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.
Although the terms Actual Cash Value and Replacement Cost Value are not commonly used outside of property insurance disputes, they can have a substantial effect on the amount of money you receive from your insurance company after a loss.
After your insurance company determines that your insurance policy provides coverage for your loss, the insurance company has various ways to calculate the value it will pay you for your lost or damaged property. There are two main methods by which the insurance company calculates the value of your damaged property – Actual Cash Value and Replacement Cost Value – both of which will be discussed in detail below.
Actual Cash Value
Actual Cash Value (“ACV”) represents the actual dollar value of the damaged item in its depreciated, but not damaged, condition. Replacement Cost Value (“RCV”) represents the cost to actually rebuild or replace the damaged item with a new one. For example, let’s say your five year old 55” television was destroyed by a covered cause of loss. Since television prices are constantly dropping, the television you paid $1,000.00 for five years ago may now have a present “actual cash value” of only $200.00, which represents what you could actually sell a five year old television for today.
Replacement Cash Value
On the other hand, let’s say the cost today to replace your damaged television with a brand new 55” television is $800.00 – which would represent the Replacement Cost Value of the television. Replacement cost insurance is designed to cover the difference between what property is actually worth and what it would cost to rebuild or repair that property. In essence, it is insurance to protect the depreciation of the insured property.
Under current law, most insurance policies provide that the insurance company only has to initially pay the value of the damage on an Actual Cash basis. Later, after the insured has completed the repairs or replaced the damaged item, the insurer then has the obligation to pay the additional amount of money necessary to bring the payments up to the Replacement Cost Value of the loss.
If You Have Questions Regarding Your Property Insurance Claim – Call (800) 451-6786 for Immediate Help.
It is important to note that the replacement or repair of the damaged property must actually occur, otherwise the insurer has no obligation to provide the additional replacement cost reimbursement under the policy. If the policyholder fails to make the repairs or replace the damaged property, the insurer is only required to pay the actual cash value of the loss. Similarly, if the policyholder performs the full extent of the repairs for less than the amount of the initial Actual Cash Value payment, the policyholder is not entitled to then seek additional Replacement Cost Value funds (as the initial ACV payment was sufficient to fully repair/replace the item).
Lastly (and perhaps most importantly), the insurance company does not have the unbridled right to determine the Actual Cash Value of your damages – or the Replacement Cost Value, for that matter. As a policyholder, you have the right to question the insurance company’s damage payment and to determine whether such payment is sufficient to fully compensate you for your loss. Should you have any questions whatsoever with regard to your insurance claim, contact our office and we would be happy to discuss your claim with you.
Roof damage is the most common type of hurricane insurance claim we see after a hurricane, wind storm or hail event. Wind from hurricanes and tropical storms can cause substantial roof damage – whether just a few loose shingles or the total destruction of the entire roof structure. Even worse, any opening in your roof can cause water to enter your home and devastate your belongings. Hail can also cause severe damage and greatly reduce the functional life of your roof.
If You Have Questions Regarding Your Storm Damage Claim – Call (800) 451-6786 for Immediate Help.
After a roof damage loss, it is crucial to get your roof repaired or replaced as soon as possible. The longer you wait, the more time there is for additional damage to be caused by water loss. On the other hand, if full repairs are not completed and only a quick patch job is performed, you may be asking for an even greater problem down the road.
The question whether to repair or replace a damaged roof is hotly debated by insurance companies and their policy holders. During this epic struggle, you will most likely hear terms and phrases such as the “25% Rule”, the brittle shingle test, asphalt granular shingle loss and shingle bruising. In order to help better understand your insurance claim, we’ve provided a quick summary of these terms below.
The 25% Roof Replacement Rule of the Florida Building Code
The most commonly referenced roof damage term is the 25% Rule. The 25% Rule arises out of Section 708.1.1 of the Florida Building Code. The pertinent portion of this Code Section states as follows:
Not more than 25 percent of the total roof area or roof section of any existing building or structure shall be repaired, replaced or recovered in any 12 month period unless the entire roofing system or roof section conforms to requirements of this code.
There are a couple of important points to keep in mind with this Code Section. First, if a more than 25% of your roof is damaged – either from a fallen tree, high winds, or otherwise – then the entire roof must be replaced. If less than 25% of any portion of your roof is damaged, then (at least pursuant to this Code Section) the roof can just be repaired or patched. Secondly, the 25% can be measured by any given section of the roof. If more than 25% of any given section of the roof is damaged, then that section must be replaced and not merely repaired. Thirdly, there is a 12 month time frame over which this 25% is calculated. For example, if the initial damage does not reach the 25% threshold for replacement, but then over the next 12 months, additional repairs are required that cause the damage to go beyond the 25% threshold, then the entire roof section must then be replaced.
The Brittle Shingle Test
The brittle shingle test is a super scientific testing method whereby an inquisitive person picks up a shingle, tries to fold or bend the shingle up to a 90 degree angle, and then checks to see if the shingle breaks or bends. If the shingle breaks, then the shingle is brittle and the roof probably needs to be replaced. If, on the other hand, the shingle is still pliable and bends, then the roof is not a candidate for replacement (or so the insurance representative would say). This testing method is clearly subject to many variables (temperature of shingle being tested, etc.), but is often used by insurance companies as “proof” that the roof shingles are still functional.
Shingle Granular Loss
Asphalt granular shingle loss is generally calculated to occur at about a 3% rate per year. Unfortunately, damage from wind or bruising by hail can accelerate this loss by anywhere from 15% to 40%. Even if the damage doesn’t totally destroy the shingle or make an opening all the way to the matting, the artificially accelerated “aging” of your roof may be a covered loss under your insurance policy. The theory is that prior to the storm you had a roof with (hypothetically) 15 years of remaining life, but now after the storm damage, you left with a roof with only 5 years of useful life left.
Shingle bruising is usually caused by hail damage. When hail strikes an asphalt shingle, it can cause a localized loss of granules, usually circular in shape, to the shingle and a fracture in the mat beneath the shingle. The damage to the mat is usually referred to as a bruise and can be indicative of damage to the functional ability of the roof. Bruising and hail damage to a roof can cause a diminution of the water shedding ability of the shingle and a reduction in the functional life of the roof. Bruised shingles need to be replaced as such damaged shingles are no longer able to keep water and other elements from entering the structure.
Get Experienced Help for your Hurricane Insurance Claim
Please know that many of these determinations are very subjective and, unless you have a working knowledge of building construction and a mastery of the coverages available under your insurance policy, you may not be best equipped to handle your property damage claim by yourself, and may want to discuss your claim with an experienced property insurance claim attorney. Should you have any questions whatsoever, please contact our office and we will help guide you through whatever issues you may have with 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.
Even as the internet is full of Hurricane Harvey damage pictures, another storm is quickly approaching Florida from the eastern Atlantic. Tropical Storm Irma – soon to be Hurricane Irma – is projected to be a major storm and may make landfall along Florida’s coastline. The time is now to stop looking at flood pictures in Texas and realize that we could be in the same situation – or worse – if a major storm hit our shores.
Please take a moment to review my previous post on the crucial steps you need to take in order to protect your family during the storm. Also, you can click here to download a detailed Hurricane Supply Checklist. Make sure you obtain all or as many of these items as possible, because you may have to fend for yourself and your family for an extended period after the storm.
If you don’t already have adequate property insurance coverage, then it is mostly likely too late for you. Sorry, but it is not like we didn’t warn you. If you do have a solid policy of homeowners insurance, then at least you know that you will be able to seek recovery from your insurance carrier for any property loss you may incur.
If you have any questions regarding your property insurance coverage or need help with your claim, please either contact us online or call our office at (888) 898-5297.
Policyholders are often shocked to learn that the loss settlement check they receive from the insurance company is payable not only to the policyholder, but to their mortgage company as well. Homeowners insurance policies are broken down into several types of coverage – whether for the building, personal property, liability, alternative living expense, or other losses. For certain types of coverage, the insurance policy will list the mortgage company as an “additional payee” on the policy – which means that the mortgage company’s name must be listed on any loss settlement check.
If you have any questions regarding your insurance claim, call (800) 451-6786 to speak with an insurance claim lawyer regarding your rights.
The reason the mortgage company is listed as an “additional payee” on the insurance policy is that the mortgage company has a vested interest in insurance coverage payments issued for any loss to the insured property. The mortgage company presumably loaned money to the policyholder and, in order to provide a guarantee of repayment, the policyholder agreed to grant the bank a mortgage on the property as collateral for the loan.
Should the subject property be damaged or destroyed, the unrepaired property would then be worth less than before the loss and therefore, the mortgage company would not have the same amount of security for the loan as prior to the loss. In order to protect the mortgage company’s security for the loan, the mortgage company’s name will appear on all insurance loss payments related to the property given as collateral for the loan. Because the property protects the mortgage company in case of non-payment of the loan by the policyholder, the mortgage holder has a strong interest in making sure the property is either repaired or the outstanding loan is paid down to a point at which the loan is again fully secured by the value of the property.
The inclusion of the mortgage company’s name on the insurance check usually just affects coverage relating to the actual building on the property, since the home is usually given as collateral for the mortgage loan. On the other hand, claims for damage to personal property, liability, or loss of use do not relate to property subject to a mortgage and therefore settlement checks on these losses would not have to include mortgage company’s name as an additional payee.