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Insurance Carrier: State Farm
State: Louisana

Consumer Complaint:

I have a roof that was damaged in Hurricane Gustav that is in need of replacement and my insurance company only wants to pay for part of the roof and not the whole roof because they discovered that 3 years ago they over paid my claim for roof damage from Hurricane Katrina. That damage from 3 years ago was minor and repairs were made and I have the receipt and cancelled check for those repairs but my insurance company is saying that they paid for 1,000 square feet of roof damage when in reality I only had about 100 square feet of damage. They said since they paid for 1,000 square feet of damage and I only repaired 100 square feet, they are not going to pay for that again. They want me to pay for the error they made 3 years ago when they now have discovered their mistake. My contractor said that the damage to the roof is consistent throughout and that no section of the roof is any more damaged than any other section of the roof.


Insurance Expert Answer:

Their demand seems to be fact based. If they did overpay last time and the statute of limitations has not run, they may have a claim which they are trying to set off against their current claim liability.

Mistakes are a 2-way street. If they made an underpayment you'd want to be paid. So do they want to be reimbursed for the overpayment. You could try to send a letter to the VP for claims stating that the earlier claim was properly paid, they are wrongfully denying this claim and acting in bad faith; but on the other hand they could claim you engaged in insurance fraud on claim 1.

Send a copy to the state insurance department. But my sense is that the equities are on their side.