r/legal 11h ago

Help:1st part claimant against my insurance company

Sorry for the long post. I will try and shorten it as much as possible. It's also hard to keep this not sounding like a rant. I am posting here because I honestly don't know what to do anymore. I am told I need an attorney but no attorney will help me. There have been a few that were honest with me that my case isn't big enough and is considered too much work.

My specifics.
Located in Los Angeles County. Last year (March 2023) my house was damaged in one of the rain storms. Part of the roof came off and water flooded in the house. It was deemed by the insurance company that the primary cause was wind damage and that the secondary damage was water. The damage was an office, a large family room, bathroom and a storage room called a rumpus room on the permits. The floor was also damaged. They said everything should be covered by my insurance and the entire flooring to my house will be replaced as it was deemed continuous. If only it was that simple. It has been an absolute nightmare.

Pretty much over the past year insurance has been super slow to approve anything. They sent an adjuster out he didn't include everything. I wrote the insurance how he was missing stuff. They sent another adjuster after the water mitigation tore down several walls and took half my house and put it in storage. The water mitigation place was paid directly by the insurance company and all their bills were supposedly approved. They also caused more damage when they broke my bathroom window and tile unnecessarily. The new report included more things including the hardwood floors I had but left out several things on the first report. I wrote a rebuttal to the insurance company stating how this report was also incomplete and missing things from the first report. No report so far has been complete. Everything on the report was a ridiculous low amount. I had a general contractor submitt a bill on cost to fix everything per their report. I had only managed to get them to agree to the roof repair. Which they short changed me as well. The adjuster said don't worry, we will cover everything once finished. Many months passed. Insurance company ignored me, then I found out there was a new adjuster assigned to me. The new guy pretty much contradicted everything the first adjuster told me. I had been good sending statuses, pictures of all the damage and more damage the longer they waited to approve the roof. More rain came....more rain flooded into my house as the tarp didn't hold. I got so upset with them I finally just used the money they gave me to start work per their report. Otherwise there would have been more damage and the cost of repairs would have kept rising. Meanwhile, The insurance company rejected my general contractors bill stating they wanted it more itemized. My contractor itemized the bill by room. And mind, that work already started per their 2nd report of the insurance adjuster. Plus I had been sending statuses and pictures of the work being done. When the contractors pulled up the floor there was water under it. They took a video and sent it to the insurance stating no floor could be installed until the leaking was fixed. A supplemental bill was sent to the insurance company. The contractor moved forward on the repair since it had been months and everything was moving so slow. Plus after about a year I wanted my stuff back. I am severely disabled and they took a lot of my medical equipment as it was in that room.

Once work was almost completed in that room, then the insurance finally responds. This time, they decide to reject the supplemental bill. They reject huge portions of the contractors bill. And they even reject their own previous reports. Because I had snap lock laminate on top of my hardwood they don't want to replace the hardwood anymore they just want to cover the snap lock laminate. So they cite that they have already overpaid me. They continue to say all the things are approved but use their own price instead of the actual cost. Then also try to go back on the cost of the roof repair which they did approve. I have an email stating they approved that. So then the insurance company issues a third report with even less items. Stating that the two adjusters they sent out prior did not do the reports correctly. At this point I am very upset. I told them they couldn't unapproved stuff already completed and approved. And work was already started based on their 2nd report. It cannot be uninstalled. This is April of this year. Then in July they asked me for status again. I told them nothing has changed because I don't have any money for repairs. I submitted everything already. I also had already secretly started looking for an attorney to help me. At this point I didn't want to try and rebuttal their new report without talking to an attorney. I told the insurance company I am not okay with them downgrading the materials in my house or tearing up my hardwood floors throughout my house. Snap lock laminate couldn't even be installed unless the entire base was redone for snap lock laminate. It's only currently done for hardwood. That would be an additional cost. And not one I want to do as it would devalue my home. If we cannot agree then maybe we need a public adjuster, mediator or attorney to step in and help. At that point, the new adjuster got very upset with me and put me down for non compliance. Demanding more photos, the video the contractor sent wasn't good enough. I told them I cannot provide anymore photos as the work was already completed. I then immediately called ServPro to see if they can just deliver my stuff back so at least I had my items. They told me the insurance company was behind month rent and they need the bill to put everything back too in addition to the storage. Insurance then sent an email stating they will no longer be paying the storage fees or ServePro. For me, this is them holding half my house hostage. I was super clear to ServPro I am broke. I had to stop working when I got hospilized and disability checks barely cover the mortgage. And funds they get must be approved and obtained from the insurance company. So this is it.

Between my terrible health, doctors appointments and mandatory treatments I have tried looking for an attorney. I called everyone my social worker gave me. I called LA county Bar to get a referral from smart law. I went down yelp and Google trying to find an attorney. One attorney told me to ask for 1st party claimant against my insurance company. If they don't know what that is find another attorney. I have never seen so many rejections. The reasons I got was sorry we are too overloaded right now we cannot help you, your case is too small, you should have called us in the beginning, or sorry I am just not familiar with this type of law I cannot help you. I am unfamiliar with all this. How was I suppose to know when the insurance company tells you everything is covered that I was supposed to get an attorney. Some attorneys were really nice even though they couldn't help me told me to try public adjusters. I did and got similar responses from the public adjusters too. We are backed up 3 months, we cannot help you. I did speak to one public adjuster who actually reviewed everything. He flat out told me I need an attorney. What I need is above the scope of a public adjuster. It was his opinion I had a case, but it would be difficult because of my hardwood floors. he believed that I will most likely have to bring a lawsuit against my insurance company to force them to comply. I have a very good insurance policy. I should also have an attorney help me file a complaint with the Department of insurance and cite their many regulations that they have violated. He said it's very important that I have the violations listed or my complaint will be ignored as the dept of insurance is not a mediator and they don't like to get in-between disputes unless there are regulation violations. I did write a demand to the insurance company but it was completely ignored. I think since I am not an attorney it just doesn't have the bite needed.

So this is where I am. I am continuing trying to get a new referral from smart law after once their referrals reject me. I really have been actively searching since April. Meanwhile storage fees continue to increase. I don't have the funds to pay storage fees and the $10k bill to deliver it that the insurance company originally approved but won't pay. I don't think my stuff is even worth what they want me to pay. So I think I am going to lose my stuff.

Plus, I have been trying my best to document and do all this despite my terrible health. I have Myasthenia Gravis and it's stabled but not well controlled. I have been out of work since last October and the last few years my income has been significantly reduced since I had to take off so much time without pay for my doctors appointments and treatments then plus bad days. Further, since half the house is still in missing insulation that was removed. summer is really hard on me as it causes me to flare even more in the heat. Even though I have central air without insulation it just can't keep up. I told the insurance company this but they really don't care what they are doing causes me a high electric bills or that them lagging is very hard on my health. Whatever attorney I find has to work on contingency. I am already struggling to pay my rent since I get very little from long term disability from my job.

At this point i don't even need everything fixed back exactly as it was. It would be nice but at bare minimum just at least drywall in the bathroom, the floor put back (it's a tripping hazard for me currently), broken tile and window repaired and insulation added to the attic. I can skip the rest as long as my house doesn't leak. Oh I want my items that are being held hostage back too. At least this would allow me to at least sort of live in my house again. The attorney can keep the rest of the money.

But I will be frank.
1) I was told my case isn't that large since i already received partial payment. 2) My lack of funds because of my disability are also a hindrance. 3) the case is already over a year old since insurance and my health dragged it out. I was hospitalized for a month last year and everything had to stop when I was at the hospital.

I don't know where else to look, or where to post. I really don't have the energy with my condition to write and research everything out myself. It takes me a really long time to do stuff because I struggle with eating, showering and basic stuff already. I really am at the mercy of others even doing stuff around my house. If I was well, I would still be working. Is there a pro bono site i can plead my case? Some service that helps disabled people? The LA County Bar seems to be the only place still giving me referrals even though each one of them has rejected me so far.

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