Irene Victims Fight Insurance Company Over Payments - NBC Connecticut
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Irene Victims Fight Insurance Company Over Payments

Pedro Francisco claims he could lose his home if he doesn't receive enough money to fix it.



    An Old Saybrook couple is fighting back after their insurance company denied their flood claim.  Pedro Francisco says he's not ready to give up on the summer home his children grew up in.

    "You can still see the water line throughout the house," Francisco said as he pointed at the baseboards.

    Almost a year after Tropical Storm Irene hit Connecticut, Francisco's home is still in shambles.

    "We haven't touched a single thing in this house," he said.

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    Sand still covers his hardwood floors and ceiling tiles are still missing.  The piers underneath the home are in pieces and the floors are slanted.  Francisco says the damage remains, because his insurance company won't pay what he says he needs to fix it.

    "You pay insurance for 15 years on a property that you've never collected insurance on and you figure when it's time for them to do their job they're there for you," Francisco fumed.

    Eight weeks after Irene hit, a structural engineer from Francisco's flood insurance company took a look at the home.  Francisco says the engineer came at night though and never looked under the home, yet weeks later he got the engineer's report and a letter in the mail from The Hartford insurance company denying the flood claim.  According to the report, much of the damage was caused by poor workmanship and substandard materials, not the water and therefore not covered by his policy.

    "When we got that engineer report back we said this is not right, so I hired my own structural engineer," said Francisco.

    He hired Kratzert, Jones and Associates out of Milldale.  The company's engineer found the damage to the home was caused by the flood of water that rushed underneath and through Francisco's property, something that would be covered by the insurance policy.  Also included in this report was a home appraisal done just 7 months before the flood that reports the quality of construction and condition of the property as "average."

    "We have pictures and evidence to support all that," said Francisco.

    Since last August Francisco's insurance claim as been in limbo.  He was paid $53,000 by The Hartford to clean and replace the wood floors and wall paneling, but Francisco says it's not enough and doesn't cover the cost of replacing the piers, fixing the floors and bringing the home up to code.  According to one contractor, he'll need well over $200,000 to do all that.

    The NBC Connecticut Troubleshooters wanted to know why The Hartford paid just $53,000 for what at least one engineer says is substantial damage.  We placed several calls to the insurance company and a spokesperson would not comment on the case because of privacy concerns.  They also would not tell us how many Irene-related flood claims they received or how many they denied.  But Francisco says just a few days after our first call to The Hartford he got a letter denying his appeal for more money.  It's the first time he's heard anything from The Hartford in months.

    "If I don't get any resolve I'm going to have to turn the mortgage in.  I don't have any choice," Francisco said.

    According to Francisco's insurance agent, the letter allows Francisco to move forward with an appeal to FEMA, the federal agency that oversees all flood insurance policies.  It's Francisco's last shot at the getting the money he says he's owed, and something he's now pursuing.

    "If I can't get the insurance companies to pay, I can't afford it," Francisco said.

    According to FEMA, more than 3,700 flood claims were filed in Connecticut after Irene. Of those, 657 were denied for various reasons.  But Gerard O'Sullivan, with the state insurance commission, says there is hope for Francisco and others who file insurance claims and feel they are unfairly denied.

    "People get something from the insurance companies and think they must be right, but the fact that we returned $4 million a year shows that they aren't always right," O'Sullivan said.

    In fact, the commission recovered money for more than a dozen consumers who filed complaints after Irene.

    "Make sure that you're documenting everything.  Make sure that your company is responding to your concerns and if they're not, come to us and we'll help you out," said O'Sullivan.

    He says many flood policies offer minimal coverage and include many exclusions- so read the fine print.  Also, keep all paperwork or expenses prior and during a claim.  Always get your insurance agent involved when filing a claim and document the conversation.  Finally if all else fails, file a complaint.

    Francisco just hopes his story encourages others to question the insurance companies and fight a system he says isn't always fair.

    "I just hate the system period.  I'm sorry.  I mean you pay so much for insurance, I think you should expect something on the tail end of it," Francisco said.