A Georgia case involving hail and alleged vandalism injury1 will definitely be a subject of dialogue at subsequent week’s Georgia Affiliation of Public Insurance coverage Adjusters (GAPIA) Spring Convention. I first observed that the court docket’s ruling indicated that the general public adjuster representing the condominium affiliation was additionally the roofing contractor.
I’m not an skilled on public adjusters’ contracts like Holly Soffer, however I assumed that Georgia public adjusters couldn’t have a direct or oblique curiosity within the work of the broken property. Brelly’s Information to Georgia Public Adjusters signifies the next as being required within the public adjuster’s contract:
An announcement prominently captioned in a minimal 12 level font indicating that the general public adjuster has no direct or oblique curiosity, together with participation in actions that could be moderately construed as a battle of curiosity or as compensation by or curiosity in, any agency that performs any work at the side of the damages incident to any loss the general public adjuster has been contracted to regulate, aside from the compensation or price from the insured for such public adjuster’s providers.
The related details of the hail and vandalism injury have been as follows:
In August 2019…Full Roofing Programs contacted Beverly Martin, Plaintiff’s property supervisor, mentioned Full Roofing had inspected the roofs in 2017, and requested to re-inspect them. Full Roofing performed a drone inspection of the property on October 18, 2019 and allegedly found injury to the roofs. On October 23, 2019, Plaintiff filed a declare with Defendant for wind and hail injury that allegedly occurred on July 20, 2018. Defendant refers to this as Declare 1….
Defendant performed its personal investigation of the alleged injury. Defendant first employed Russ Toole, an unbiased adjuster, to examine the roofs by drone. He concluded there was hail injury. Defendant, nonetheless, decided Toole’s inspection was incomplete and retained Dr. Jonathan Goode, a structural engineer, to re-inspect the roofs and decide the trigger and extent of any injury. Within the meantime, Defendant obtained a letter from Chad Conley, a public adjuster with U.S. Public Adjusters (‘USPA’) and proprietor of Full Roofing, saying he represented Plaintiff.
Dr. Goode inspected the property on January 30, 2020. He later submitted a report back to Defendant, saying the roofs had sustained no hail-related injury. He famous areas of round ‘granule loss’ however didn’t establish any related bruising or fracturing of the shingle mat in these areas. He attributed these anomalies—to not hail injury that may be coated beneath the insurance coverage coverage—however to variations in weathering, inconsistencies in manufacturing, nails protruding up from the deck, deterioration from chicken droppings, foot site visitors, and tough dealing with of shingles throughout set up. Dr. Goode recognized a small quantity of injury—impacting solely a number of shingles—that he attributed to wind….
On March 10, 2020, Toole offered Defendant an estimate totaling $834.33 for repairs to the seven broken shingles. As a result of that was lower than Plaintiff’s deductible, Defendant despatched Plaintiff an under-deductible letter, a replica of Toole’s estimate, and Dr. Goode’s report. Defendant additionally suggested Plaintiff it was closing Declare 1.
On July 7, 2020, Plaintiff filed a second declare with Defendant, claiming somebody had vandalized the roofs on October 17, 2019—the day earlier than Full Roofing had performed its preliminary drone inspection earlier than submitting Declare 1. Defendant refers to this as Declare 2…Conley despatched Defendant one other letter of illustration.
Defendant retained Dr. Goode to examine the roofs once more. He did that in October and December 2020. Conley attended the December 2020 inspection to point out Dr. Goode the alleged vandalism. Earlier than that inspection, Conley additionally took a few of Dr. Goode’s images from the January 2020 inspection and ‘post-edited’ or processed the images to establish circumstances or gadgets on the roofs that Conley believed confirmed injury from vandalism. He offered Dr. Goode a hyperlink to these images at the beginning of the December 2020 inspection.
Dr. Goode discovered no proof any of the circumstances he noticed resulted from mechanical contact or mechanical pressure— that means they didn’t come from vandalism. Dr. Goode submitted a report back to Defendant, concluding the areas of lacking granules “seemed to be from long-term weathering of the shingles” and that some areas ‘had marring or the granules and asphalt in line with incidental foot site visitors.’
This truth state of affairs didn’t seem good for a policyholder. There’s a late reporting of the hail injury. The vandalism appears to be a compelled discovering from images of the insurer’s skilled with no actual “vandal” being recognized. The defendant has an skilled saying there isn’t a injury of any kind, however that’s fairly customary for insurance coverage firm consultants within the fashionable period. The policyholder has its roofer skilled, who can be representing the claimant as its public adjuster.
The insurer ultimately took the examination beneath oath of the condominium vp, who mentioned the next:
To my understanding, [ ] there was a earlier declare that — I don’t know if it was denied or not. However they needed to come again. And I need to say that they needed to come again and alter it to vandalism. We by no means acquired a transparent understanding. I do know what vandalism means. However I didn’t see anyone stand up on high of any of the roofs and take a hammer or no matter and trigger injury.
This isn’t useful testimony for a policyholder searching for protection. One other lesson from this declare is that the policyholder’s consultant is a crucial witness and have to be correctly ready for anticipated questions concerning the reason for the loss. The court docket particularly highlighted this testimony within the order.
Georgia permits a shortened statute of limitations. On this case, the deadline to file the lawsuit was two years after the loss. The insurer argued that neither the hail injury nor the vandalism loss was filed on time.
The court docket agreed, discovering:
…First, Plaintiff didn’t establish the date on which Ameristar labored on the roof. With out that date, Plaintiff couldn’t current proof that the injury occurred throughout the related three- day window….The events agreed that, for Plaintiff’s timeline to work, it must present that the vandalism occurred after October 15, 2019 (to fall inside the 2-year go well with limitation provision) however earlier than October 18, 2019 (when Plaintiff allegedly found the injury). Plaintiff agreed that Ameristar performed just one restore earlier than October 18, 2019—particularly on September 24, 2019. In fact, which means the injury may have occurred at any time between September 24 and the beginning of the constraints interval…Plaintiff is barely entitled to an inference that the loss occurred between September 24 and October 18, 2019. Plaintiff has offered no proof from which a jury may conclude that, inside that timeframe, it occurred after October 15, 2019…..a jury can not merely speculate or wildly guess.
Second, …Plaintiff’s complete concept relies on Conley’s assumption or conclusion that the injury Dr. Goode noticed in January 2020 will need to have occurred after Ameristar’s prior work as a result of Ameristar didn’t discover it on the time. Conley’s testimony exhibits Plaintiff’s lack of proof on this regard. He testified he by no means spoke with Ameristar about this difficulty as he understood Martin did so. … A good studying of Conley’s testimony exhibits that he assumed Ameristar would have been on the lookout for different injury however by no means confirmed that truth…
Proving that the loss occurred throughout the coverage interval and earlier than the statute of limitations expires is essential to a policyholder profitable a property insurance coverage lawsuit. The policyholder on this case merely failed to take action because the court docket seen the proof.
Matt Brown and I might be presenting about post-loss duties subsequent week. I hope to see you in Atlanta if you’re a public adjuster seeking to be taught one thing new and helpful.
Thought For The Day
I take pleasure in performing for closely armed folks. It’s simpler than going to Georgia.
—Robin Williams
1 North Village Condominium Affiliation v. Auto-House owners Ins. Co., No. 1:21-cv-4776, 2024 WL 1018518 (N.D. Ga. Mar. 8, 2024).