Frequently Asked Questions About Your Insurance

WHO DO I CALL TO REPORT A CLAIM?

You can either call your insurance agent or the insurance company directly.  If you do not have a contact for your insurance company, ask your agent to provide the name of the insurance company, your policy number, and a contact number for the company.  If you are directed to leave a message, include your name, policy number, property address, and notification that you are reporting damage and would like the insurance company to contact you to open a claim.

WHAT DO I TELL THE INSURER WHEN REPORTING MY CLAIM?

When reporting your claim, you should provide a general description of the damage.  You may also be asked to advise when the damage occurred, although with hurricane damage, the insurer is usually already aware of the date of loss.

WHAT IF I DO NOT HAVE A COPY OF MY POLICY?

Ask your insurance agent.  If you cannot obtain a copy from your agent, contact the insurance company directly and ask for a certified copy of the policy.  It is important to specify that you want a certified copy, which means it is a sworn and true copy of your policy.  Your policy provides various provisions outlining your coverages, the duties and obligations of you and the insurer, the policy limits, deductibles, and other pertinent information.

You do not need to have a copy of your policy in order to report a claim to your insurer.  By providing your name and property address, the insurer should be able to identify your policy information.

WHAT SHOULD I DO AFTER I REPORT THE CLAIM?

Take steps to protect the property from further damage.  This may involve tarping your roof or boarding up broken windows to prevent further water intrusion. It is also a good idea to photograph and video the damage.  For more information on protecting your property, see the Helpful Tips For Pursuing Your Claim section above.

WHAT AM I REQUIRED TO PROVIDE TO THE INSURANCE COMPANY DURING THE CLAIM INVESTIGATION?

The insurance company will likely request information and documentation during the claim process. This may include written or verbal requests that should be reasonably related to the claim.  For example, photographs, videos, repair estimates, invoices, documents related to the pre-loss condition of the property (e.g. appraisal inspection reports), a damaged personal property inventory, proof of temporary relocation expenses, and other pertinent documents may be requested.

As referenced below, the insurance company may also request a Proof of Loss form, a recorded statement, and an Examination Under Oath.  The insurer is permitted to request these under the terms of the policy.

WHAT IS A PROOF OF LOSS?

Most policies permit the insurer to request and receive a sworn Proof of Loss from the insured.  This is a sworn and formal submission of the damage and amount(s) claimed. If your insurance company requests a Proof of Loss, your are required to timely submit it.  If it is requested, ask the insurance company to provide you with the Proof of Loss form it wants you to submit, and make sure you are aware of the deadline to submit the completed form.

DOES MY POLICY COVER MOLD DAMAGE?

Most policies contain an endorsement providing mold coverage, but only if the mold resulted from a loss that is covered under the policy.  Typically, if a hurricane is the cause of loss, the mold should be covered.  However, most policies limit mold coverage to $10,000 even if the cost necessary to remove and remediate the mold exceed this amount.

DOES MY POLICY COVER TEMPORARY LIVING EXPENSES IF I AM FORCED TO MOVE OUT OF MY HOME DUE TO THE DAMAGE?

Most homeowner’s policies contain coverage for Additional Living Expenses (ALE) if you are forced to move out of the home while the damage is repaired.  This coverage is only available if you are reasonably forced to vacate your home because of a covered loss.  Also, most policies require you to incur these costs before they are covered.

DOES MY POLICY COVER FLOOD DAMAGE?

Most homeowner’s policies exclude flood damage.  However, you may have a policy in place through the National Flood Insurance Program that is separate from your homeowners’ policy that covers flood damage.  Flood policies contain very strict requirements that must be complied with in order for coverage to apply.

DOES MY POLICY CONTAIN A HURRICANE DEDUCTIBLE?

Most homeowner’s policies contain a separate deductible for hurricane losses based on a percentage of the policy limits.  The percentage should be noted on the declarations pages at the front of your policy.

HOW DO I KNOW IF WHAT MY INSURANCE COMPANY IS PAYING ME FOR THE LOSS IS REALLY THE TOTAL AMOUNT OWED?

This can be difficult to determine.  The insurance company is required to pay you for the amount of loss that is covered by the policy based on the loss payment conditions in the policy.  Sometimes the insurance company is permitted to deduct depreciation from certain items of damage and pay you on an actual cash value (ACV) basis, which means you may not be paid the full amount needed to repair or replace the items.  Other times, the insurance company is required to pay you the full amount of the loss on a replacement cost value (RCV) basis, which means you are owed the amount necessary to repair or replace the items of like kind and quality, without any deduction for depreciation.

The terms of the policy govern these issues, which is why it is so important to obtain a certified copy of your policy.  If you are unsure about whether the insurance company is paying you the correct amount for your loss, it is a good idea to seek legal advice.  Also, use great caution before signing any release as a condition to claim payment.

WHAT SHOULD I DO IF MY INSURANCE COMPANY DENIES MY CLAIM?

An insurance company is required to conduct a thorough investigation of your claim prior to making a claim decision.  If the insurance company denies your claim, it is required to provide you with a written explanation of the basis for the denial.  If you receive a written denial letter, you should seek legal advice to determine if the denial was proper.  Oftentimes, the insurance company will deny your claim even though the policy clearly provides coverage.

IS THE INSURANCE COMPANY REQUIRED TO COVER ANY ATTORNEY’S FEES IF I HIRE A LAWYER?

Florida law provides that your insurance company may be required to pay for your attorney’s fees if you are forced to file a lawsuit and you prevail with a judgment against your insurer.

The attorneys at Thomas Nutter Thomas will provide you with free and thorough consultation at any point in the claim process.  If you hire us to make sure you are paid everything you are owed by your insurance company, our fees are only paid if we recover for you.

Questions?

Contact TNT Attorneys for a Free Lawyer Consultation

 

The attorneys at Thomas Nutter Thomas will provide you with free and thorough consultation at any point during the claim process.  If you hire us to make sure you are treated fairly and paid everything you are owed by your insurance company – our fees are only paid if we recover for you.

 
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