If you are a homeowner in the State of Florida, you undoubtedly purchased a homeowner’s insurance policy at the time you bought your home. You did so with the expectation that you would be compensated in the event you suffered a loss or that your home was damaged. What happens though, if you file a claim and your homeowner’s insurance company denies the claim?
Most policyholders are understandably confused and upset when their legitimate property damage claims are denied outright by their insurance companies. They may be frustrated and discouraged, but the good news is that they have options rights policyholders. The more you know about the rationale insurance companies give for denying claims and policyholders’ rights, the better prepared you will be to file a claim and assert your rights when the need arises.
Tactics Florida Insurance Companies Use to Deny Property Damage Claims
Like other businesses, the goal of insurance companies is to make a profit. That means that your insurance company is highly motivated to protect the bottom line and minimize payouts to policyholders. Consequently, they may interpret language in your policy in a way that enables them to deny legitimate claims.
Common tactics your insurance company may use to justify denying or undervaluing a claim include:
- Ambiguous terms. An insurance policy is a contract between the insurance company and the insured. Even when both sides negotiate the terms of a contract, ambiguous language can sometimes end up in the final version. When an insurance company drafts the entire contract, it should come as no surprise that unclear or vague language is used that allows the insurance company the wiggle room it needs to deny claims.
- Policy exclusions. Most homeowners’ insurance policies include legitimate exclusions to coverage. For example, damage caused by flooding may not be covered unless you purchased separate flood insurance. Floridians may also need to pay for separate hurricane coverage or pay a separate deductible if a home is damaged by a hurricane. While exclusions do exist, your insurance company may incorrectly assert that an otherwise valid claim falls under an exclusion.
- Failing to submit documents. Submitting a claim to your homeowner’s insurance company should be an easy and simple process. Often, however, it is anything but that. A common tactic used to deny claims is to inundate the homeowner with document and evidence requests in the hope that the homeowner will either give up or be unable to provide something deemed “essential” to processing the claim.
- Third-party liability. Your insurance company may claim that a third-party is wholly or partially liable for your losses. For example, if you suffered damage to your roof in a storm, they may allege that the roofing installer incorrectly installed your roof and, therefore, shares in the responsibility for the damage.
- Repair vs. replacement coverage. You may also run into a problem if your homeowner’s insurance policy only provides repair coverage. While this is less common, there are policies that do not cover replacement costs which can be a problem if you suffered damage that cannot be repaired.
- Low–balling the cost. Insurance companies frequently try and “low-ball” the cost involved in repairing or replacing damages to your property. For instance, you may have an estimate for $5,000 to repair the damage caused by a tree falling on your home, but your insurance company contends that it can be repaired for $3,000.
Your Right to Appeal an Insurance Claim Denial in Florida
Fortunately, as a Florida homeowner’s insurance policyholder you have rights. If your insurance company has denied your claim, you have the right to appeal that decision. Before filing an official appeal with your insurance company, be sure to gather evidence to support your appeal. Evidence might include:
- Photos of the damage to your property
- Independent estimates of the cost to repair the damage
- Documentary evidence of any additional losses you have claimed (such as receipts for the cost of a hotel or the purchase of new clothing)
If your insurance company continues to deny your claim after you appeal, you can file a complaint with the Florida Division of Consumer Services. Consulting with an experienced insurance claim dispute attorney prior to filing an appeal may help you determine your best course of action.
Where Can I Get Help Challenging Denial of a Florida Property Damage Insurance Claim?
If you suffered property damage and your insurance company has denied your claim or there has been an unreasonable delay in paying your claim, call us at 407-500-1000 or submit our online form today. One of our experienced Florida property damage insurance claims attorneys will explain your rights to you and discuss your legal options at no cost.
