Who Left the Ball Peen Hammer on the Roof?

Ken Kayse

Before you call your insurance company about hail damage, make sure there are no hammers left on the roof.

Every Monday in my insurance agency was usually crazy, filled with phone calls from customers about accidents, burst water pipes in the house, or tree limbs causing damage. In our industry, filing a claim usually makes or breaks the agent/customer relationship.

At these "moments of truth," as we called them, it was critical for me and my staff to show true concern for the customer's circumstances so we could initiate the claim process. As it turned out, I became friends with many of my customers over my 43-year career so it was important to listen to them as they explained whatever terrible incident had happened. That way, I could give them the proper counseling as they went through the claim process.

Most of these conversations were well received by my customers. These were easy decisions where there was no doubt the customer had sustained a covered loss. The more challenging talks were when I had to tell them that their claim wasn't going to be covered. That was always the spot where communication would break down.

There was one Monday that stood out from all the rest. One of my insureds called to report his roof had been hit by a hailstorm. As I was taking the information needed to set up the claim, the customer asked me a question.

"This is a covered claim, right?"

I was always cautious when this was asked because it would be easy to make a mistake and say "yes" when the answer was "no" because of some fact or missing information they hadn't told me. In this instance, I was hesitant to answer because I had not heard of any hailstorms in our area for months.

Knowing this, I deflected his question by telling him I don't make those decisions and would have to let the claims department sort it out. He told me he understood and I completed setting up his claim, then hung up with him.

As soon as I could get everyone's attention in the office, I asked them if we had other people calling in to report hail damage. In unison, they all replied "no." Next, I went online to look up when the last hailstorm had struck our area--it was over two years before the date of this claim.

By itself, this information isn't fishy. I've had many customers report hail damage when it turned out to be wind damage instead. No biggie, we just change the claim to reflect wind damage and go ahead and settle the claim. That's what I expected to happen to this man's claim.

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"rebuild" by b e m is licensed under CC BY-NC-ND 2.0

Several days later, I got a call from the Claims adjustor wanting to talk about the claim. He had been on the customer's roof and wanted to tell me what he found. As I picked up the phone, I had a sinking feeling this man's claim was going to be denied.

It turns out, while he had been on the roof with my customer, he noticed a ball-peen hammer laying next to the guttering. The entire roof showed small indentations where something did hit the shingles, but the adjustor was able to match each of the indents to the exact size of the ball-peen hammer's head. He was denying the claim because intentional acts causing damage aren't covered under any insurance policy.

It was left up to me to call my insured to give him the bad news. Not surprisingly, he was not very happy. In fact, he became quite angry and wanted to know why it wasn't covered, so I had to reiterate what the claims adjustor told me about both of them finding a ball-peen hammer on the roof. It still didn't sit well with him, but he did become a bit more subdued with me and we ended our conversation on friendlier terms.

Undaunted by the bad news, my customer had his wife call me several days later. She called to report a new claim, saying someone had vandalized their roof by using a ball-peen hammer. Knowing full well that this claim would also be denied, I advised her not to report it. Filing false claims is considered fraud and it subjects the customer to being immediately canceled.

Unfortunately, this customer wouldn't take "no" for an answer. Despite my recommendation, the customer called the toll-free claims number and reported the vandalism claim anyway. The claims department set up the claim and assigned it to the Special Investigation Unit (SIU).

This unit handles potential fraudulent claims. They will painstakingly scrutinize every piece of information and have also been known to canvas the neighborhood, to see if anyone may have noticed somebody on the roof. Regrettably, several neighbors recalled the customer being on his roof with, of all things, a ball-peen hammer!

The obvious moral of this story is... If you're going to turn in a claim for hail damage to your roof, make sure you don't have a ball-peen hammer laying on the roof first.

Thanks for reading this!

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I am a retired entrepreneur who devotes time to my grandchildren and writing a variety of entertaining stories. I enjoy writing about life experiences, happiness, the qualities of mankind, mental health, and opinion editorials. Writing allows me to escape the stress of each day.

New Albany, IN
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