Simplifying the Insurance Claim Process for South Florida Homeowners

• Not having enough coverage ("underinsured")
  Delays
• Confusion over what's covered and what's not
• "Lowball" estimates and settlement offer
• The adjuster assigned to the claim is unpleasant or hard to work with
• Differences of opinion over scopes and values of losses

Take lots of photos of the damage and before removing any damaged or destroyed items from the home or starting any dry out or repairs and hire a qualified and reputable local company that specializes in insurance funded repairs.

• Keep a diary of conversations and events related to the damage and your claim
• Be cooperative and as polite as possible with the adjuster, let them to inspect damage and the remains of the property
• Provide documentation of your loss / all damage
• Get independent estimates to repair the damage and restore your home to a safe and habitable condition
• If the adjuster tells you damage isn’t covered and what they’re saying doesn’t make sense to you, consult a professional expert with experience in insurance claims and complain in writing to your Congressional and Senate representatives.

A written “Proof of Loss” (document you sign that confirms/certifies your loss/claim) must be filed within sixty (60) days after a loss.  The majority of lawsuits involving flood claims are related to the issue of POL and the failure to file in a timely manner.

Insurance companies are profit-making businesses and their employees are not social workers. Their goal is to close your claim quickly and without paying a dime more than necessary. Your adjuster may be friendly but he or she is not your friend.
Insurance companies are naturally trying to control their payouts after a devastating disaster. There is a lot of confusing wording and legalese in insurance contracts and there are laws to protect you from getting taken advantage of.
Many insurance companies are reading their policies with a bias that is too much in their own favor and against their policyholders. If you’re like most people, your home is your biggest asset. Don’t accept an insurance company’s denial of your claim without getting other opinions on the causes of the damage and the wording of the exclusion.
You paid good money for insurance protection. There are laws that protect you against unfair treatment. 

Computers don't repair and build homes...licensed contractors do. Your insurance company owes you for what an experienced and reputable contractor would charge you to do the required work to put your home back to its pre-loss condition. Insurance companies use guideline pricing and "Xactimate" (computerized home replacement cost estimating software) to predict how much materials and labor should cost. But an estimate prepared by a qualified local, licensed and bonded contractor who has visited the loss site and reviewed information about the pre-loss structure is generally the most reliable basis for a claim settlement

Frustrating delays, rotating adjusters, wrong information about what’s covered and what’s not, “lowball” repair estimates and settlement offers, (lowball means unfairly low – rip-off), and what many people describe as a “second nightmare” of being treated badly by the company they trusted for many years.

This is a very, very common problem. If you’ve submitted all the information your insurance company needs to pay your claim, written follow up letters and made phone calls to higher-ups in the company but nothing’s worked, consider “Mediation” or “Appraisal” to resolve the difference.
Mediation is an informal way of resolving problems without going to court. Insurance Appraisals are like mini-trials without a jury. Almost every homeowner’s policy has an Appraisal section that is supposed to help resolve disputes over repair estimates. If you and your insurance company are far apart on the amount you’re owed for repairs, consider using the appraisal process to settle the dispute. If you decide to use the process, make sure you get help from experts who don’t work for the insurance industry or you’ll be wasting your time and money.

YES. Take the time to read the wording of the specific exclusion the adjuster is relying on. Make sure to read the whole policy and whatever brochures or sales materials you can get your hands on. You may find words that show they promised or owe more benefits than they’re offering. Insurance policies are contracts written by insurance company lawyers. Doesn’t it make sense to get legal advice for yourself before taking the insurance company’s word that you’re not covered?

You can use legal advice and arguments to convince your insurance company to change its position without getting involved in a lawsuit. Get together with neighbors and others in your situation. Find home videos taken of the storm that show the wind that came first. Pool your money and hire a “forensics” engineer who’s experienced in evaluating hurricane damage. If the engineer concludes that wind or another covered “peril” was a triggering cause in your neighborhood, present the information to your insurance company and don’t take no for an answer.

Follow UP’s claim tips by keeping a claim diary, staying organized, writing to higher-ups in the company, and getting help from your state Insurance Commissioner’s office. Don’t take “no” for an answer until you’ve run out of options.

Although you may feel discouraged and in no mood for fighting, it doesn’t make economic sense to take “no” for an answer from your insurance company this soon in the process. Your fellow Americans, elected officials and the media are paying attention to how insurance companies are treating the hurricane survivors.

That pressure will help you get a fair shake. It’s still very early in the process – way too early to under-settle your claim. Before you give up or agree to take less than you need to repair/rebuild, it can’t hurt to get advice from an attorney. Just make sure it’s an attorney who has already had experience representing property owners on insurance matters.

No. We surely hope you don’t.

Some insurance companies have the reputation of being fairer and more prompt in handling claims than others, but it’s hard to predict what’s going to happen in this unprecedented situation. Working together with neighbors, following UP’s claim tips and using the materials in your three-ring binder will really increase your chances of getting treated well. 

If you're like most people, your home is your biggest asset. Insurance companies often read their policies with a bias that is too much in their own favor. Don't accept an insurance company's calculation of what they owe on your claim without getting other opinions. 

Labor and material costs always go up after disasters due to supply, demand and greed. Your insurance company owes you for what it will cost in real life, not on paper (up to your policy limits). Guideline pricing is something insurance companies use to predict how much materials and labor should cost. This system is often a problem because reality demands flexibility. No one can accurately predict how much prices will change after a disaster – especially one this big. Take plywood for example – its price fluctuates wildly and can vary from $12 per sheet up to $25 per sheet in a post-disaster scenario. That doesn’t make it right, but it’s not fair or legal to make you wait until things stabilize to start repairing/rebuilding your home.

Roofs are a highly contested item – if the insurance company’s pricing is $150 per square foot but the market price is $240, keep all receipts and demand the difference along with all amounts the insurance company “held back” due to ACV rules. 

This is a common problem with some insurance companies and it’s unfair and in some states – illegal. Overhead and profit, (“O & P”) is a known expense that all contractors charge, usually at a rate of 10% and 10%. An insurer that holds back O & P until repairs are completed puts the property owner in an impossible financial position. It is wrong for your insurance company to hold back O & P until your home is completely repaired.

NO. Your insurer owes to restore your property to its pre-loss condition subject to the dollar limits of your coverage. The appearance of your home after repairs have been made is legally supposed to be “uniform and consistent”.