presented undeniable evidence from the insurance company’s own leak detection company that the real cause was a covered loss (the shower pan failure, NOT grout failure).
- Exposed the fraud—proving that the insurance company was knowingly contradicting its own investigation to wrongfully deny the claim.
- Negotiated aggressively, making it clear that this denial would not stand.
The Final Outcome: A Major Victory
- Final Settlement: $45,000
- A staggering 4,499,900% increase from the insurance company’s original offer ($0).
- Our client was finally able to repair her home and move forward with peace of mind.
Why This Case Matters
This case is a perfect example of insurance companies attempting to exploit policyholders, especially vulnerable seniors on fixed incomes.
- The insurance company had proof of a covered loss and STILL denied the claim.
- Without proper representation, this senior citizen would have been left without options.
- We turned a wrongful denial into a $45,000 settlement—proving that fighting back WORKS.
Lessons for Every Policyholder
- Always question an insurance denial—especially when the facts don’t add up.
- Even if an adjuster tells you your claim is covered, a desk adjuster may still try to deny it.
- Having a public adjuster can mean the difference between a denied claim and a FULL settlement.
