Insurance stopped paying for ALE before we can move back into our home Teresa Sims asked 2 years ago
Insurance stopped paying for ALE before we can move back into our home

We had a fire over a year ago. From the start the insurance has been denying obvious things, delaying answers and payments, and often not even responding to our questions. After 4 months we hired a public adjuster but he was more hindrance than help; six months later we terminated his services. Then the insurance stopped our ALE in November because they are saying we should have already done the repairs and moved back home. We have proved to them and to the CDI that we still have soot in the kitchen that cannot be cleaned unless the cabinets are taken down; the insurance approved taking down the kitchen cabinets to clean this soot after they terminated our ALE, but they are still saying we should have moved back in already. We have not even received the estimate for this work from the insurance vendor so we cannot do it. And this cleaning needs to be done before other work in the house is done such as the painting, so it is obvious that we could not have moved back. However, the insurance is still denying the ALE and CDI is not helping.

What can we do?

1 Answers
Sandra L. Moriarty Sandra L. Moriarty Expert answered 2 years ago
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Hi Teresa,

Thanks for reaching out to UP, and I am so sorry to hear of your difficulties.

The policy language varies by insurance company, but in general if a covered loss renders your home “not fit to live in” then the insurance company owes for the amount to maintain your standard of living, up to the policy limits, for the shortest amount of time to repair the damaged property. They can’t arbitrarily decide what this amount of time is, and barring any UNREASONABLE delays on your part, have to continue to pay until the repairs are complete. (Unreasonable being the key.)

In your case, assuming that the delay in agreeing to remove the cabinets was the insurer’s, I would argue the following: 1) it was agreed that the home was uninhabitable after the fire, 2) the repairs are not complete, 3) the repairs included work that they have only recently agreed to pay (and you still don’t know the amount), then 4) they owe you ALE for the time it takes to get this work done.

You might want to ask them to explain why they seem to think the delay in repairing was unreasonable, since that appears to be the position they are taking.

I know that sounds simplistic, but sometimes you have to spell it out. Unfortunately, the DOI is not in a position to force insurers to do much on individual claims, but keep copying them on your correspondence, and keep asking, over and over. Ask to speak with a supervisor, and do everything in writing, making sure that they respond within the 15 day statutory time period.

Also, if anyone in your household has a medical condition that would be compromised by residing in the home, it is often helpful to get a note from the doctor explaining this. The EPA does have some information that might help: https://www.epa.gov/pm-pollution/health-and-environmental-effects-particulate-matter-pm

Hope this helps.

Best, Sandy