'Do not occupy,' Lancaster warns; Go ahead, insurance firm says




Posted on April 10, 2012 at 7:51 PM

Updated Tuesday, Apr 10 at 10:31 PM

LANCASTER — Exactly one week after the North Texas tornado outbreak, the City of Lancaster has determined that many of the houses struck by the storm are unlivable.

But an insurance company disagrees, and its adjuster says a family should go back to their home — even though there's roof damage, broken windows and no power.

"We are the only home inside the circle where they cut our lights back off," said Brandon Gaines. "We have water in our light fixtures that can cause a fire."

Last Tuesday, the tornado sent a tree through Gaines' roof, leaving a gaping hole. But what's more shocking than the damage is what Gaines said the insurance adjuster told him.

"They're telling us we can live here... that we could have been living here," he said.

The father of three said that's unbelievable to him. His coverage for the last eight years has been with Houston-based American Risk Insurance Company. The firm hired an independent adjuster to assess the damage, and the adjuster told Gaines the home is livable, and that a hotel stay may not be reimbursed.

"It's very frustrating, because on my insurance policy I have a $10,000 coverage where they should pay for living expenses," Gaines said.

The City of Lancaster building inspector posted a sticker on the home that says "Do Not Occupy." With that warning, the extensive damage to the roof, and the broken bedroom windows, Gaines packed to move his family of five into a nearby cousin's home.

He can't afford a hotel stay that the adjuster is saying American Risk may not pay for.

American Risk Insurance officials said "they are at the mercy of adjusters out in the field," and that they trust them to do their jobs.

If there is a dispute with a claim, the insurer has the right to call in a third-party adjuster who could rule in the insurer's favor.

Carlos Lynn, American Risk director of marketing, also said that Gaines did the right thing by taking his family out of a situation he deemed dangerous.

"Residents need to do what's best for their family," he said.

Lynn said residents need to let the process play out, because the final evaluation has not yet been determined. The independent adjuster merely is giving his preliminary opinion, and the evaluation of damage has to be approved by American Risk.

That has not yet happened, but tornado victim Gaines is running out of patience.

"We need answers, and we want a resolution to this," he said. "We're a family of five, and I don't want to be a burden while staying at a cousin's house, when we should be in a hotel."

E-mail ddenmon@wfaa.com