5 Common Reasons For Property Damage Claim Denials In Florida, And What To Do About Them

A person’s home or business are usually their most important assets, which is why they pay high premiums to insure them. Property insurance exists to protect homeowners from paying out-of-pocket for property restoration after an incident that was outside of their control. Coverage policies will set out the various types of damages that are covered, including what damage origins are within the scope of the policy, and what the responsibilities of both the insured and the insurer are.

When an incident occurs, property owners plan to take the necessary steps and then receive payment for damage they sustained. Unfortunately, the process is not always as simple as they hope, and insurance claims get delayed or denied due for various reasons.

Some common grounds for denials by an insurer often include:

1. The particular damage was not covered, or it was not an “insured event”. For instance, your property sustained flooding, but your policy did not cover flood damage. (Surprisingly to some, only 23% of Floridians carry flood insurance that would cover them in the event of a damaging flood.) Other times, for example, a fallen tree limb can cause damage that the insurer claims is not covered through the policy, as the tree should have been trimmed or removed prior to a storm.

2. The claim was not filed in a timely manner. Your insurance policy will include timeframes for submitting claims and providing requested documentation. If these deadlines are not met, the insurer may delay or deny your claim outright, pointing to an alleged missed deadline. It is important to remember that insurance companies are for-profit businesses concerned with their bottom lines. Any excuse to deny coverage – including something seemingly minor like having something postmarked a few days late – can give them grounds to save money and deny your claim.

3. Failure to comply with policy conditions or duties after a loss. When a loss occurs, the insured should promptly notify their insurer, while reviewing the terms and conditions of their policy. The policy typically includes a “Duties After a Loss” provision, which sets out important requirements for the homeowner. Failure to comply with these conditions and duties – such as not making efforts to mitigate damage, or make required temporary repairs – can lead to problems recovering under the policy.

The insurer might also request certain itemizations of damages, or the right to inspect the property. Failure to heed these requests can also lead to denials of coverage.

4. The home inventory checklist was incomplete or inaccurate. Ideally, you will have a home inventory checklist prior to a damaging event, which itemizes the personal property in your home with estimated values, as well as the value of fixtures and parts of the home itself. Photos and proof of ownership can be critical for future reference as well. To receive fair compensation for your losses (and avoid allegations of insurance fraud), you want to have an accurate reporting of these items and submit them as requested by your insurer. Incomplete or questionable submissions can be denied for coverage by your insurer, or cause unexpected delays in the handling of your claim.
5. Disagreements over the scope and value of damage. Aside from the technical disqualifications an insurance company may use against homeowners, disagreements over the value of damage may be the highest point of conflict. This is because homeowners and insurers have two separate goals in mind: homeowners, to recover as much compensation as possible after a loss, and insurers to pay out as little as possible while technically satisfying a claim. This is one area where having an attorney can be useful. Too often, insurance companies will bully property owners into accepting less than what they deserve using a variety of techniques – including estimates that reduce the scope or value of damage. Again, these companies exist to make profits and overpaying homeowners on damage claims does not fit their business models.

Property owners have a number of rights under Florida law, and should be mindful of these when an insurance claim is underway. Florida’s Homeowner Claims Bill of Rights is a good starting point for review; the next logical step is to discuss your options with a property damage attorney who has dealt with these situations before in the Daytona area.

If Your Insurance Claim has been Delayed or Denied, Contact our Daytona, Florida Property Damage Insurance Attorneys 

Insurance companies will use many tactics to protect their resources and avoid paying full value on property damage claims. If your insurance claim is being unnecessarily delayed, denied, or the insurer is refusing to pay what you believe is needed to cover your loss, our property damage attorneys at Bundza & Rodriguez, P.A., can help. We will review all aspects of your situation and pending claim, and make your voice heard by the insurance company. If needed, we will utilize the court system to explore and enforce your legal rights. Call our Daytona law offices at 386-252-5170 or contact our Daytona Beach property damage attorneys online to request a consultation today.

Sources:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0600-0699/0627/Sections/0627.7142.html

myfloridacfo.com/docs-sf/insurance-consumer-advocate-libraries/ica-documents/anywhere-it-rains-it-can-flood.pdf?sfvrsn=4fb0a8a7_12