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USAA Insurance promises to loyally serve its veteran members and their families. But that may not always be so according to a lawsuit, Kraig Vandewalle vs. USAA.
Thousands of lawsuits are filed against insurance companies in Texas every year. The Watchdog examined one to study a process used to deny claims.
Vandewalle is a retired Air Force colonel from San Antonio. According to his lawsuit, USAA declined to pay for a replacement roof after a hailstorm.
Clare P. Rodgers, his lawyer, received during pre-trial discovery a cache of internal emails from USAA and Allcat Claims Service of Boerne, a company of outside independent adjusters who inspect roof claims for USAA.
The emails show that Allcat adjuster Gair Allie inspected Vandewalle’s roof and scored it for replacement. But then a vice president of claims at Allcat, Joel Love, worked with USAA to force adjuster Allie to change his decision.
Love then asked that his name be removed from the file to keep his role hidden, a no-no in the insurance industry.
In a deposition, Allie appeared surprised to learn that the opposing side had emails showing these details. Allie said he had never seen them, and no one told him opposing counsel had them.
“It’s obvious to me that they are throwing Gair under the bus,” Vandewalle lawyer Rodgers told me.
This is the second time I’ve come across a legal case where adjuster Allie inspects a roof and then has his expert decision overturned by superiors.
Allie declined to talk to me, saying: “Unfortunately, this case is still under litigation and I am not able to discuss at this time. I am sure you understand.”
I asked USAA about this plus other cases I wrote about in part one of this series, but USAA communications director Rebekah Nelson would only say: “USAA will not speak to specific issues due to member privacy or pending litigation. However, USAA handles millions of claims every year with a high satisfaction rate and remains committed to serving its membership.” There was no further comment.
Joel Love and Allcat officials did not answer my requests for comment.
Estimate overturned
In the first instance involving adjuster Allie, he inspected the Georgetown home of retired Navy flight surgeon John Kelley, a 53-year client of USAA. He told Kelley he found wind damage and he’d write it up for a new roof.
But that estimate was overturned. Allie dropped the roof payment from $19,800 all the way down to $1,200, well under Kelley’s deductible.
Kelley sued and the case went to a 5-day trial, and Kelley won. The jury awarded $143,000 in damages and attorney fees. Before USAA could appeal, the couple reached a confidential settlement with USAA.
‘Delete the reference’
In the second more recent instance, Allie testified under oath last month in a deposition in the Vandewalle case.
After Vandewalle’s lawyer learned that Love, the Allcat claims vice president, in conjunction with USAA, had secretly worked to lower the claim, she amended the lawsuit to include Allcat and Love. She also added charges of fraud and conspiracy.
Allie testified that he was told to change his original opinion, which first was for a smaller estimate, but when he learned that matching clay tiles were no longer available, he upgraded his recommendation to a full roof replacement.
That didn’t fly with his superiors.
Lawyer Rodgers, who questioned Allie, told me, “He was given a word-for-word statement of what his conclusion should be. … They were manipulating it to make it look like he [Allie] was in agreement with the ultimate decision made by USAA.”
Love also wanted his name deleted from the activity log to hide any conversations he had with management.
“Delete the reference” to him, Love wrote in an email to another Allcat official.
The official had written to Love: “Gair Allie resubmitted the file. The file seems to follow your directives.”
Allie testified that he probably deleted Love’s name from the activity log, but he couldn’t recall doing it.
In another email, Love wrote that he reviewed the file with USAA.
A USAA claims adjuster wrote to Love: “We would not owe to replace the entire roofing system. We can replace a slope and repair the tiles.” That would have been a lot less expensive.
The repair estimates bounced from $10,000 to $70,000 back to $11,000, Rodgers said.
Meanwhile, the retired colonel’s home is still damaged three years after the storm. There are 200 broken tiles, representing about a third of the entire roof.
Independent insurance adjusters don’t have to capitulate, says Mike Martin of Azle, who worked as an Allcat adjuster until he resigned.
He said: “I’ve turned in claims where desk reviewers say, ‘I need you to take this off and that off.’ And I say, ‘No, I’m not going to do it.’ I put eyes and hands on everybody’s house, and the thing is, they didn’t.”
They may call themselves “independent insurance adjusters.”
But it appears they’re not always independent.