Hello, I seek your insight about a dilemma I’m facing with State Farm regarding debris removal payment. For context, I lost my house in the CZU Lightning Complex in August 2020. After State Farm issued its last Dwelling payment in September 2021, I informed my adjuster that I would like to buy a replacement home instead of rebuild on-site. Before submitting an offer, I emailed my claims associate to confirm how much money State Farm had paid me that was earmarked for debris removal to ensure I did not include those funds in my down payment. She responded with a call a couple days later and confirmed that I had been issued $7,695, under the Additional Coverages section in my Summary of Loss statement. She further explained that because I exceeded my limits for Dwelling and Dwelling Extension, I was not paid out for debris removal in those categories, as evidenced by $0.00 in their Subtotal columns. I recently remitted $7,695 to Santa Cruz County, who has reached out to homeowners who participated in the public debris removal option to request copies of our policy, declarations page, summary of loss, and a letter from my insurance agent confirming the amount of money included in my coverage for debris removal. State Farm did not respond to my first request for a letter. When I recently followed up a second time, they said I have been paid ~$22,000 for debris removal, and when my public adjuster pushed back and called out their error, they responded and said they have paid me over $18,000 for debris removal and that I owe that to Santa Cruz County. Unfortunately, I did not follow up with an email to my claims associate in November 2021 reflecting that I heard her confirm that I have been paid $7,695. The Summary of Loss is such a confusing document that even State Farm representatives seem to have trouble deciphering it. Given that I do not have written record of what my claims associate confirmed, how can I push back on State Farm for putting me on the hook for an additional ~$11,000 given that I did all the due diligence I could to confirm how much in debris removal funds they issued to me before placing an offer on my replacement home? It feels like an injustice that I may have to pay Santa Cruz County money that I put into my replacement home because of potentially inaccurate information that State Farm provided over a year and a half ago. I’m at a loss and don’t know what to do. I would appreciate any insight you can provide. Thank you!
I am so sorry you are dealing with this. As you noted, even the adjustors do not always know what the exact breakdown of payments is, and with numerous adjustors over the years, it is easy for them to become confused. That confusion should not be your problem, however. Since there is no email confirmation of your call, there are a few things you can do. First, ask for a copy of your claim file. They will likely tell you no, that they do not provide that to insureds. However, in California under Cal. Ins. Code Section 2071, they are required to provide “all claims-related documents” within 15 days of request. So push back when they refuse. Adjustors are required to keep notes of all phone calls, so it is possible that your conversation was documented by the adjustor. Second, contact the California Department of Insurance and make a complaint. If your insurer refuses to provide you the requested claims-related documents, you can inform the Department of Insurance of that as well. State Farm is legally required to respond to the DOI about your issues and provide an explanation. If the DOI chooses, it can also mediate between you and State Farm to help resolve the issue. I hope these steps help you to resolve the issue.
United Policyholders provides a Sample Letter for Requesting Copies of Claim-Related Documents that you can modify for your own purposes.