Same Old Story: Insurance Delays, Denials, and Coverage Issues

Having your home or belongings destroyed or damaged by a hurricane, storm, or other natural disaster can be a traumatic experience. It can be even worse if your insurance company refuses to pay to repair or replace your property. Though insurance companies are tough to fight, you do have rights. When Hurricane Ian moved through Fort Myers Beach, Sanibel Island, Captiva Island, Matlacha, Pine Island, Fort Myers, and the surrounding coastal areas, it left monumental devastation in its wake.

Hurricane Ian damage was caused by a combination of high winds and heavy amounts of rainfall. The problem for property owners is that flood insurance must be obtained separately through the Federal Emergency Management Agency (FEMA).

While damages from wind and wind-driven rain are covered by a standard homeowner’s policy, many charge separate wind deductibles, which means higher out-of-pocket costs for you. The deductibles are usually based on a percentage (roughly 5% to 10%) of your coverage rather than a flat dollar amount.

Here are some reasons for a denial that the insurance company might give:

No coverage

An insurance policy covers only what’s in its written policy. If you have a type of loss covered by the policy, the insurance company must pay you.

Pre-existing damage 

Natural wear and tear and inadequate maintenance on the part of the property owner may result in a surprise insurance claim denial. Even if the hurricane contributed to the damages, the insurance company may claim that the actual cause is the homeowner failing to do routine maintenance before the accident.

Missing premium payments 

Skipping a premium payment can cause an insurance policy to lapse.

Lack of evidence of losses 

Insurance claims are based on documentation. You need to submit photographs, videos, or other documentation to explain to the insurance company what losses you have and what compensation you deserve. If insufficient evidence is the reason given for the denial, additional documentation may result in a different decision.

Policy limits

Expect payment up to the amount of your policy limit.

For example, suppose your home is insured for $500,000 with a 5% wind deductible, and you have $30,000 worth of roof and siding damage from high winds. You’re responsible for $25,000, with your insurance covering only $5,000 of the damages.

While an insurance adjuster may sometimes find a legitimate reason to deny your claim or pay out less than they should, other times it is done in bad faith to get the policyholder to accept much less than their claim value. In some cases, insurers have been found to go even further and cross the line into outright fraud by misrepresenting what is and is not insured under a policy.

Hurricane Ian insurance adjusters will be bombarded with a heavy workload immediately after a hurricane. They arrive at the scene from hundreds of miles away, often unfamiliar with the area, and only staying there for weeks at a time.

Here are some of the things to watch out for when dealing with an insurance adjuster:

  • Unreasonable delays in the processing of the claim.
  • Falsely denying that your policy covers damage from the storm.
  • Making other false and/or misleading statements about what your policy covers.
  • Making a lowball settlement offer.
  • Pressuring you to sign a written release of supplemental claims to receive your settlement.

In addition to undervaluing damages and raising deductibles, insurance companies may not consider the real cost to repair and replace the damage or the current realities of workforce and supply demands to the areas affected by the storm.

The point here is that you need to be sure that you and the claims adjuster are talking about the same thing. And remember that he or she is not motivated to help you sort one kind of damage from another so that you can get paid. In fact, quite the opposite, which is why you need a skilled hurricane damage lawyer on your side. Don’t sign or agree to anything until you have consulted with an insurance claim expert. Once you settle for a small sum it will be very difficult to go back and ask for more money. You can do that, and indeed you should if they underpaid your claim unjustly. The law allows you to reopen a claim, but you will have to bring in additional proof. The statute of limitation for supplemental claim of losses is 3 years from the date of the hurricane or storm that damaged your property.

How Williams Law, P.A. Can Help?

The application of the many terms, conditions, and exclusions can be difficult to understand. It is not uncommon for insurance professionals to improperly deny claims based on inappropriate application of the policy’s exclusions.  If your insurance company underpaid or denied your claim or you’re in the process of filing a claim our Florida hurricane damage lawyers can negotiate for a full payout, sometimes beyond what is listed on your policy.  We will review the details of your policy to help you determine what is covered under your policy. 

Has Your Home Insurance Company Denied or Undervalued Your Property Damage Claim in Florida?

If your insurance company is dragging its feet regarding your property damage claim you should speak with an experienced insurance claim lawyer as soon as possible. Please contact us online or call our Florida law office directly at 800.451.6786 to schedule your free consultation. We help Florida residents just like you fight the big insurance companies who fail to abide by their own policies. Remember, we work on a contingent basis, meaning you don't pay us anything until we win your case. 

K.C. Williams III
Managing Partner who has spent his entire career representing Florida insurance and personal injury claims.
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