Over the past year or so, we have been getting an increasing number of calls from property owners who continue to experience sinkhole damage to their property – even after their property has been repaired by the insurance company!  The factual circumstances are almost always the same – the insurance company mandates that the insured repair the sinkhole damage pursuant to the recommendations of the insurance company’s experts and then, after these supposed repairs are completed, the property continues to incur new damage.  Although sometimes this new damage appears immediately after the insurance company’s repairs are completed, many times the damage appears years later.  In almost every scenario, after the insured contacts the insurance company regarding this damage, the insurance company’s expert issues a quick report saying that the damage – if the expert even acknowledges the damage – is not from sinkhole activity and the claim is then summarily denied.

Many property owners do not realize that if the insurance company repairs the property pursuant to the insurance company’s recommended repair method, the insurance company must stand behind that repair method and must continue to repair the property – regardless of the cost – until the property is fully remediated.  The law on this process is clear – if the insurance company mandates that a property owner perform the insurance company’s sinkhole repairs to the property, the insurance company must continue to pay the cost of the repairs until the property is fully remediated or, if the insurance company gives up on repairing the home after beginning the process, the insurance company must issue a check for policy limits to the property owner without deduction for monies already spent towards the repair! 

Always know that you have rights against your insurance company and that you do not have to accept whatever remedy the insurance company may try to force upon you.  Clearly, it is important to have your claim reviewed by an experienced insurance attorney who can explain your options and, if necessary, zealously pursue your claim against the insurance company.

Over the past several years, many homeowners in Florida have had the misfortune of incurring damage to their property as the result of sinkhole activity. For many homeowners, the headaches and inconvenience caused by having to undergo the initial repair of this damage turned out to only be the beginning of the battle.

In almost every claim, when an insurance company agrees to repair an insured’s property, the insurance company will only agree to provide coverage for the repair protocol set forth by its chosen expert. Not surprisingly, the insurance company’s chosen expert will usually choose the least expensive repair method for the home. (It goes without saying that, were the expert to recommend a more complete repair method, he would not be the insurance company’s “chosen expert” for very long!) Faced with the insurance company’s mandate, the homeowner often agrees to allow the insurance company to repair the home pursuant to the insurance company’s chosen method.

The problem which has now arisen for numerous property owners is that the repair method mandated by the insurance company is insufficient to fully repair the property. Even though the insurance company’s version of the repairs have been completed, the property owner continues to incur damage to the home as the result of the sinkhole activity. Unfortunately, when this additional damage is pointed out to the insurance company, the carrier will deny any further repair to the property and state that the issue has been resolved – regardless of the existence of this new damage.

Fortunately, these property owners continue to have rights under their policies of insurance. Under Florida law, if an insurance carrier mandates that an insured repair his property pursuant to the insurance company’s chosen repair method, the insurance company must fully warrant those repairs. In other words, if the insurance company’s chosen repair fails to fully solve the problem, the insurance company is responsible to pay for any additional repairs necessary in order to bring the property to its pre-loss condition.

If you’ve filed an insurance claim for sinkhole related damage in the past few years in Florida, you’ve most likely seen the term “neutral evaluation” in various correspondence or heard the term mentioned by an insurance adjuster.  A few years ago, the Florida Legislature enacted a law whereby if there is a disagreement as to whether sinkhole activity is present on the property or as to the appropriate method to repair the damage, either party to the claim can elect to submit the claim to the neutral evaluation process.  During the neutral evaluation process, a third-party expert chosen from a list maintained by the Department of Financial Services reviews all the investigative reports, inspects the property, and then renders a non-binding “third-party” opinion as to the issue in dispute.  Although the report issued by the neutral evaluator is non-binding, the law states that his report is automatically admissible in any legal proceeding relating to the claim.

Sounds pretty straight forward, right?  Perhaps not.  Exactly what standard does a neutral evaluator have meet in order to be considered “neutral”?  When the neutral evaluation process first began, the Florida Legislature (or perhaps, the insurance company lobbyists?) set forth that an expert would be deemed “neutral” if that expert received 90% or less of their income from insurance companies.  So, in light of this definition, an expert who received 89% of his livelihood from an insurance company would not be seen as being biased in favor of insurance companies.  Hmm – how odd.

Recently, the insurance company lobbyists – er, I mean, the Florida Legislature – further refined the definition as to what would be deemed “neutral”.  Currently, the only “neutral” qualification they must meet is that the expert be, “determined by the department (of financial services) to be impartial”.  Apparently, the Legislature believed that the 90% cut-off requirement was too restrictive and that experts who received in excess of  90% of their income from insurance companies should still be considered “neutral” for this process.  Who are we to question that logic!

Clearly, the use of the word “neutral” in the neutral evaluation process is subject to scrutiny.  Although this process may have been sold to the general public as a way to have sinkhole claim disputes resolved by an “impartial” third party, the reality may be that the “independent” expert may be very beholden to the insurance industry.