Unexpected Twists in HVAC Claims

When you handle property claims, it doesn’t take long to realize that the reported cause of loss for HVAC equipment included in claims isn’t always what an expert assessment finds to be the actual cause of loss.  Here are real examples of the more unusual causes of loss determined by an HVACi assessment.

Case #1: Collateral Damage

The adjuster requested HVACi determine why a split system wasn’t operating as intended and to make repair vs. replacement recommendations.

Reported Cause of Loss: Water

Observations: The condenser coil contained flattened fins, and the condensing unit had been shifted from its original location into a dirt hole beside the unit.

Claimed Amount: $6,050

What Really Happened?

Case #1: Collateral Damage

To learn more about split system claims, check out our article:
Actual Cause of Loss Determined by the HVACi Assessment: 
Foreign Object Impact

Though water was involved in this loss, the flattened fins and shifted condensing unit were the result of firefighting efforts nearby.* The water struck the unit with enough force to move it. Since no other components showed signs of water damage, this loss was the result of a foreign object impact.

 

*The standard working pressure of a firehose is between 116 and 290 pounds per square inch of pressure.

Recommendation: If coverage is afforded, the split system could be repaired by replacing the condensing unit and the evaporator coil. A full system replacement was not required.

The HVACi Recommended Settlement: $4,458

Next Case

Case #2: A Different Kind of Foreign “Object”

A residential HVAC system wasn’t operating at peak efficiency. The adjuster hired HVACi to determine the cause of loss and make recommendations to restore the system to pre-loss condition.

Reported Cause of Loss: Unknown

Observations: Though the HVAC system itself worked, ductwork was heavily damaged, and low levels of refrigerant were found in the system. 

Claimed Amount: $19,612

What Really Happened?

Case #2: A Different Kind of Foreign “Object”

Read about another example of what ductwork can tell an HVAC and refrigeration expert:
Actual Cause of Loss Determined by the HVACi Assessment: 
Foreign Object Impact

In the case, the foreign "object" was an animal, such as a raccoon. The animal tore the insulation from the flexible and metal ductwork. The investigation also found dirty HVAC components due to lack of maintenance and low refrigerant levels.

Recommendation: If coverage is afforded, the HVAC system could be restored to its pre-loss condition via replacing the flexible ductwork and re-insulating the main duct line.  A full system replacement was not required.

The HVACi Recommended Settlement: $8,271

For another example of what ductwork can tell an HVAC and Refrigeration expert, read our
Next Case

Case #3: A Precious Metal

The adjuster engaged HVACi to inspect two HVAC systems at a duplex, as neither was functioning as designed.

Reported​ Cause of Loss: Water

Observations: The onsite assessment revealed that refrigerant piping on both systems was missing and had been cut.

Claimed Amount: $19,190

What Really Happened?

Case #3: A Precious Metal

Gain a better understanding of what adjusters should know about intentional damage:
Actual Cause of Loss Determined by the HVACi Assessment: 
Theft/Vandalism

The copper lineset was stolen from the system. The refrigerant lines were cut, allowing refrigerant to escape the systems. The refrigerant circuits were contaminated, and one system was also contaminated by water.

Recommendation: If coverage is afforded, one HVAC system should be replaced in full, while the other could be repaired with a replacement of the condensing unit, lineset, and evaporator coil.  

The HVACi Recommended Settlement: $17,068

Next Case

Case #4: A Whole Nest of Problems

After a suspected high voltage surge, the adjuster handling this claim wanted HVACi to confirm whether the HVAC unit was damaged due to surge or another cause of loss.

Reported​ Cause of Loss: High Voltage Surge

Observations: The control board in the furnace had failed. The wiring was in poor condition and showed signs of fraying, and organic matter was clumped in the condensing unit. All other components measured in an optimal range.

Claimed Amount: $21,109

What Really Happened?

Case #4: A Whole Nest of Problems

Know how to differentiate between three common causes of loss in HVAC system claims:
Actual Cause of Loss Determined by the HVACi Assessment: 
Infestation

The organic matter inside the condensing unit was a rodent nest, and the fraying was the result of its inhabitants chewing through the wiring in the electrical compartment.

Recommendation: If coverage is afforded, the system could be sufficiently repaired by replacing the control board and capacitor, repairing the wiring, and cleaning the condensing unit. 

The HVACi Recommended Settlement: $1,482

First Case
Settling a claim without expert cause of loss verification could result in:
  • Settling for unnecessary repairs or replacements
  • Accepting an inaccurate contractor or policyholder estimate for repair and replacement costs
  • Not addressing the actual cause of loss, resulting in reoccurring problems with the equipment
Aside from preventing claims indemnity leakage, some inspections have unexpected results.

Thanks for Reading These Cases

These are just a few examples of assignments where HVACi has determined an actual cause of loss that differs from the reported cause of loss. All the HVAC inspections we complete help adjusters resolve claims quickly and accurately. Avoid settling for an unnecessary repair or replacement and lower the risk of recurring losses by using HVACi to provide just the facts.

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