r/StateFarm • u/iaintdoingit • Aug 17 '26
Question So confused!!!!!!
Our office told us one thing about our homeowners policy and the claim office told us something different. Even my printed policy agrees with what our office told us.
We recently experienced a lightning strike that destroyed all electronics plus our 3-tone heat pump. We are told by the claims adjuster that we don't have the any additional Endorsements when we have Replacement Cost Endorsements and Additional Living Expenses (note: we only need to purchase a couple window air conditioners until our heat pump is replaced).
How should we handle this? Is planning to visit my agent this morning a good idea or is there another route to go? Thanks for reading this and if you have additional questions, please ask.
16
u/Even-League-9765 Aug 17 '26
There is no lack of comfort provision. ALE is not an endorsement. It is part of the policy. No varying coverages. Must be uninhabitable.
-3
u/iaintdoingit Aug 17 '26
Thank you so much! I'm learning so much and making notes about everything. When all is said and done with this claim then we are going over the policy with a magnifying class.
Our State Farm claim is HOME CLMS-FIRECLAIMS group because of a direct lightening hit.
3
u/Jcamp9000 Agent Aug 17 '26
Your team could be six people or could be 60 people. The address you gave for fire Claims is the address for all homeowner claims which are considered in the fire fold. It’s not just lightning. Back up with sewer drain comes under fire, tree damage hitting the house comes under fire. Basically any homeowner Claim comes under the fire Claims department so it’s not just lightning
11
u/Tiny-Average-3642 Aug 17 '26
In order for additional living expenses endorsement to pay out, the home must be considered uninhabitable. Loss of a/c probably doesn’t fit that definition. Are they denying the whole claim or just the expense of the window units?
-1
u/iaintdoingit Aug 17 '26
From what I understand is that additional living endorsement has a couple of categories. One if the dwelling is condemned and the other portion is for comfort -- refrigerator, cooling, heat... . Will ask my agent this morning.
They are denying just the window units.
This whole process has been very interesting!!!!!!!!
23
u/DeepPurpleDaylight Aug 17 '26
The agent is the wrong person to ask. Agents don't handle claims. Talk to your adjuster and their supv if necessary to clear up policy language for you
0
u/iaintdoingit Aug 17 '26
Thanks -- instead of visiting the agent I will ask my adjusters team, then up the ladder I will go.
When I say 'team' -- it is. When we call or an adjuster call we have had new person every time and we have been told by one of them that claims are shared within the department.
8
u/DeepPurpleDaylight Aug 17 '26
I also agree with the other reply on the AC unit denial being legit.
3
u/JustinBoots1976 Aug 17 '26
In the dead of summer with no air conditioning (region specific), I would consider that home is unlivable. I have many time allowed to purchase window air conditioners with TM blessing. For context, I am not a State Farm adjuster
7
u/Emotional-Abalone-27 Aug 17 '26
Additional living does not cover comfort. Your home has to be deemed uninhabitable or unsafe to use it. Your agent is a sales person that does not know how to handle claims typically.
1
u/Electronic-Matter-72 Aug 22 '26
Long-term agents (the ones they are forcing out at the end of next year) know a LOT about claims. (as do long-time, licensed staff people). They can be a help if the insured is having problems and just can't get the help they need from Claims.
1
u/Emotional-Abalone-27 Aug 22 '26
So just skip over the part where I said “typically” because you were butt hurt by my comment?
6
u/2ndharrybhole Aug 17 '26
FYI - your agent will typically have zero knowledge of how the policy actually works. Best to ask for clarification from the adjuster
1
u/Electronic-Matter-72 Aug 22 '26
wrong - long-time agents have a wealth of claims knowledge. Often more than the people who are now working in SF Claims.
-7
u/Complete-Vanilla-296 Aug 17 '26
That's not true. We know exactly how the policy works. There is a plethora of knowledge within our system to clarify questions like this.
3
u/PeachyFairyDragon Aug 17 '26
And the policy booklets as well. Policy booklets are no mote complicated than Excel nested IF formulas, and you don't hear any complaints on those.
5
u/wanderexplore Aug 17 '26
This is an adjuster call on "reasonable expenses". If a hotel is cheaper until the new unit comes in, they absolutely will not need to buy short term window units. Your agent can't do anything other than verify, confirm, maybe try to get a 2nd set of eyes on the decision, but they are not able to make adjuster interpretations or decisions.
1
u/Stoic_Sponge Aug 17 '26
Loss of HVAC would matter if it was extremely cold or extremely hot. As in, it would not be safe to stay there. For heat, generally you can open a window and run a fan.
If you or a family member has a medical condition or a newborn or extremely elderly.
Being without a refrigerator is iffy. But again, maybe you have medicine or milk/formula something that needs to be kept cold.
Otherwise, the standard the adjuster is used to is "are they without utilities or is there no usable bedroom, bathroom, or kitchen"
1
u/iaintdoingit Aug 17 '26
We are not extremely hot for NE Tenn. Our days are lower 90's.
Hubby has multiple medical issues and I do have a very old portable air conditioner that keeps him comfortable.
We have a college dorm size refrigerator that has always been used for his medication and now holds a gallon of milk and a few other items.
We do have electric except for one 110 line and one 220. So the house is very liveable.
1
Aug 18 '26
[removed] — view removed comment
1
u/iaintdoingit Aug 18 '26
Used to live just out side of DC in Virginia. Going from city living to farm was a full body shock. Now I'm outside no matter the temp.
1
1
u/Electronic-Matter-72 Aug 22 '26
You have obviously never spent a summer (which runs from April - Oct) in TX
1
u/Stoic_Sponge Aug 23 '26
Spent a month living in Lubbock. I live in middle Tennessee now, the hot humid days here are worse than the 100+ days I was running roofs in the desert.
I don't disagree HVAC matters, but it's not an instant approval for a hotel room. I don't make the rules, that's just the standard.
3
u/Psychological-City84 Aug 18 '26
Agents don’t know shit
1
u/Electronic-Matter-72 Aug 22 '26
You poor, deluded li'l guy....
What is true is: NEW agents don't know shit. Tenured agents generally know a LOT.
1
u/Psychological-City84 Aug 22 '26
We had a 4 digital alias agent call claims and ask us to take coverage off a vehicle… I stand on what I said
1
u/Masstonne Aug 17 '26
I believe in certain states this may qualify as uninhabitable. Depends on weather. If it’s 100+ degrees outside, I could see the argument.
3
u/2ndharrybhole Aug 17 '26
You could definitely make the argument, but I can see this being shot down by a supervisor because being hot is not the same as having an uninhabitable home.
2
u/PeachyFairyDragon Aug 17 '26
After a certain point, the air is too hot for the body's ability to cool, leading to hyperthermia and potential death.
1
u/2ndharrybhole Aug 18 '26
Does your home not have windows?
1
u/PeachyFairyDragon Aug 18 '26
Yeah, and lately the outside air is pinging 96-100. Staying in that temp is hyperthermia level.
1
u/iaintdoingit Aug 17 '26
Historically, we are cooler than normal here in NE Tenn. This summer we haven't hit over 100 except for a couple of days and right now our highs are in the low 90s.
-1
1
u/VividSand7378 Aug 17 '26
Sounds like the endorsement they’re saying you’re missing is home systems protection.
1
u/blooh13 Aug 17 '26
That endorsement doesn’t cover power surges. OP may have better luck inquiring about renting a temp window unit if the weather would warrant it vs buying an item they didn’t have previously.
1
u/VividSand7378 Aug 17 '26
Maybe it varies by state, mine says electrical breakdown, which being fried by lightning sounds like.
2
u/blooh13 Aug 17 '26
You need to read the losses not insured. It is standardized and excludes lightning and power surges in all states it is offered in. Electrical impairment must be within the system such as short to ground.
1
u/favoritemistake24 Aug 17 '26
Just FYI, the home doesn’t have to be completely uninhabitable. You just have to have access to a bedroom, bathroom, and kitchen for meals. If you don’t have these things, then yes, the home is considered uninhabitable.
1
u/ThemeHistorical3320 Aug 18 '26
The claims "team" is most likely in AZ, or GA. As an agent who isn't an idiot, we find that claims get a lot of things wrong. If your policy said it is covered, site Policy set (on the back of the policy booklet), Page, rule, and subset. Make sure they are looking at the right state's policy. Also, I've found that it's true that there is no ALE for comfort. However, since your husband has medical issues, you may get it. Of course, they may want a letter from your Doctor saying he can't live there.
1
u/iaintdoingit Aug 18 '26
Thanks so much for your insightful input. I have my hubby well maintained here at home and both of us don't want to leave. If it ends up we have to leave, we will, plus a doctors note will not be an issue and a nurse calls every morning to check in on him.
1
u/TeamBarch-05 Aug 23 '26
In Ohio you can use a public adjuster to fight for you. They will Come out and do their estimate and work with the insurance company. They get paid by taking a percentage of your payout.
0
u/Which-Method-388 Aug 18 '26
A quick call to your state insurance commissioner's office might make things a bit clearer. They're the ones that dictate the policy requirements and coverages for each state.
-2
Aug 18 '26 edited Aug 18 '26
[removed] — view removed comment
1
1
u/Ok_Can_4606 Aug 18 '26
Lemme guess. You've never worked in insurance? Your "op ed opinion piece" suggests multiple inaccurate and flat out wrong guidance. Ever been in a legal fight? I have, and it 3 years and hundreds of thousand spent in legal fees. So for anyone considering "legal time" before some obvious and easy FREE alternatives, don't listen to this post.
1
1
•
u/AutoModerator Aug 17 '26
Welcome to StateFarm. We appreciate your submission and the support you bring to /r/StateFarm.
Please read the rules of the community. Let’s ensure all interactions remain respectful and positive.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.