Informed Clients | Insurance Claims FAQ

When water damage happens, many questions arise particularly regarding insurance claims. An informed client is a reassured client. Your confidence and comfort are our primary concern. In this section, you can learn about tips on filing a claim, insurance billing practices, and more. To learn about water damage procedures, please refer to the water damage page.

 
Should I File A Claim?
When a client experiences a whole house flood, this question is seldom considered and the client goes straight to filing a claim, but sometimes the question remains when the water damage lies somewhere between full house damage to a little wet corner. Upon experiencing even a moderate sized water damage, perhaps only involving a single room, the costs usually exceed expectations. So here are some ways to help you come to a conclusion of whether to claim or not to claim.
  • Consider the water category: All materials and personal belongings may be unsalvageable due to the water source such as raw sewage. 

  • Consider the true extent of structural damage: Using our thermal imagers and moisture detectors will help reveal hidden moisture. Once you become aware of the actual size of the damage, what is involved to properly mitigate the damages, and a general idea of the cost, you can make an informed decision.

  • Consider all damages: Oftentimes, simply the building materials are the focus, but personal belongings are also often affected. The cost of replacing furniture, clothing, art  work, electronics and the like can really add up. So take a look around and consider the whole picture.

 

Using your insurance can be unsettling, but remember that you have insurance for this very reason and this is the proper time to use it.

 
How Do I File A Claim?

Calling your insurance company is the short answer, but when you file a claim, your initial conversation is very important.  Here are a few recommendations:

  • Allow us to arrive and assess the extent of damage using our thermal imagers and moisture detectors.

  • Be clear about the water source: toilet / sink / bath overflow, pipe break, water supply line break (refrigerator, toilet hose).

  • Have your policy number ready. 

  • State that you have an emergency water damage.

  • State that you had an immediate and sudden water damage. 

  • State that you have called a water damage company to dry out your premises.

Waiting days for an adjustor to show up is not an option. This is an emergency and should be treated as such. 

 

How Do You Determine The Charges For Your Services?

Rest assured, we do not create random charges in order to bill your insurance company; however, we can understand your concerns of how this works. Sudden loss water damages are considered emergencies and you certainly wouldn't wait to round up estimates from doctors if you were facing a medical emergency nor would you leisurely wait days for firemen to show up if your house were on fire. Likewise, you can't wait for several estimates, which can take days on end, before attending to your emergency water damage. The solution to the problem is through an insurance billing program called Xactimate. This program was created for contractors and insurance companies to establish fair billing practices for restoration and reconstruction services. Every insurance company either utilizes or recognizes the validity of Xactimate.

 
 
Do You Bill My Insurance Company Directly?

Yes we do. We bill all insurance claims directly with your insurance company. We do ask for your cooperation in the process to keep your adjuster on top of your claim. While we bill them, you are ultimately responsible to make sure your insurance company issues payment in a timely manner.

How Do You Prove Your Bill Is Fair & Accurate?

Throughout the entire restoration process we document the extent of damage, work performed, and drying progress.

  • Photos are taken at the preliminary stages of the drying process revealing the extent of the damage and the steps necessary to remediate the damage.

  • Moisture elevations are determined by utilizing thermal imagers, moisture detectors, and hygrometers as additional evidence of preliminary conditions. 

  • The same moisture detecting equipment is used throughout the drying process by a water damage technician who will monitor the premises daily in order to check the progress of the drying, making sure the drying is on track, and to determinine when the structure is sufficiently dry. 

 
Am I Required To Use My Insurance Company's Vendor?

No, you are not obigated in any way to use your insurance company's vendor. In the state of California, according to the California Department of Insurance under the "Fair Claims Settlement Practices": 

"No insurer shall require that the insured have the property repaired by a specific individual or entity." Section 2695.9. Additional Standards Applicable to First Party Residential and Commercial Property Insurance Policies.

If your insurance company is pressuring you to use their vendor, particularly through scare tactics, they are disregarding the law. You can certainly state you know your rights and demand they back down.

 
What Are The Benefits Of Choosing My Own Restoration Company?

Here are some great benefits when choosing a qualified restoration company, such as Western Carpet Care's "Heroes On Call" water damage restoration services, over a "preferred vendor" working for your insurance company:

  • We work for you and not the insurance company. We are on your side and have your best interest in mind.

  • We follow standards as set forth by the IICRC.  This means we do not cut corners.

  • You can hire the company in whom you have the most confidence. This is particulary becomes important if  you are uncomfortable with or doubtful of your insurance company's recommended vendor.

 
Does My Insurance Company Pay You Directly?

Every insurance company holds different policies regarding how they pay for restoration services, but payments from the insurance company will usually fall into one of these four scenarios:

  • Issues a check payable directly to the contractor.

  • Issues a check payable to the property owner and relies on owner to issue check to contractor.

  • Issues a check payable to both property owner and contractor.

  • Issues a check payable to property owner and mortgage company. If this occurs, you are responsible to issue payment to contractor.

In order to clarify the funds due to us in the event your insurance company pays you directly, we mail you a copy of the invoice submitted to your insurance company.

What Is Included In My Contract & Invoice For Drying Services?

The contract and invoice for water damage service strictly includes the services associated with the drying phase of the restoration. Such services billed on the invoice will include:

  • Removing damaged structural materials such as dry wall, flooring, and ceilings.

  • Setting up drying equipment such as air movers, dehumidifiers, and injecta dry machines.

  • Daily montioring of the job site to make sure the structure is on track for drying in a reasonable amount of time.

 

Separate contracts will be necessary for any necessary additional services even if the vendor hired for these services is indeed the same vendor you hired to perform the drying services.

For example:

  • You hire Western Carpet Care's (WCC) Water Damage "Heroes On Call"  to perform your dry out.

  • When the drying is complete, you also hire WCC to perform reconstruction services.

  • Reconstruction services will require signing a new contract with WCC. 

  • An new invoice will be generated separately from the drying invoice.

  • A check from your insurance company will be issued per contract.

 
What Other Services May Be Required Besides Drying My Property?

The following services are often involved in water damage restoration. Aside from the environmental testing, these services often can be performed by the same company you hire for the drying phase or you can choose to hire another company to perform the services.

  • Content Packing: The non structural contents of your home that are located in affected areas will be inventoried and packed up. Oftentimes, the contents are left on the premises or within a portable storage container directly outside the premises. Contents include such items as furniture, collectibles, home decor, clothing, etc.

  • Reconstruction Services: This is repairing and restoring damaged structural materials including replacing dry wall, ceiling caps, bathroom and kitchen cabinets, and painting.

  • Environmental Testing: In the event your structure was built during an era when hazardous materials were known to be frequently used in construction, an external environmental testing company will be contracted to perform the tests necessary. The two common hazardous materials used in construction are lead and asbestos and are generally the focus of the environmental testing.

  • Environmental Abatement: This is the service that engages in safely removing the hazardous materials from your structure.

Again, invoices for these services are all generated separately and by the respective contractors performing the work even if the vendor hired for these services is indeed the same vendor you hired to perform the drying services.

 
Do you have more questions?

Please give us a call at 1-800-440-6080 so we may be of service.