RESIDENTIAL PROPERTY INSURANCE CLAIMS

Despite accepting premiums and issuing policies, it is not uncommon for insurance companies in Florida to deny coverage for claims. There are different reasons an insurance company may give for denying your claim, some may be valid while others are not. An insurance company may be engaging in bad faith insurance practices when denying valid claims — especially if they are denying claims in an effort to increase profits to the detriment of their policyholders.

Below is a list of reasons your insurance company may give you for denying your claim:

• The claim was not reported in a timely manner
• The property is underinsured
• Insufficient evidence to support payments
• Lack of documentation provided
• Sources of water damage not covered (e.g., sewage backups, flooding)
• Illegal activity or fraud
• Unpermitted work on the property
• Pre-existing damage or wear and tear
• Policy exclusions limiting coverage
• Unpaid policy premiums

Although you may not have the ability to stop an insurance company from denying your claim outright, you can take steps to minimize the chances of a claim denial if you do the following:

• File a claim right after the incident
• Request a copy of your policy
• Comply with the duties after loss section of the policy
• Provide the documents and records requested
• Take steps to protect the property and mitigate damage
• Pay your premiums on time
• Keep records of all repair costs and expenses incurred
• Know what your policy covers and excludes
• Engage professionals to represent your interests

Insurance claims are often undervalued and underpaid by the insurance company. Insurance companies and adjusters are not interested in paying out settlements timely and properly. The insurance company wants to keep payouts low and premiums high to improve its profit margin.

Signs your claim may have been underpaid include:

1. Insurance Company’s Estimate Seems Too Low: If you feel that the estimate is too low, trust your gut and intuition. More often than not, if you suspect the estimate is too low, then it probably is.
2. Adjuster Rushed the Property Inspection: By law, the adjuster must inspect your damaged property and issue a damage estimate within 60 days of the loss. Many adjusters rush through the inspection and do not do a thorough investigation, thereby creating an estimate of repair costs that is artificially low. This is called a low-ball estimate. Whether the adjuster is careless or has bad faith intentions, it can leave you with a lower settlement offer than you need.
3. Damage Was Overlooked or Not Accounted For: Review the insurance estimate and the adjuster documents carefully to ensure all damage and repair costs are identified. If damage has been overlooked or not accounted for in the estimate or documents, you need to take action. Failure to act could result in the underpayment of your claim.
4. Part of Your Claim Was Denied: If any part of your claim was denied, then your claim may be undervalued. Often the insurance company will deny part of your claim to save money. If your property damage claim has been partially denied, it’s not the end of the claim. The claim can be reopened.
5. Offered the Actual Cash Value Instead of Replacement Costs: Your insurance company may also offer to pay the actual cash value instead of the full cost required to replace or repair the property. Depending on your claim and your insurance policy, the insurance company may be underpaying your claim intentionally to save money.
6. Wear & Tear or Old Damages: If your insurance company states that the damages are old or are from wear and tear, this may be a sign they are trying to underpay the repairs. If the insurance company did not ask you to make repairs to your property prior to issuing or renewing the insurance policy, and after a claim states damages are from wear and tear or are old damages, it’s a sign they’re intentionally trying to underpay your claim.
7. Told You Do Not Need an Attorney or a Public Adjuster: If you are told you don’t need an attorney or a public adjuster on your claim, then you should call one and ask for a free claims review. Most attorneys or public adjusters will perform a free claim review to ensure you are being treated properly under your insurance policy.
8. Advised their there is a Lack of Coverage or a Gap in Coverage: Another sign that your insurance company has undervalued your property damage claim is when you have been advised about a lack of coverage or a gap in coverage under your insurance policy. If your insurance company says there is no coverage for certain types of damages or losses, always get a second opinion.

Several factors are essential in selecting an insurance claim attorney. When choosing an attorney, hire someone who has experience and a good reputation in the legal community. Read online reviews to see what other clients are saying about the attorney’s services. Consider the experience and expertise of the attorney handling the claim and how many trials and/or arbitrations the attorney has handled. All these factors are crucial. Choose an attorney only after careful consideration and after speaking with the actual attorney who will be assisting you.

Murray Law Group attorneys work most insurance claim cases on a contingency fee basis. This means there is no payment owed for attorney’s fees or costs to you unless we win your case. We will hire industry experts and engage the professionals necessary to build the most convincing case for you. Murray Law Group understands that in-depth expert analyses can make or break your insurance claim and that is why we work with the best in the industry.