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After a loss, an insurance company will often mandate that the policyholder complete and sign a form called a Proof of Loss regarding the damages claimed by the policyholder. A Proof of Loss is a one page form (possibly with attachments) that is usually provided to the policyholder by the insurance company.

The Proof of Loss form requests specific information from the policyholder regarding the date and time the loss occurred, type of loss claimed, the available insurance policy limits, and the exact amount of damages sought by the policyholder. The Proof of Loss form may also mandate that the policyholder attach any damage estimates or other calculations that support the policyholder’s claims.

If you have any questions regarding the insurance claim process, please do not hesitate to call us at (800) 451-6786.

The policyholder must fill out this Proof of Loss form completely, sign it in front of a notary, and then timely provide the notarized Proof of Loss back to the insurance company. The insurance policy usually mandates that the policyholder has to provide the signed Proof of Loss within 60 days of the insurance company’s request.

Do I Have to Provide a  Proof of Loss?

The most important issue relating to a Proof of Loss is that if the insurance company requests the provision of an executed Proof of Loss, the policyholder MUST comply with this request prior to filing suit against the insurance company or otherwise moving forward with the claim. If the policyholder fails or refuses to provide the signed Proof of Loss along with all the requested information, this failure may be deemed a “failure to cooperate” with the insurance company’s investigation of the loss and could become a complete bar to payment on the loss.

If your insurance company requests that you provide a Proof of Loss in support of your claim, it is highly advised that you obtain the assistance of a qualified insurance claim lawyer that has experience dealing with the tactics used by insurance companies to deny damage claims.  Please feel free to call our office with any questions you may have about a Proof of Loss or if we can be of any assistance with any other part of your insurance damage claim.

After a hurricane, storm or other disaster, you hoped that your property insurance company would honor your claim and pay for your damages.  After all, you purchased homeowners insurance with the expectation that, if a catastrophic loss ever occurred, your insurance company would provide for the repair of your property back to its pre-loss condition.  Unfortunately, as many homeowners are now experiencing after Hurricane Irma, property insurance companies do not always live up to policyholders’ expectations.

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

During the initial inspection, the insurance company’s adjuster may have even indicated to you that your damages would be covered and that the insurance company would “take care of everything”.  Then, after not hearing from the adjuster for a few weeks, you received a check in the mail for not only substantially less than you hoped for, but nowhere near enough to repair all of your damages.  What happened?

Denying Claims Based On Pre-Existing Damage Defense Or Other Exclusions

The insurance company’s first weapon to underpay your claim is the denial of all or a large portion of your damages.  This denial could be a claim that your damage pre-existed the insurance policy period, that your damage was not the result of the subject weather event, that your damage is specifically excluded under the policy, or any other reason manufactured by the insurance company.

Limiting Scope of Repairs and Undervaluing Value of Damages

If the insurance company cannot find a way to deny your claim, they will then try to underpay or undervalue the cost of repairing your damage.  The insurance company will attempt to limit the scope of your repairs (the actual items to be repaired) and/or limit the actual cost allowed for such repairs.  Insurance companies have created quite a cottage industry for contractors, adjusters, and other “experts” who are retained specifically for the purpose of minimizing the valuation of your damage claim.

Aggressively Depreciating the Value of Your Property

The insurance company’s next weapon is the application of depreciation.  Pursuant to Florida law, the insurance company only has to pay the Actual Cash Value of your damages after a loss.  In short, Actual Cash Value (ACV) is the “garage sale value” of your items, and not the current cost to repair or replace same.  It is only after you totally repair or replace the damaged items that the insurance company has the obligation to pay the Replacement Cost Value (RCV) of your damaged items.  The insurance company takes the Replacement Cost Value of your damaged property, and then subtracts an estimated “depreciation” amount in order to get the Actual Cash Value which it pays to you.  As you can imagine, this process is replete with subjective calculations (who says what the current value of my two year old TV is?  How is my roof depreciated by 40% in four years?) and the subject of many disputes.

Applying High Hurricane Deductibles

Perhaps the biggest – or at least, the most apparent – slap in the face by the insurance company is the application of a deductible to your loss payment.  If your loss is not the result of a hurricane or named storm, the deductible may only be $1,000.00 or so, but if your damage is the result of a hurricane or named storm, then your deductible may be substantially higher.  We have written about the application of hurricane deductibles in a previous post, so we will ease the pain by not repeating that narrative here.  Needless to say, these deductibles can come as quite a shock – especially when the insurance company’s calculation of your damages somehow “magically” comes in at just below the amount of your deductible.

The presentation of an insurance claim for property damage from a hurricane or other type of loss can be a minefield.  Without the help of an experienced lawyer or other professional, you run the risk of having your property claim severely underpaid or even outright denied.  If you believe you are not being treated fairly by your insurance company, or if you just have questions regarding the process, please feel free to contact our office and we will do our best to assist you.

 

Now that Hurricane Irma has marched through the entire length of Florida, those affected by the storm must now face perhaps an even more stressful event – the pursuit of a property damage claim against their homeowners insurance company.  Although it may take several weeks for property owners to fully realize the damage caused to their property, they need to move quickly with a claim against their property insurance company.                          
 
Since the focus has long been on preparing for Irma’s high winds and water, it is understandably difficult to now turn your focus to the language of your insurance policy and the numerous exclusions contained therein.  It is also eye-opening to realize that the insurance company’s representatives do not always fully investigate the scope of your damage and will often leave a lot of damage uncompensated.                                                                                                                                                     
If You Have Questions Regarding Your Storm Damage Claim – Call (800) 451-6786 for Immediate Help.                                                                                                                                                            
As important as your pre-storm preparation was, you must now focus on obtaining the most compensation possible from your insurance company to help put your property (and life!) back together again.  The steps you take immediately after the storm are crucial with regard to your ability to adequately present a claim with your insurance company for the damage to your property.  As you begin your insurance claim presentation process, you may want to keep the following in mind:                                                                                                                                  
 
The Safety of Your Family.  This may seem obvious, buy it needs to remain your overriding priority after the storm.  Do not get caught up in documenting your damages or any other claim activity until later the safety of your family is assured.                                                                      
 
Document Your Damage:  In order to best receive reimbursement for your lost or damaged items, you will need to prove to the insurance company what property you had and the pre-storm condition of same.  Hopefully, you took pictures and video of the pre-storm condition of your property.  With the advent of cell phone cameras and other video devices, it is easier than ever to memorialize the damage caused by the storm and to easily provide same to your insurance carrier.
 
Contact Your Insurance Company.  As soon as communications allow, you should immediately place your insurance company on notice of your loss.  The most obvious reason for this is so that the sooner your place your claim, the sooner you can start the process.  If you wait to place your claim, you may be forced to wait behind others that placed their claims before you.  
A not so obvious reason to place your claim quickly is that many insurance policies now mandate that you provide them with “immediate” notice of a loss.  If you wait to place your claim and do not give the insurance company “immediate” notice of your loss, the insurance company may claim to have been “prejudiced” by your delayed reporting and deny your claim.  Insurance company lawyers have created quite a cottage industry for themselves by defending against the payment of your claim based upon an alleged “late notice” defense.                                          
 
Point Out All Damage to the Insurance Representative.  After the receipt of your claim, an insurance company representative will come and inspect the damage to your home.  It is crucially important that you point out any and all damage to your property so that the damage can be documented.  Don’t worry if you miss something, as your claim is not limited to only the damage you point out on this initial visit, but the more damage you can document to the insurance company, the higher the insurer’s initial settlement offer may be.
Remember, the insurance company representative  does not work for you, but instead works for the insurance company.  Even though the insurance adjuster may be friendly and professional, he is not an advocate for the full payment of your loss.  The adjuster is employed solely by the insurance company and, whether consciously or unconsciously, his goal will be to provide the least amount of coverage for your damage.
 
Flood vs. Wind Damage.  Since Hurricane Irma caused damage both by high winds and rising water, your homeowners insurance company may try to deny coverage for some of your damage by claiming the damage was caused by water and not wind.  In general, your homeowners insurance policy covers damage caused by wind, and your flood insurance policy covers damage caused by rising water.  The dispute over whether damage is covered by flood or homeowners insurance has generated mountains of litigation and is discussed in detail in a previous post
Examine your Insurance Policy for Additional Coverages.  The insurance company representatives may not point out all the benefits provided by your homeowners insurance policy.  For instance, there may be additional insurance coverage for items such as any alternative living arrangements while repairs are being done, food that may have spoiled in your refrigerator, the cost of bringing your home up to current building codes, and other such non-obvious coverages.
Remember, if you are not satisfied with the treatment, coverage, or payment provided to you by your insurance company, it is advisable to contact an attorney or other professional who has experience with handling property insurance claims.  Most of these professionals work on a contingency fee basis and offer a free initial consultation, so there are no out of pocket costs to obtain help with your storm damage insurance claim.
 

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.

For the past three years, my clients have had to battle with their insurance carrier, Tower Hill Select Insurance Company, to obtain coverage for the repair of damage caused to their home by sinkhole activity.  Time and time again, Tower Hill Select refused to provide any assistance to our clients and instead, threatened to pursue legal action against them for the insurance company’s attorney’s fees and costs.  We were finally able to obtain justice for our clients at trial last week.

On the first day of trial, the Court struck all of our experts’ testing and data which reflected the existence of sinkhole activity on the property.  The Court made this ruling because the insurance company was able to confuse the Court as to the law applicable to this matter and to convince the Court that our clients’ testing and data was “not relevant” as to the issue of existence of sinkhole activity on the property.  What?!?!  Although the Court’s ruling on this issue created a right for our clients to appeal this ruling and to seek the reversal of same, at trial we had no option but to push forward and to do the best we could for our clients with the evidence we had.  Unfortunately, the only thing we had left to present to the jury was the data obtained by the insurance company’s experts.  Fortunately, the data and opinions set forth by the insurance company’s experts were clearly biased towards denying the claim and replete with errors and omissions.

In the end, the jury saw through the shell game set forth by Tower Hill Select and their experts and we were able to obtain a jury verdict for  the full amount of our clients’ damages.  This victory was especially sweet as we were able to prove our case merely through the severe impeachment of the insurance company’s experts and the ability to greatly discredit their biased data.  Since we were the prevailing party at trial, the insurance company is now also responsible for the payment of not only all the attorney’s fees and costs associated with our representation of our clients, but also pre-judgment interest on the full amount of the jury award for the past three years.

 

After watching scores of television commercials and other paid advertisements touting the supporting and nurturing nature of insurance companies, one can’t help but feel that the “good hands people” will always act “like a good neighbor” once a policy holder incurs a loss.  After years of practicing insurance claims law, we have learned the unfortunate truth that insurance companies – like all big corporations – are only after one thing.  Profit!  Unfortunately, the way the insurance companies make this profit is by collecting insurance premiums from its insureds for years and then, upon the placement of a claim by its insured, denying or otherwise minimizing the payment the insurance company makes to the insured on the claim.

A perfect example of this attitute was reflected in a claim we recently resolved for one of our clients.  Our client was a 90 year old gentleman who had served his country honorably in the military for decades and had even parachuted into France the day before D-Day!  He was one of the original members of USAA Property and Casualty Insurance and had been insured by them for 60 years – without ever having made a claim!  After noticing a substantial amount of cracking to his house, he placed a sinkhole claim with his insurance company, only to be summarily denied – in spite of the fact that the report from the insurance company’s expert clearly reflected sinkhole activity and that sinkhole activity had been confirmed to be a cause of loss to all of the other houses in his neighborhood!  After vigorously pursuing this matter for our client, the insurance company eventually agreed to a substantial settlement which allowed our client to finally repair his home.

Although insurance companies will often try to do the right thing, their judgment is too often clouded by their desire to keep your premium dollars in the insurance company’s coffers.  If you ever have the unfortunate experience of incurring a loss or other damage, make sure you seek the advice and counsel of an insurance claim professional who can explain your rights and make sure you are appropriately compensated for your loss.