Why Do Universal Property and Casualty Insurance Claims Get Denied?
Navigating the complexities of insurance claims can be challenging, especially when dealing with claim denials. Universal Property and Casualty Insurance Company (UPCIC) is a significant player in the Florida insurance market, providing coverage to thousands of homeowners. However, many policyholders have reported issues with claim denials.
The average homeowners’ insurance policy from Universal Property and Casualty Insurance covers many different types of events and property losses. If your home gets damaged in a storm or another covered event, you can file a claim to pursue financial compensation under the terms of your policy. It may surprise you to find, however, that the insurance company denies your claim for one or more reasons. The insurance company lawfully must explain the reason for the rejection, which could be:
- Fault or liability dispute
- Not the correct type of coverage on your policy
- Failure to mitigate your losses
- Policy limits
- Missed deadline
- Missing information
- Lack of supporting documents
- Further proof of losses is needed
Policy Exclusions
One of the most common reasons for claim denials is that the damage falls under policy exclusions. UPCIC policies, like those of other insurers, have specific exclusions for certain types of damage, such as:
- Flood Damage: Standard home insurance policies typically do not cover flood damage, requiring separate flood insurance.
- Wear and Tear: Damage from regular wear and tear or lack of maintenance is excluded.
- Mold or Rot: Unless directly caused by a covered peril, mold or rot damage is often excluded.
Disputed Cause of Damage
UPCIC may deny claims by disputing the cause of the damage. For example, after a hurricane, they might argue that the damage was due to pre-existing issues or lack of maintenance rather than the storm itself.
What You Can Do:
- Document the damage immediately after it occurs, including photos, videos, and repair estimates.
- Obtain a professional inspection report to substantiate your claim.
Failure to Report Damage Promptly
UPCIC often requires policyholders to report claims within a specific timeframe. Delayed reporting can result in a denial, as the insurer may argue that the delay prevented them from verifying the cause and extent of the damage.
What You Can Do: Report damage to UPCIC as soon as possible. Prompt action strengthens your case and avoids complications from delayed reporting.
Insufficient Documentation
Insurance claims require thorough documentation, including evidence of the damage, repair estimates, and receipts. UPCIC may deny a claim if it believes the provided documentation is incomplete or inconsistent.
What You Can Do:
- Keep all records related to your home, including maintenance logs, receipts for repairs, and photos of the property’s condition before and after damage.
- Working with an insurance attorney can help ensure your documentation meets insurance standards and expedite the claim process.
Underpayment Disguised as Denials
In some cases, a denial may come in the form of an underpayment. UPCIC may claim that only part of the damage is covered or that the repair costs are lower than estimated. While not a full denial, this tactic effectively prevents policyholders from receiving the full benefits of their coverage.
What You Can Do:
- Challenge underpayments by obtaining independent repair estimates.
- If negotiations fail, consider hiring an insurance claim lawyer experienced in handling property insurance claims.
Alleged Policy Violations
UPCIC may deny claims if it believes the policyholder violated the terms of the policy, such as:
- Failing to mitigate further damage after the incident.
- Misrepresenting facts when applying for coverage or filing a claim.
What You Can Do:
- Take steps to prevent additional damage, such as tarping a roof or removing water after a flood.
- Having an experienced insurance claim attorney can protect your rights during the claim process.
Claims for Pre-Existing Damage
UPCIC may deny claims by alleging that the damage existed before the policy’s effective date or was not caused by a covered event.
What You Can Do:
- Maintain records of your property’s condition, including inspection reports and photos, before purchasing insurance.
- Challenge pre-existing damage claims with evidence of recent inspections or repairs.
What to Do if Your Universal Property and Casualty Insurance Claim Gets Denied
If you feel that Universal Property and Casualty Insurance wrongly denied your insurance claim or that you are not being offered a fair settlement based on the extent of your property loss, you should contact us. In that case, you have a few different options. In general, the process for disputing a Florida insurance claim follows these steps:
If your claim with Universal Property and Casualty Insurance is denied, it’s important not to panic. Instead, follow these steps:
- Review the Denial Letter: UPCIC will send a denial letter outlining the reasons for the denial. Carefully review this letter to understand why your claim was denied.
- Gather Documentation: Collect all documentation related to your claim, including photographs, repair estimates, receipts, and correspondence with UPCIC. This information will be essential if you choose to dispute the denial.
- Consult an Insurance Claim Lawyer. If your claim is wrongfully denied, consulting a Florida insurance claim lawyer can significantly improve your chances of a favorable resolution. Lawyers experienced with Universal Property and Casualty Insurance claims can identify bad faith practices and help you take legal action if necessary.
Your Rights as a Florida Property Owner
After filing a property damage claim, your insurer must acknowledge it within 14 days, respond within 30 days after receiving your proof-of-loss statement, and pay or deny the claim within 90 days. Florida homeowners have the right to free mediation, neutral evaluation for sinkhole claims, and assistance with insurance claims through the Florida Department of Financial Services.
The Florida Homeowner Bill of Rights reassures homeowners by outlining the steps the insurance carrier takes after a claim. However, complexities, the random assignment of adjusters, and insurers’ tendencies to underpay or deny claims complicate the process.
Signs of Bad Faith Practices
In some cases, claim denials are not justifiable but may stem from bad faith practices by the insurer. Watch for these red flags:
- Delays in processing your claim without valid reasons.
- Denial of claims without a thorough investigation.
- Misrepresentation of policy terms to avoid paying a claim.
- Offering an unreasonably low settlement.
If you suspect bad faith, consult one of our insurance claim attorneys immediately to protect your rights.
How Williams Law, P.A. Insurance Claim Lawyers Can Help You:
1. Comprehensive Claim Review
We examine your denial letter, engineering reports, photos, and repair estimates to uncover bad faith tactics or errors.
2. Independent Damage Assessment
Our team works with licensed:
- Public adjusters
- Structural engineers
- Roofing contractors to produce objective estimates reflecting your loss’s real extent.
3. Reopening and Supplementing Claims
Under Florida law, denied or underpaid claims can be reopened. We:
- Submit supplemental documentation
- Trigger appraisal or mediation if allowed
- Prepare litigation if negotiations fail
4. Filing a Lawsuit
Every case varies. Some are resolved in weeks through mediation. Others may take months if litigation is required.
Conclusion: Don’t Accept No for an Answer
Dealing with an insurance claim denial from Universal Property and Casualty Insurance can be a stressful and frustrating experience, especially when you’re already dealing with the aftermath of property damage. However, understanding the reasons behind claim denials and knowing how to respond can help you navigate the process more effectively. If you’re facing a denial, don’t hesitate to seek professional advice to ensure that your rights are protected and that you receive the coverage you’re entitled to under your policy. Call us at 1-800-451-6786 or fill out our online contact form.