What appeal options do I have if I disagree with the findings of my home insurance company

Following the completion of a sinkhole investigation, your home insurance company will provide you with a copy of the engineering report regarding the findings and conclusion as to whether there is a sinkhole in your yard. Sometimes you will be happy if the answer is “no sink hole,” especially when the actual damage is minor. Oftentimes, however, when you have significant damage or other reasons why you filed the claim (e.g. neighbor has a sinkhole), you may disagree with the findings made by your home insurance company. (Read my tips on filing a sinkhole claim with your home insurance company.)

What Is an NEP, and how can my home insurance company challenge it?

Under a new law passed about two years ago, there is a process called a “neutral evaluation program (NEP).” Under this program, the State appoints a “neutral” party to examine the information provided by your home insurance company so that they can determine the accuracy of their findings. After the neutral evaluator does an investigation, s/he will issue a report, either agreeing with the home insurance company’s conclusions (if that is the source of the dispute) or commenting on the repair recommended by the insurance company (if the dispute is over the method of repair, most often underpinning or grouting).

The part that is most important about the NEP is that the findings of the neutral evaluation can be used against you later. For example, home insurance companies will often bring the engineer to the NEP, who they will pay to argue their position to the neutral evaluator. If the neutral evaluator is persuaded to keep the original opinion asserted by the home insurance company, the report of the neutral evaluation can be used later in a trial. This is very damaging to your claim, obviously, because they will be able to suggest that the neutral evaluator was a disinterested party. Most of the time, however, the engineers or geologists selected are working extensively with the home insurance companies, who pay for the vast majority of these sinkhole investigations. So, they are hardly neutral.

How We Can Help

We are able to assist clients three ways:

  1. Appearing at the neutral evaluation hearing with the home insurance company on their behalf
  2. Providing guidance on whether to object to particular neutrals, who are on the State approved list
  3. Providing the persuasive arguments at the hearing, so that we have a great opportunity to obtain a neutral report in your favor.

A lot of cases get settled because of these reports, in the insureds’ favors and sometimes not, so if you are facing one of these, move cautiously.

Have a burning question you’d like to ask about sinkholes? Let us know.

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