The Ohio Department of Insurance has resolved 47 complaints in the past year from people in this area saying their insurance company mishandled claims related to windstorm damage, siding more often with the insurer, a Dayton Daily News analysis found.
The complaints from Montgomery, Greene and Miami counties mostly relate to damage from the Memorial Day 2019 tornadoes, but include other wind events as well.
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The Ohio Department of Insurance looked into the claims and sided with insurance companies in 29 cases and overturned the company’s position in 13 cases. Sixteen cases were referred for possible disciplinary action, and others involved a complicated legal question or were resolved with a settlement. Claims often involve multiple outcomes.
The state sided with Teresa and Frank Semons in their complaint against Liberty Mutual Insurance they filed April 27 after fighting nearly a year to have the roof of their Dayton home fixed from damage caused by the Memorial Day storms.
“It’s been a catastrophe, more or less, with a good outcome,” Teresa Semons said in an interview with the Dayton Daily News.
Semons’ complaint says that after the storm, the insurance company sent out a contractor whose poor work caused additional damage. She then dealt with months of rigmarole with seven different adjusters being assigned to work with her and nothing getting done, she said.
Semons said she never heard from the Ohio Department of Insurance about her complaint, but state records say the state overturned the company’s position and referred her complaint to another division for possible disciplinary action. Semons said she finally got paid by the company a couple of weeks ago.
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“I finally got the rest of the money to remediate the mold and do the rest of the tornado damage work,” she said.
ODI officials say issues are referred for possible disciplinary action if a complaint suggests a company or agent is violating state rules or laws. Outcomes can include making companies take corrective action or taking action against an agent or agency’s license.
Most claims paid without complaint
Liberty Mutual Insurance spokesman Glenn Greenberg said he cannot comment on a specific customer’s claim, but “we aim to resolve each claim fairly and promptly.”
“For this specific event, we resolved and closed 92% of our customers’ claims within 60 days and approximately 98% of claims have been closed to date,” he said. “Most of the claims that remain open are large and complex, which, by their nature, have a longer life as they are often require insurance supplements throughout the repair or rebuild process.”
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Dean Fadel, president of the Ohio Insurance Institute, noted over 30,000 claims were filed statewide as a result of the May 2019 tornadoes and insurance companies paid out about $500 million in insured losses. So the number of complaints is comparatively small.
“Each individual claim has its own unique facts and dynamics,” he said. “Fortunately, the Ohio Department of Insurance is well-equipped to protect consumers and make sure insurance companies are complying with the relevant laws and regulations.”
‘It isn’t right’
Tornado survivors responding to an online Dayton Daily News survey about obstacles to recovery a year later frequently listed problems with insurance companies.
“You have to fight insurance to get what your policy owes you,” wrote Jeffrey Smith, who just this month got the money from his insurance company to replace his tornado-damaged deck.
“It was honestly a part-time job last summer and beyond. If you do not have the financial means to wait for the full payment you deserve, you get bullied into taking a settlement because you have to financially,” he said. “We were lucky that we had enough savings to play the long game and fight for what we were owed by our policy. Many people did not have that luxury and it isn’t right.”
Smith said he didn’t file a complaint with the state but succeeded with binding arbitration where the company and policyholder both hire adjusters to present their findings.
Ruth Barron said she filed a complaint with the state but “nothing came of that. I think they were overwhelmed with everyone else.”
Plywood still covers the windows and tarp tops the roof of her family’s farm house in Jamestown. They have lived in a house rented from a neighbor down the road since the storm.
“Just dealing with the insurance company, we haven’t gotten our house repaired at all. We hired a lawyer, too, but that’s at a standstill now with the other stuff going on,” Barron said, referring to additional delays caused by the coronavirus pandemic.
Barron said they also lost farm equipment and a barn in the storm. Insurance took care of the barn and truck. She and the insurance company remain in a dispute over how much work needs to be done to the home.
“We paid insurance on our house for 16 years to the same company,” she said. “I cannot believe they are treating us the way they are. It upsets me the way this is all affecting our lives especially our children.”
In a dispute with your insurance company?
Ohio Department of Insurance hotline: 800-686-1526
File a complaint: https://gateway.insurance.ohio.gov/UI/ODI.CS.Public.UI/Complaint.mvc/DisplayConsumerComplaintForm
Assistance available
Homeowners with who were uninsured or under-insured with tornado caused damage should call 211 if they need repair/rebuild assistance.
