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Subject: HOA Insurance Claim unfairly denied
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JenniferS22
(California)

Posts:17


06/03/2019 5:35 PM  
Hello,

I am a homeowner who recently experienced water damage in my unit. The CC&Rs state that the HOA master policy is the primary insurance and the policy has a 5K deductible. At this time, I have received a quote from a contractor that states I have 17K worth of water damage. I submitted my documentation to property management and they submitted it to their carrier. About 3 weeks ago, I spoke with their adjuster and he decided to assess the damage to my home via video. He has not come to my home to see the damage. Not surprisingly, he estimates that the damage to my home is less than 5K so no coverage is available.

As I work for a property and casualty TPA, I know that it's unacceptable that he is trying to assess my damage without actually seeing it. And I demanded that he come to view the damage in person. Property Management told me that their agent had requested that he come to see the damage and that the adjuster agreed and would get in contact with me, but he hasn't.

Since the HOA's insurance claims it's less than 5K, my H0-6 carrier would then be responsible, so I contacted them and they sent an adjuster out to view my property last week. I am still waiting on the report but the initial assessment is that it's at least 5K. I have a valid claim under my HOA master policy and I am being given the runaround. The HOA carrier will not return my calls or contact me, presumably because I am not the insured. Property Management hasn't followed up with them or me.

What recourse if any do I have? How can I get the HOA to make an adjuster come out to view the damage to my property properly? At this point, the HOA insurance is acting in bad faith by failing to thoroughly investigate my claim. However, it seems to me the HOA needs to escalate this issue with their insurance. I pay my assessments and have the right to have my claim handled fairly and quickly.

Any help is greatly appreciated.
MelissaP1
(Alabama)

Posts:8396


06/03/2019 6:01 PM  
Need to understand why it makes it the HOA's responsibility. Normally, I would say you claim it on your insurance and then they go after the HOA's insurance if it's necessary. That 5K deductible if it's on the HOA's side, means the HOA has to pay that 5K out of the HOA's budget. So have to factor in that scenario.

Former HOA President
JenniferS22
(California)

Posts:17


06/03/2019 6:53 PM  
The CC&Rs are very vague and make no mention of where the HOA's coverage starts or ends. No language about "studs out" or "bare walls coverage. The H0-6 carrier has advised that I pay them my 1k deductible and then they cover the rest of the 5k deductible to the HOA carrier. Additionally, since the HOA insurance is primary it seems to me that there must be reserves somewhere if the HOA is responsible for the deductible. Also, the HOA carrier didn't deny my claim because there wasn't coverage. I have asked my H0-6 to subrogate but they appear to be unwilling. Possibly because there coverage is considered excess...

The insurance section of the CC&Rs states the following:

7.6 Insurance:
7.6.1(b) Named Insured: Unless otherwise provided in this section, the named insured shall be
the Association or its authorized representative, as a trustee for the Members. However, all
policies shall be for the benefit of Owners and their Mortgagees, as their interests may appear.
7.6.1(d) Authority to Negotiate: Exclusive 'authority to adjust losses under policies obtained by
the Association shall be vested in the Board; provided, however, that no Mortgagee having an
interest in such losses may be prohibited from participating in any settlement negotiations
related thereto.
7.6.1(f) General Provisions: To the extent possible, the Board shall make every reasonable
effort to secure insurance policies providing for the following:

(ii) That the policy will be primary, even if an Owner has other insurance which covers the same loss;
7.6.2 Types of Coverage: Unless the Association determines otherwise pursuant to section
7.6, the Board shall obtain at least the following insurance policies in the amounts specified:
(a) Property Insurance: A policy or policies of all risk property insurance for all
insurable Common Area Improvements and Residences, including fixtures and building
service equipment, against loss or damage by fire or other casualty, in an amount equal to
at least ninety percent (90%) of the current full replacement cost (without respect to
depreciation) of the Common Area and Residences, and exclusive of land, foundations,
excavation and other items normally excluded from coverage. A replacement cost endorsement
shall be part of the policy.
SteveM9
(Massachusetts)

Posts:3296


06/03/2019 7:47 PM  
Want it done quickly, call "your" insurance company. That is why you pay for insurance.

The HOA insurance company doesnt work for you. You are not a customer. So if your going to go it alone without help from a lawyer or insurance company, they are going to treat you that way. Drag it out forever.

House claims follow the address. So if you make a claim under your insurance, it will be listed as a claim for your address. If you file a claim with the HOA insurance company it will be listed as a claim for your address. Same thing.

Do yourself a favor and call your insurance company.
JeffT2
(Iowa)

Posts:479


06/03/2019 10:05 PM  
If for some reason the HOA insurance denies your claim, your own HO-6 policy will cover the costs. The HOA insurance may be primary, but you should still have coverage (indemnified) up to the amount specified in your policy. In that sense it is not your problem but your insurance company's problem. Your adjuster should be calling their adjuster to work out the details.

You can hire a public adjuster, who will take a percentage of the $17,000, but I would wait a while before giving away a percentage, at least until you get your adjuster's report.

Your CCRs will have a definition/description of your unit (or Residence or separate interest), but not in the insurance section. It will probably not have phrases such as "studs out" or "bare walls," but instead something more specific like "undecorated surfaces of the perimeter walls and the space so contained," which it is the description of what you own. Then the insurance section uses this definition by using the word Residences.

Get more estimates (broken down by Residence/common area).
JenniferS22
(California)

Posts:17


06/03/2019 10:35 PM  
Is there something you could reference that I could present to my HO-6 adjuster so that they move forward with coverage? At this point, they are telling me that if my adjuster report states that the damage is more than 5K, then it is the HOA responsibility. I have asked them to move forward with subrogation but they won't respond to my question. The definition of a Residence is below:

2.30 RESIDENCE: The term "Residence" shall mean a dwelling situated on a Lot, including any attached garage also situated on a Lot.
NpS
(Pennsylvania)

Posts:3572


06/04/2019 12:05 AM  
1. Per HOA policy:
- coverage is "primary";
- scope is "Common Area and Residences"; and
- "Residence" is a clearly defined term - which is in your favor.

2. Your insurance company sent an adjuster. If the HOA insurance company didn't, then there is only one legitimate evaluation of the damage. If you're comfortable with your insurance adjuster's estimate, no need to pay for a public adjuster.

3. Let the battle of the insurance companies begin. Your insurance company is on much more solid ground than the HOA's insurance company. As others have said, you should be pressing your insurance company to get this resolved. Their fight with the HOA insurance company, not yours. Call you're insurance company as often as you need to to get them to take the appropriate steps.

4. If your insurance policy covers you for time delay in some way, and if that's not part of the HOA policy, then you have additional leverage against your insurance company. Use it.

Best of luck.


Sikubali jukumu. Read all posts at your own risk.
MelissaP1
(Alabama)

Posts:8396


06/04/2019 4:52 AM  
You have to keep in mind the HOA insurance is NOT going to pay for "improvements". Let's say that you decided to put in "marble" flooring over the original linoleum. The HOA is NOT going to pay to replace that damaged marble but to replace the linoleum. So there goes the price difference between claiming 10K in damages and 1K...

It still hasn't been established why the water damage is on the HOA. Which will also play a factor in the claim. Let's say a during the construction period a pipe was punctured. Eventually that nail shrunk causing the pipe to leak. Now that could be a HOA responsibility. However, let's say you were hanging a picture and punctured a pipe. That most likely isn't on the HOA.

So far have not seen where it has been established what makes this a HOA insurance issue. Just the price it's going to cost to fix it according to the OP. They disagree with the 5K amount which is equal to the deductible payment. The HOA isn't going to fork out the 5K deductible basically if the amount isn't more than that.

Again, it's up to you to talk to your insurer. Not sure why you haven't gone that route and straight to the HOA. Even if I had a car accident it was the other driver's fault, I am going to my insurance first.

Former HOA President
RichardP13
(California)

Posts:3763


06/04/2019 8:05 AM  
Minor technicality, but what was cause of the water damage?

Been there, Done that
JenniferS22
(California)

Posts:17


06/04/2019 9:52 AM  
The cause of water damage was a pinhole leak in a water pipe in the wall, a few inches above the slab. The leak was spontaneous and was not caused by anything we had done. The waterline services only my unit. We're a 32 unit PUD development- so essentially we're townhomes.

With regard to pushing the issued with my insurance, when I do this the always point to the governing docs which in fact state that HOA is the primary, so on what basis can I compel them to take action? I am asking because I would love to do this but I need to know that a good reason that supersedes the governing documents.

I also noted that many of the responses say I should be taking this up with my HO-6, which I really wish I could as I would have more leverage with them. However, the governing documents are precluding me from using my insurance. I don't want to go through the HOA- but that appears to be the directive from the governing docs.
NpS
(Pennsylvania)

Posts:3572


06/04/2019 10:29 AM  
Posted By JenniferS22 on 06/04/2019 9:52 AM
With regard to pushing the issued with my insurance, when I do this the always point to the governing docs which in fact state that HOA is the primary, so on what basis can I compel them to take action? I am asking because I would love to do this but I need to know that a good reason that supersedes the governing documents.



You're right. You can't compel them to take action.
But you can get the appraisal. And you can get a letter clearly stating their assessment of no responsibility. And you can ask for their help in pursuing your claim against the HOA policy.

Sikubali jukumu. Read all posts at your own risk.
PatJ1
(North Carolina)

Posts:93


06/04/2019 10:49 AM  
Have you been speaking with your insurance agent or directly with your carrier? Many agents are not fully aware of the complexities of HO-6 policies and how they relate to the governing docs. Has anyone at your insurance company asked for a copy of the docs? You can perhaps reach out to the California Department of Insurance for assistance in dealing with your HO-6 provider. There is a hotline number here: http://www.insurance.ca.gov/01-consumers/105-type/5-residential/index.cfm



Board members are volunteers. Many have no idea what they're doing. Educate them. Don't beat them up.
JenniferS22
(California)

Posts:17


06/04/2019 11:49 AM  
I have been speaking directly with the adjuster at my HO-6, I don't have an agent. My HO-6 has reviewed the CC&Rs and was the one the alerted me the HOA being primary. I also have spoken to an attorney who has agreed that the HOA is primary and recommended going throught the ADR process, to the tune of 10K. And since the CC&Rs are so vaugue the decision could really go anyway. In the worst possible case scenario I would rather use that 10K to repair my home as opposed to giving it to an attorney and potentially still be left without a living room.

It seems to me that the HOA insurance should be willing to come to my home to give a fair assesment of the damage. Using video seems like a cheap and lazy way to handle a property damage claim.
PatJ1
(North Carolina)

Posts:93


06/04/2019 12:08 PM  
Has your HO-6 carrier adjuster given you their repair estimate yet? If it's nearer the amount your looking to collect you can present it to the HOA for review.

Board members are volunteers. Many have no idea what they're doing. Educate them. Don't beat them up.
JenniferS22
(California)

Posts:17


06/04/2019 1:07 PM  
I should get it soon. I just followed up with my HO-6 adjuster to see if it's available. Yes, I plan to send this and a letter to the HOA Board requesting their assistance since I am basically at their mercy. I am hoping that they are as reasonable as you all have been.
SamE2
(New Jersey)

Posts:133


06/05/2019 3:50 AM  
I would call the state insurance commission and see if they can help you. Also in New Jersey they have adjusters that you hire and they help you work with the insurance company and make sure you get everything you should. Does CA have adjusters?
RichardP13
(California)

Posts:3763


06/05/2019 9:10 AM  
From the first post, it appears the damage was under $5K. It sounds like the deductible for the HOA policy is $5K, therefore, the homeowner would need to cover the deductible, or in this case cover the repair. This is not uncommon. I managed an HOA that had so many claims agaisnt their policy the HOA raised the deductible to &25K.

Been there, Done that
NpS
(Pennsylvania)

Posts:3572


06/05/2019 9:12 AM  
Posted By RichardP13 on 06/05/2019 9:10 AM
From the first post, it appears the damage was under $5K. It sounds like the deductible for the HOA policy is $5K, therefore, the homeowner would need to cover the deductible, or in this case cover the repair. This is not uncommon. I managed an HOA that had so many claims agaisnt their policy the HOA raised the deductible to &25K.



As I read it, damage was 17k, but HOA said it was 5k without doing an inspection.

Sikubali jukumu. Read all posts at your own risk.
JenniferS22
(California)

Posts:17


06/05/2019 9:35 AM  
I received the report from my HO-6 adjuster today. Per their report, the damage totals $14,293.76. And they have issued me $4K- minus my 1K deductible to pay the $5k HOA Insurance deductible. I have a letter that I've addressed to the HOA Board and Property Management and I will be attaching the report and my invoices. I will ask them to review my documentation and move forward with payment. Is that how it works? Seems to me their insurance should be paying and their insurance should have come out to view the damage. It's ridiculous that he looked at video and guessed that the damage is under 5k, and expected me to just go away.
JenniferS22
(California)

Posts:17


06/05/2019 9:39 AM  
Are you talking about public adjusters? It appears that as a third party, I can't hire a public adjuster. I could if the issue was with my HO-6, but since I an not the insured on the HOA policy I'm limited.

I have filed a complaint with the CA state commission but essentially I am a third party to my own claim so I am not sure how much traction my compliant will get.
JenniferS22
(California)

Posts:17


06/05/2019 9:41 AM  
If the HOA would raise the deductible, that would actually beneficial as my HO-6 would then pay for the damage as it's over my deductible but less than the HOA's.
PatJ1
(North Carolina)

Posts:93


06/05/2019 10:01 AM  
Jennifer, now you have something to present them. Since the Master Plan is primary the HOA master policy will cover the amount over the $5,000. The BOD and the MC may not be too well informed on their next steps. They need to present your report under the Master Policy and have an adjuster come out.

The HOA will then have a choice to either let the Master Policy pay or pay out of Operating Funds. If they refuse to further assist with the claim you could hire an attorney to write a letter to the HOA stating their obligations to owners under the Master Policy. The Master Policy also belongs to the owners as they are the one's who pay the premiums through monthly dues. The attorney's fee should not be that much because you have the report from your carrier.

As a board member faced with trying to learn all of this a few years ago, I had to call the HOA attorney. I found out the HOA must file the claim or write the check.

Board members are volunteers. Many have no idea what they're doing. Educate them. Don't beat them up.
JenniferS22
(California)

Posts:17


06/10/2019 6:02 PM  
I went ahead and submitted my letter (addressed to BOD and property manager), independent adjusters report, HO-6 denial letter and picture to Property Management and asked that forward to the BOD for their consideration.

The PM responded today informing me that she was going to submit the new information to the carrier for their review and that upon the carrier's final determination she would then notify the BOD. I am not satisfied with this. Since I am now 60 days without a living room, I feel it's prudent to bring the BOD into the loop. I feel all parties need to be informed about the situation.

Am I missing something here? Should I ask PM to still send my letter to the BOD? Is she just trying to cover for herself?
JenniferS22
(California)

Posts:17


06/10/2019 6:04 PM  
Posted By JenniferS22 on 06/10/2019 6:02 PM
That is atrocious grammar. What I mean to say is. I went ahead and submitted my letter (addressed to BOD and property manager), independent adjusters report, HO-6 denial letter and pictures to Property Management and asked that they forward it to the BOD for their consideration.

The PM responded today informing me that she was going to submit the new information to the carrier for their review and that upon the carrier's final determination she would then notify the BOD. I am not satisfied with this. Since I am now 60 days without a living room, I feel it's prudent to bring the BOD into the loop. I feel all parties need to be informed about the situation.

Am I missing something here? Should I ask PM to still send my letter to the BOD? Is she just trying to cover for herself?



MelissaP1
(Alabama)

Posts:8396


06/10/2019 7:11 PM  
Why isn't this being brought to the boards attention first? Confused. The BOD should have been the first in the loop IMO. The PM works for the board. The board should been able to make a decision on how to proceed. So why aren't they being given this information?

Are you waiting on the claim to be issued before getting anything fixed? Mmmm...

Former HOA President
JenniferS22
(California)

Posts:17


06/10/2019 9:10 PM  
Yes, I am trying to wait till the claim is accepted because if I pay I don't see how I could recoup the costs other than suing the HOA. Additionally, seeing my home is disrepair every day is an incentive to keep up the good fight for what I feel is a legitimate claim.

I am starting to wonder if the PM never asked the HOA adjuster to come back because she thought my claim wasn't legit and that I would go away. I was baffled that she never followed up with me after telling me that the adjuster would come out,
MelissaP1
(Alabama)

Posts:8396


06/10/2019 9:22 PM  
It seems to be the HOA boards call not the PM. The PM is to do what board authorizes to do. So why board not involved?

Plus if you claim on your insurance your insurance sues for the expenses.

Is it me or something fishy in this water?

Former HOA President
RichardP13
(California)

Posts:3763


06/10/2019 11:44 PM  
Melissa

Have you ever worked with a management company? or even what they actually do. As a manager, I am the one that makes things work, 24/7/365. If they is a insurance issue, I am the point person with the insurance company. I know a HOA's governing documents better than anyone. Once I have done all the work, the Board makes the final decision. Yea, I will throw in my recommendation.

Actually, I am hired by the Board, BUT I work for the association. Ever read an attorney letter to a homeowner? kinda goes the same way. They never say they represent the Board.

Without knowing how the CCR's were written and how the insurance policy was written I am only guessing. Based on what the OP said, I would always direct the homeowner to their insurance carrier first and provide their adjuster any information they may need. Remember, the unit is not HOA property, but homeowner property.

Been there, Done that
JenniferS22
(California)

Posts:17


06/11/2019 12:02 AM  
Richard, I have filed a claim with my HO-6 and it's being denied because the HOA is primary even if the homeowner has insurance that covers the same thing. The previous denial letter that the PM wrote says that "Resulting damage to the affected portions of wall and floor are covered under the policy" but that their adjuster opined that the damage was less than the 5K deductible.

Seeing as that the HOA adjuster still has not come out to see the damage, I do feel like I need to escalate this issue directly to the Board as they have the exclusive rights to negotiate claims. As a member of the association am I not within my right to request that my letter and documentation be considered? As the point person for the insurance company shouldn't the PM have ensured that someone came to my home to provide a fair assessment? Not because I am owed this but becaue it's in the interest of the HOA as there policy does cover this damage.
NpS
(Pennsylvania)

Posts:3572


06/11/2019 3:42 AM  
Posted By JenniferS22 on 06/11/2019 12:02 AM
Seeing as that the HOA adjuster still has not come out to see the damage, I do feel like I need to escalate this issue directly to the Board as they have the exclusive rights to negotiate claims. As a member of the association am I not within my right to request that my letter and documentation be considered? As the point person for the insurance company shouldn't the PM have ensured that someone came to my home to provide a fair assessment? Not because I am owed this but becaue it's in the interest of the HOA as there policy does cover this damage.



The PM said they would submit your estimate and notice of denial from your insurance company.
As far as I can see, that's the correct step.
You are looking for the HOA insurance company to reverse its decision based on your new information.
Aren't you trying to get the Board involved prematurely?
Shouldn't the Board first wait to see if the HOA insurance company reverses itself?

Sikubali jukumu. Read all posts at your own risk.
RichardP13
(California)

Posts:3763


06/11/2019 11:58 AM  
I have no idea how your documents are written, but I will tell you how I would handle a situation like this.

Once a leak was reported, I would have the homeowner contact their insurance agent. They in turn, if needed, would contact us for the CCR's and name of HOA agent. Let's say it was the HOA's responsibility and the damage was $6K and the deductible was $5K, Generally, the homeowner's policy should cover the deductible and the HOA's policy would pay the $1K. The HOA does not, I repeat, does not have a slush fund to pay for homeowner deductibles.

What the HOA insurance covers is going to be based on how the policy was written, based on their interpretation on the CCRs of the association. What you posted for insurance has nothing to do with what the HOA's responsibility is. That is found in another section.

I will give you an example of how obscene some situations can be. Years ago my former boss took on an association close to his office of 172 homes saying how easy it was going to manage. What he never did was read their governing docs to see what might lay before him. It turned out that two owners who happened to be attorneys re-wrote the CCRs and got them passed and recorded. Within three years of passage, their monthly dues went from $120 to $450. The CCRs stated that the HOA was responsibility for everything and would pay for everything that went wrong in their units. Their annual insurance costs were $100K for earthquake and $250K for liability, with a $25K deductible (to keep the premium down). If your upstairs toilet overflowed because you put too much toilet paper in, GOOD NEWS, the HOA covered it. For $30K of damage, the homeowner had to cover the $25K deductible.

I have never in my life seen that many pissed off owners showing up for Board meetings. Needless to say, I resigned after 4 months which wasn't soon enough.

Been there, Done that
PatJ1
(North Carolina)

Posts:93


06/22/2019 1:29 AM  
Jennifer,

Are there any updates to your situation. Curious what's been happening.

Board members are volunteers. Many have no idea what they're doing. Educate them. Don't beat them up.
JenniferS22
(California)

Posts:17


06/23/2019 1:09 AM  
Hi Pat! Thanks for your help and interest in my story. The HOA's adjuster FINALLY came to my home to see the damage this past Monday. It was a little awkward since he did not responded to my calls or emails but I was civil. He thanked us for our patience while he went through "his process", which I suppose is trying to discourage people from bringing forth legit claims. He agreed that the whole floor had to be replaced and agreed to re-evaluate my water mitigation invoice. He advised I should reach out to PM on Friday which I did.

PM responded that their carrier was going to issue payment to them in an amount close to 10K and that I can begin repairs now, even though they have not received the check. I received her email late on Friday and I need to follow-up back up with her for clarification, but she is out on vacation all next week.

I assume that the 10K is total damage cost less the 5K deductible? So about 15K for the whole first level floor and it appears that we can use our own contractor which is great, seeing as we are going to change the material of the floor to something waterproof.

Also, I recieved notice this week that the complaint I filed with the State Insurance comission is being looked into. I am not sure what that really means, and probably doesn't mean much now that the carrier has accepted the claim. But, it felt good to feel like I was finally being heard.

Is there anything else I should know about the reimbursment process? Her email stated that we need to send a paid invoice, in the event that the repair cost less than 15K, would they only reimburse the difference between the final cost and deductible?

I still intend to appear at the next Board meeting, I really think the CC&R's could be reviewed and that the HOA should not be primary or at minimum that the deductible be increased to 20K or something greater than 5K. I also think that there should be some guidelines with regards to how claims are handled. If I would have known that the PM needed more documentation to "vet" my claim, I would have provided it right away. In retrospect it felt as though she kept pushing me to file a claim with my H0-6, but I already had done so when I contacted her and said this in my inital email to her.

I am just so happy that there appears to be the start of a resolution to this and I can have my house back.

I really appreciate everyones input and help.
PatJ1
(North Carolina)

Posts:93


06/23/2019 2:33 AM  
Thank you for the update. We are in NC and had a similar claim a few years ago without the issues with the adjuster not wanting to come out. The monies were handled differently though.

Once the work order was signed by both the owner and the HOA, the check from our insurance carrier was paid to the HOA. The contractor began the work. The monies were paid directly from the HOA to the contractor once the owner approved and the HOA confirmed the work was completed. There are owners who wouldn't have $10,000 to pay the contractor and get reimbursed.

You stated "I really think the CC&R's could be reviewed and that the HOA should not be primary or at minimum that the deductible be increased to 20K or something greater than 5K" - In NC the HOA is required by the state to be primary under certain conditions. In our case, we are stacked condos. Deductible amounts are usually set by the Board. Remember the HOA also has to cover the deductible if the claim is to rebuild common property. Depending on how the policy is written, this could mean meeting the deductible several times during 1 event. We have 21 buildings and if we had severe roof damage to several buildings, we have to meet the deductible on each building.

Our deductible is $10,000. This amount has kept our HOA out of many claims. We considered raising it to $25,000 but had to take into consideration the exposure to the HOA in the event of a loss.

"in the event that the repair cost less than 15K, would they only reimburse the difference between the final cost and deductible?" Doubtful this would happen. Adjusters work off the same guidelines and the contractor will invoice the amount of the estimate. You will be responsible if you decide to upgrade any items while re-constructing. If you do, don't forget to increase your coverage on your HO-6 as the HOA policy will only cover original build. For example, if carpet was original build and you install hardwood, that's an upgrade and the HOA policy won't cover that. They will only cover for carpet.

Yes, the check from the HOA insurance carrier is for the amount of the estimate less the deductible. Your HO-6 policy covered the first $5,000 less your personal policy deductible.

Glad to hear you can move forward with the repairs.

Board members are volunteers. Many have no idea what they're doing. Educate them. Don't beat them up.
MelaniW
(Maryland)

Posts:8


07/03/2019 8:15 AM  
Has the Association's adjuster submitted something to you (or the manager) explaining in detail why they are proceeding in this way? They should, and it should include explanation (as in a detailed explanation of their <$5k estimate).

I don't know California law on this, but in Maryland the association by default is involved in covering all expenses over $5k in the condo. So I would imagine you are legally entitled to a written explanation of the association's plans.

I also wanted to mention that the Manager saying she would submit your letter to the insurance adjuster, and then to the Board, is standard procedure. It doesn't mean the Board doesn't know about your claim. I can only imagine the Board is aware, and proceeding via the professional opinions of the manager and the insurance adjuster.
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