Discrepancies and Omissions in Estimate Dani asked 2 weeks ago
Discrepancies and Omissions in Estimate

Hi, I have kind of an unusual situation, and I’d like to know how best to approach it. My insurance company drafted an initial estimate for repairs that was, let’s say, $50,000. My contractor then drafted an estimate for repairs that was double the initial estimate – let’s say $100,000. The insurance company approved the contractor’s dollar amount and sent me a revised estimate. However, this revised estimate simply says “per contract” instead of listing a number for many of the line items. Furthermore, the items are not listed the same way they are in the contractor’s estimate.

For example, the contractor’s estimate says something like “tear out/rebuild kitchen cabinets – $20,000,” while the insurance estimate says “kitchen counters – per contract, kitchen cabinets – per contract,” etc. It lists multiple, slightly different items. As a result, I can’t even tell exactly what is covered or what the amount is for many of the items.

This has become especially relevant because I need to be able to calculate the total amounts. The insurance company recently claimed that everything had been paid, despite still owing me tens of thousands of dollars on this claim. It took me over an hour on the phone with them to straighten it out, and now I don’t trust their bookkeeping.

Is there a way to determine what the “per contract” amounts actually are? Is this standard practice for the final version of an estimate? Who can I speak with or escalate this issue to?

1 Answers
Jeff Major Jeff Major Expert answered 2 weeks ago

Hi Dani,

GIven the scenario you’ve laid out, If the contractor’s estimate directly relates to the repairs identified by the insurance company, then the carrier may be relying on the contractor’s pricing rather than assigning separate values to each line item in its own estimate. In that situation, “per contract” may indicate that the carrier accepted the contractor’s pricing for those repairs.

If the contractor’s estimate and the carrier’s estimate describe the work differently, it may be necessary to compare them side-by-side to determine whether they are addressing the same repairs and costs. UP has a great resource that may help you with this process.

While it is not unusual to see “per contract” language when a carrier relies on a contractor’s estimate, you should still be able to determine what repairs were approved and how payments were calculated. Given your concerns about the carrier’s accounting, consider requesting a complete payment ledger, the specific contractor estimate the carrier approved, and a written explanation of how the “per contract” items correspond to the approved repairs. If you cannot obtain a clear explanation from the adjuster, consider escalating the matter to a claim supervisor or manager.

A detailed breakdown of the approved scope and payments should help you determine whether all amounts owed under the claim have been paid. UP has a great template letter that you can modify to ask your carrier for all of these documents.

Best of luck, Jeff