Yes, dear reader, the above title is correct.  A Florida Appellate Court actually had to rule that your homeowner’s insurance is not responsible to pay for damage caused by the “sudden explosion” of someone’s body.  If you don’t believe me, you can read the actual opinion here.

Per the facts of the case, Ms. Rodrigo filed a lawsuit against State Farm Insurance Company for the damage caused to her condominium unit by blood and bodily fluids that had leaked into her unit from the above unit.  Apparently, an elderly lady living above Ms. Rodrigo passed away and, since no one discovered the body for a long period of time, the body began to bloat and decay –  to the point that the gasses inside the corpse built up enough pressure and the body’s abdomen burst.  The sudden “bursting” of her body released gases and fluids which, per Mr. Rodrigo’s claim, leaked into Mr. Rodrigo’s unit and caused damage to her personal items and….well….certain smells.  (I’ll ignore the parts about the deceased lady having several hungry dogs in the unit and the manner by which those dogs kept their hunger at bay during this time.)

The issue then became how to pay for the damage caused by this yucky stuff.  The subject insurance policy was a “named peril” policy, which only provided coverage for causes of loss that are specifically listed in the policy.  After noting that there was no coverage for gooey bodily fluids, Ms. Rodrigo tried to obtain coverage under the named peril of “explosion” – apparently keeping a straight face while doing so.  At trial, she presented testimony from a doctor that the contents of the deceased’s body, after undergoing advanced decomposition, “explosively expanded and leaked”.  She argued that since there had been an “explosion” of the deceased’s organs – surely it would qualify as damage caused by an “explosion” under the terms of the insurance policy.

Needless to say, neither the trial court nor the appellate court (Really??  You actually appealed this to a higher court!) agreed with this interpretation.

 

 

tornado-damage-floridaOver the last few days, Central Florida has been pounded by torrential rain, tornadoes and high winds.  These damaging windstorms and tornados were especially violent in Manatee, Sarasota, Lee, Hillsborough and Pinellas Counties.  These thunder storms caused flooding in Shore Acres, wind damage in Siesta Key, and claimed the lives of two people in Duette.  Now that the storms have past, we are left to deal with the damage done by this weather event.  Fortunately, most people have homeowners insurance to help pay for the damage to their property, but as we have often seen, going through the insurance claim process can be a world of heartache all its own.

After the storm or tornado has past and/or the flood waters have receded, you should immediately contact your insurance company and place them on notice of your claim.  The sooner you start the insurance claim process, the better chance all parties have of accurately calculating your damage and the cost to repair same. You should also take whatever ever steps you can to mitigate the damage caused to your property and otherwise take action to keep additional damage from occurring.  You should also, to the best of your ability, make a listing of the damaged property.  Although making a listing of your damaged property can be difficult – especially when the items are missing or totally destroyed – you are the best person to know the extent of your property.  If you can’t properly itemize your lost or damaged property, most likley the insurance company will not reimbuse you for same.

After a storm or other weather event, you may also have to deal with emergency restoration companies.  These companies will come to your house soon after the damage occurs and will do the immediate repairs or restoration that may be necessary to protect your home from further damage.  These services usually include the placement of large fans or other equipment to dry out your property, the installation of tarps over your damaged roof, or other similar activities.  Although these services can often be crucial for the protection of your property, always remember that these services are very expensive and that you only have a certain amount of money under your insurance policy limits with which to repair your home.  If large sums of your policy limits are spent on these initial emergency repairs, you run the risk of not having sufficient funds remaining to repair the remainder of your home.  Therefore, it is always important to obtain an agreed upon written estimate of the work prior to the performance of same.

Lastly, it is important to remember the difference between flood insurance and wind insurance.  Your normal policy of property insurance does not cover flood damage – meaning damage caused by “rising water”, but will only cover damage caused by water which was “blown into” your home by wind.  For instance, if your property was damaged by water that had been blown in through a window or a damaged roof, your normal homeowners policy would cover it.  If the damage was caused by water rising from a nearby creek, your homeowner’s policy would not cover the damage.  It is crucial that you understand the coverages available to you prior to authorizing any repair work to your home.  If you authorize a contractor to dry out your home after a flood and then realize that you do not have flood insurance – you will be on the hook to pay the contractor out of your own pocket!

As always, should you have any questions regarding what coverage may be available to you under your insurance policy, please feel free to contact our office and we will do our best to answer any questions you may have regarding your property damage claim.

 

It may come as a surprise to many homeowners, but you may be able to substantially reduce your homeowner’s property insurance premiums by just looking through the provisions of your policy.  Specifically, most homeowner’s insurance policies set forth numerous premium “credits” for which you can qualify based upon the age and condition of your home.  These available credits are usually listed in the documents you receive along with your annual policy renewal – you know, the stuff you never read and immediately throw away.

For instance, you may be entitled to a substantial premium discount if your roof has wind mitigation straps.  These straps literally “tie” your roof to your exterior walls and may help avoid the structural failure of your roof and walls during a high wind event.  If your home was built after 2002 or if your roof has been recently replaced, your home most likely has these straps as the use of such was mandated after the building code was amended in 2002.  You should hire a wind mitigation specialist to do an inspection and to determine whether your roof has these wind mitigation straps and whether you qualify for any other premium discounts.  These inspections usually cost between $75.00 to $100.00 – a small investment considering the reduction in premiums you may be able to obtain.

As with many things, the devil is in the details, and this process will require that you take the time to read the onerous and often-times purposefully confusing provisions of your insurance policy – but you may be able to save several hundred dollars (every year!) in homeowner’s insurance premiums.  Better in your pocket than in your insurance company’s wallet!  As always, should you have any questions regarding your insurance policy, please feel free to give our office a call.

Yesterday, a large sinkhole opened up in the driveway of a Pasco County homeowner.  I attached a picture of the sinkhole – which I’m sure was quite a surprise to the homeowner when she began to back out of her garage yesterday morning!  The question now arises – would this issue be covered under your policy of homeowner’s insurance?  One would THINK so, but….welcome to the fantasy land that property insurance has become in Florida.

First, the most obvious analysis would be whether this issue would be covered under the “sinkhole loss” portion of the homeowner’s insurance policy.  Actually, thanks to the recent changes in the sinkhole statutes enacted in Florida, this loss would most likely not be covered as a “sinkhole loss”.  A sinkhole loss is defined under most policies of insurance as structural damage caused to the home by sinkhole activity.  Clearly, the attached picture reflects sinkhole activity, but does it reflect “structural damage” (as now defined in your policy) to the residence?  Pursuant to the recently enacted laws, in order for your home to have incurred “structural damage”, your house pretty much has to be reduced to a pile of sticks (the statute has a slightly more technical definition, but you get the point).  So, even though the subject house is clearly being affected by sinkhole activity, since the damage to the house does not arise to the new definition of “structural damage” = No Coverage!

But there is also a portion of your insurance policy which provides coverage for Catastrophic Ground Cover Collapse.  It is this coverage that the insurance company lobbyists touted as being available to cover situations where an “actual” sinkhole opened up and destroyed your house.  BUT – this Catastrophic Ground Cover Collapse coverage only applies if ALL of the following conditions are met: (1) An open hole you can clearly see with the naked eye (check!); (2) Damage which is sudden and not gradual (check!); and – here comes the kicker – the home must be condemned and ordered vacated by a government entity.  Well – since the subject home does not appear to by destroyed and therefore has not been condemned, all of the required elements have not been met and therefore = No Coverage!

Unfortunately, this homeowner is about to experience the Sinkhole Loophole mess which our Florida Legislature has created for us.  As always, when confronting a complex insurance claim issue, it is wise to contact a qualified insurance claim lawyer to help guide you through the process and to explain the rights you have under your insurance policy.

 

During the 2012 Florida Legislative Session, insurance company lobbyists pushed for the passage of HB 119, which greatly overhauled the Personal Injury Protection portion of your automobile insurance policy.  As part of their sales pitch, proponents of this bill stated that the passage of this Bill would GREATLY REDUCE the cost of automobile insurance in the State of Florida and cut down on “fraud”.

As we learned years ago, “cutting down on fraud” is just another way of saying “severely reducing a policyholder’s chance of ever getting paid on his claim.”  But what about the claimed reduction in the cost of auto insurance premiums?  Surely insurance companies have lowered their automobile insurance rates in exchange for HB 119’s severe limitation of the rights of policy holders…..right?

Well, the Office of Insurance Regulation announced this week that the cost of Personal Injury Protection coverage is expected to drop an average of 13.2 percent in Florida.  Great you say!!!  But then the fine print – since this “no fault”/ Personal Injury Protection coverage accounts for such a small percentage of your overall automobile coverage, the overall decrease in your overall policy would be about 1.2 percent!!  Not a very good reduction in exchange for the severe limitations this new law places on the rights of policy holders.

Once again, it appears Florida’s elected officials have fallen for the insurance companies’ old yarn of “Allow us to restrict coverage today, and we promise to reduce premiums…..tomorrow….maybe.”

By now you have probably seen the attached video {Click Here to Watch} of the “enthusiastic” (ok, really drunk) Alabama fan who was trying to deliver some frontier justice to an Oklahoma fan in the adjoining section.  Clearly, her activity stands out as a shining example of how fans should act on any given Saturday in the Southeastern Conference and surely there is a co-ed somewhere in Tuscaloosa who is proud to call this fine lady his mom.

But I digress.  The real reason for his post is to discuss whether or not this fine lady would be covered by her homeowner’s insurance policy for any of her extra-curricular activities.  Although most people think of their homeowners insurance as only providing coverage for either property damage or injuries which occur on the insured property (slip and falls, dog bites, etc.), the standard homeowner’s insurance policy also provides coverage for bodily injury or property damage caused by the insured while away from home.  In short, the usual policy provides coverage for: “bodily injury” or “property damage” caused by an “occurrence”… to a person off the “insured location”, if the “bodily injury”… is caused by the activities of an “insured”.  Now, since all those quoted terms are specifically defined elsewhere in the policy, you can rest assured that such coverage is subject to several exclusions and that obtaining coverage for your follies may not be as easy as it seems.  But as least it is a start.

Now, with regard to the specific example posed by our southern belle, there is a specific exclusion to this coverage for, shall we call them, intentional acts.  The exclusion reads, in pertinent part:  Personal Liability Coverage….do(es) not apply to ‘bodily injury” or “property damage”  which is expected or intended by one or more “insureds”.   Oops!  Even though some might say she is a little “cray cray”, her acts look pretty intentional.  Perhaps the better advice would be that, if you plan to get that drunk, maybe you should stay at home and watch the game from the safety of your own home.

Citizens Property Insurance Corporation has been earning a reputation for systematically denying almost every insurance claim asserted by its policyholders.  Instead of honoring valid claims, Citizens spends millions of dollars each month “defending” claims – the same type of claims that other insurance companies would routinely pay without question.  Although those of us in the industry have been decrying Citizens’ business practices for years, last week the Tampa Bay Times finally posted an article pointing out Citizens’ track record of fighting valid insurance coverage claims and needlessly lining the pockets of law firms to “defend” against these claims.

Now, on the chance you might believe that Citizens’ policy of denying claims and raising meritless defenses is just urban legend, I offer the following examples of Citizens’ behavior from our recent experience:

Example A – Our client presented Citizens with a sinkhole damage claim, which Citizens summarily denied.  We provided Citizens with testing evidence which undeniably reflected sinkhole activity on our client’s property and also provided reports from neighbors on all three adjacent sides (left, right and behind) which had been confirmed for sinkhole activity.  Citizens’ response?  They offered $500.  They also promised that, once the policy holder ultimately won at trial (which they conceded would happen), Citizens would appeal the outcome (regardless of merit) in order to further drag out the process.

Example B – Citizens’ engineers actually confirmed sinkhole activity on the property of another one of our clients, but still – three years later – Citizens refuses to pay for the appropriate repair of the property.  Just yesterday, a large sinkhole actually opened up directly next to their house.  Our clients’ story even made the evening news last night.  Even so, Citizens refuses to provide coverage for the appropriate repair of the home.

Sadly, there is no one guarding the hen house at Citizens.  Outside vendors – mostly insurance defense law firms with the most to gain from Citizens’ stance on fighting claims – have convinced Citizens that the best way to handle claims is to fight tooth and nail on every issue, even when there is absolutely no chance of winning.  Obviously, the harder you fight payment on a given claim, the more money the insurance defense law firm can make billing Citizens for delaying/defending/denying the claim.

The other side of this coin is that, once the policy holder ultimately prevails on his claim, the insurance company is also responsible for the payment of the policyholder’s attorney’s fees and costs.  Accordingly, Citizens ultimate “reward” for denying valid claims is that the insurance company has to pay (1) the full amount of the repair costs, (2) pre-judgment interest on this amount, (3) the policyholder’s attorney’s fees and costs, and (4) Citizens’ own attorney’s fees and costs.  It doesn’t take a financial genius to see that it makes more sense to resolve a valid claim early in the process – and thereby avoid the payment of items (2) through (4) above – rather than needlessly waste money defending a claim which the insurance company will ultimately have to pay anyway.  But until there is a change of heart – or management – at Citizens Property Insurance, it may be best to retain qualified representation early in the insurance claim process.

Water DamageAlthough hurricanes, earthquakes, and sinkholes get the majority of the attention in the news, the vast majority of insurance claims deal with water damage to property.  These claims are generally broken into two categories – flood damage and water leak/seapage damage.  Flood claims revolve around damage caused by “rising water”, as opposed to other types of water losses which could come from leaky pipes, water blown through windows as the result of a storm, or overflow from appliances.

For an immediate consultation with regarding your rights, call (800) 451-6786 today.

With regard to the avoidance of damage caused by a flood – well, that’s between you and Mother Nature.  With regard to protecting your property from other types of water damage, you may find the following tips helpful:

1.  Know the location of water valves.  Make sure everyone knows where the main valve is located and how to turn the water off.

2.  Monitor utility bills.  An unusually high water bill could signal a water leak.

3.  Turn off water before traveling.  Turn the water off at the main valve or directly on major appliances. Consider leaving a house key and contact information with a neighbor or trusted friend and ask the person to check the inside and outside of your home periodically while you are away

4.  Inspect your home regularly for signs and sources of moisture.   After a storm or rain shower, check for water stains or odors inside your house.  Create a maintenance schedule to check the following sources of water leaks on a regular basis:

Hot water heaters – Hot water heaters may rust or develop cracks over time. Check your water heater for rust and deterioration every year. Check the drain pan for water and ensure that the drain line for the overflow pan is not clogged. Drain and clean the water heater as recommended by the manufacturer.

Garbage disposal – Routinely check for cracks or other sources of leaks.

A/C drain lines – Damage can occur when the line that drains condensation from the evaporator coils becomes clogged and water overflows from the drip pan. Periodically check the drip pan for water and consider an annual service call to reduce the buildup of algae and mold in the drain line.

Indoor and outdoor pipes and faucets – Routinely check indoor pipes under cabinets and sinks for leaks, rust, and any signs of deterioration. Minimize the potential for water damage from frozen and broken outdoor pipes by insulating supply lines (in attics, crawlspaces, and exterior walls), protecting exposed outdoor faucets, sealing gaps in exterior walls, and maintaining adequate heat in your home.

Appliance hoses – Broken hoses are among the most common causes of water damage. Regularly inspect hoses and hose fittings on washing machines, icemakers, and dishwashers for kinks, cracks, bulges, or deterioration. Replace standard rubber washing machine hoses every two to five years or more often if they are showing signs of wear. Consider using steel-reinforced hoses for longer life.

Showers, tubs, sinks, toilets, windows, and doors – Water leaks around bathtubs, showers, sinks, and toilets can cause damage because the leak is often out of sight. To prevent leaks, make sure you have a watertight seal of caulk around tubs, sinks, toilets, tubs, shower stalls, windows, and doors. Cracks or mold on caulk or tile grout may indicate that you do not have a watertight seal. Remove all caulk or grout, clean and dry the surface thoroughly, and apply fresh caulk. Do not apply new caulk or grout on top of the old materials.

Attics and ceilings – Routinely check for wet insulation and water stains.

Wallpaper – Routinely check for bubbling, peeling, and stains.

Roofs – Keep roofs free of debris that can damage roofing and allow water to seep in. Trim tree branches to prevent them from rubbing and damaging the roof.

Repair missing or damaged shingles – Properly seal any cracks around chimneys, skylights, and vents. Check metal flashing for holes, cracks, or other damage. Replace flashing or use silicone caulk to seal any openings.

Rain gutters and downspouts – Direct rainwater away from your home. Keep gutters clear and make sure downspouts are long enough to carry water away from your foundation. Gutters that are filled with leaves and other debris allow water to back up on the roof, which can result in water damage to eaves and roofing material.

Sump pumps – Sump pumps are the first line of defense in preventing water from seeping into basements. Periodically check the sump and remove any debris that could clog the pump. Consider installing a battery-powered backup to protect your basement during power outages.

Landscape – Yards should slope away from the house to prevent puddling near the foundation or under pier and beam houses. Do not allow sprinklers or sprinkler heads to soak the exterior of your house.

Trust me – with regard to water damage, an ounce of prevention is worth a pound of cure.  A few years ago, we had a water leak at our house that resulted in our being out of the home for over 77 nights!  One tiny valve behind a toilet in my daughter’s bathroom broke free while we were on vacation and the resultant leak destroyed the hardwood flooring throughout our entire house and even seeped up the walls for approximately three feet!  Even with the best preparations, accidents may be unavoidable.  Therefore, it is vitally important that you verify that you have sufficient coverage on your homeowner’s insurance policy to protect you from water damage.  If you have any questions regarding your insurance policy or what coverages it may provide, you should contact an insurance claim lawyer to examine your policy and explain what benefits your policy may provide for this type of loss.

Pursuant to a new Federal law, premiums for residential flood insurance in Florida may soon be as high as $24,000 a year.  A new law, the Biggert-Waters Flood Insurance Reform Act, was enacted by Congress in 2012 as a knee jerk reaction to the recent large scale disasters such as hurricanes Katrina and Sandy.  Proponents of the new law stated that the passage of this law was necessary in order to make the federal flood insurance “fiscally sound”. 

People who bought homes in high-risk areas after the law was passed in July 2012 may have received the same flood insurance rates as the previous owners.  When these new owners renew their flood insurance policies, they will be required to get an elevation certificate – which will most likely cause the amount they pay for flood insurance to explode.  Much of the potential rate increase will be tied to the height of the home’s foundation as opposed to the base flood level.  It is speculated that a home at 3 feet below the base flood elevation may see rates increase to approximately $6,500 per year, and a home at 6 feet below the base flood elevation level may see a rate of $15,000 per year.  Oh – and remember that coverage limits for federal flood insurance is capped at $250,000 – regardless of the value of your home.

An article in the St. Pete Times today pointed out two specific examples of how this new law will affect Pinellas County residents.  In one example, a home was built in 1960 and was purchased in March of this year for $148,000.  Since this home is 7 feet below the base elevation, its annual flood insurance premium will soon be $22,400.  Another example was a 1956 home which is 8 feet below the base flood level.  This homeowner now pays $1,960 for his flood insurance, but next year his premium will be $29,100.  As a general rule, current property owners in the “A” flood zone who are now paying approximately $2,000 a year for flood insurance will see their premiums jump 25% in October of this year, and these premiums will continue to rise over the next eight years to approximately $11,000 per year.

Clearly, the Biggert-Waters Flood Insurance Reform Act will be catestrophic to the real estate market in Florida and beyond.  As for prospective purchasers of waterfront property in Florida, make sure you know what you are getting into as it appears that the days of affordable flood insurance are in the rear view mirror.

Property damage caused by mold can be a real problem – especially here in Florida.  The combination of Florida’s humid climate and often rainy weather create the perfect petri dish for the creation and growth of toxic and damaging mold.  Fortunately, most homeowner’s insurance policies provide coverage for the damage caused to your property by mold.  Unfortunately, the coverage provided by most policies is extremely limited.

If You Have Questions Regarding Your Mold or Water Damage Claim – Call (800) 451-6786 for Immediate Help.

Up until a few years ago, damage caused by mold was covered under Coverage A of your homeowner’s insurance policy.  Coverage A of your policy provides coverage to the main structure and sets forth a policy limit which, at least in theory, is related to the replacement cost of your entire home.  A few years ago, the insurance industry lobbied for and were allowed to alter their policies to include the following language:

Fungi, Wet or Dry Rot, Yest or Bacteria.

a.   We will pay up to $10,000 for:

(1)  The total of all loss payable under Section I – Property Coverages caused by “fungi”, wet or dry rot, yeast or bacteria;

(2) The cost to remove “fungi”, wet or dry rot, yeast or bacteria from property covered under Section I – Property Coverages;

(3) The cost to tear out and replace any part of the building or other covered property as needed to gain access to the “fungi”, wet or dry rot, yeast or bacteria; and

(4) The cost of testing of air or property to confirm the absence, presence or level of “fungi”, wet or dry rot, yeast or bacteria; whether performed prior to, during or after removal, repair, restoration or replacement.

The cost of such testing will be provided only to the extent that there is a reason to believe that there is the presence of “fungi”, wet or dry rot, yeast or bacteria.

Now – what does all that mean?  There are two kickers to this policy language.  First, no matter how catastrophic your damage is or how high the cost to repair – your policy will only provide coverage for up to $10,000 for these repairs.  Secondly, the insurance company can deduct from this limit the amount the insurance company spent initially investigating this loss!  In other words, if mold caused $50,000 worth of damage to your home and, upon contacting the insurance company, the carrier spends $2,500 investigating the existence of the mold damage and calculating the amount of the loss, you would only be provided coverage for $7,500 to repair your home ($10,000 coverage minus $2,500 investigation expense incurred by carrier).  You would then be on the hook for the remaining cost of repairing your property.

Although the mold coverage available under your homeowner’s insurance policy may be very limited, there may be other portions of your policy which may provide coverage.  Therefore, it is important to seek legal advice from an attorney with experience with water and mold claims in order to best protect your rights.

If you have any doubt about whether you are being treated fairly by your insurance company, please call (800) 451-6786 for a Free and Immediate consultation regarding your rights.