Is There Anything I Can Do To Improve The Chances Of My Property Damage Claim Being Approved?
Your insurance agent – the person who sold you the policy – has a duty to sell you a policy that covers ALL your property damages, or to explain to you the coverages so that if you choose to not have something covered, you are specifically aware of what that is. When you have a claim, your insurance agent can help you to understand exactly what is covered and who at the insurance company to contact.
Additionally, it is critical to understand all the terms of your insurance policy, from understanding Coverage A (relating to your structure), Coverage B, relating to your separate structures (like fences and detached garages), Coverage C (the contents that are insured), and Coverage D (the money you are entitled to receive for the loss of use of your home (including payment for hotels, extra food expenses, storage expenses, rentals, etc.)
The most important thing to recovering the most money is to do the following
- Securing All Insurance Policies;
- Notify All Insurance Companies
- Take Pictures/Videos
- Notify Insurance Companies of Repairs
- Hire the Best Experts
- Notify FEMA If You Don’t Have Insurance
- Constantly Write
- Consider Hiring an Attorney
Since we have also suffered through monster hurricane events and also having served as a lawyer and expert for the insurance industry, along with helping cities, government, federal agencies, and others, as well as thousands of cases privately for businesses and for the individual consumer (individuals, businesses, etc.), we are acutely familiar with the personal and business devastation that people (including myself) suffered – and how to get recovery.
Compounding the problems associated with the actual property damage, we face the real and serious stress accompanying the delays and “red tape” associated with trying to secure sufficient funds to effectuate repairs or basic needs (food, shelter, water), or to continue business endeavors. Aside from general tips given to prepare for hurricanes (get water, days of food, move things away from windows, put up shutters, etc.), people don’t know where to turn when they have property damage. Here are important secrets to maximize your chances to secure the most money the fastest.
Let’s start with the reality that none of us really understand our insurance policies. Most people have little understanding of the technical language in their insurance policy, or all that it covers or doesn’t, or how to best process a claim to get the most money in the shortest period of time from insurance entities and/or federal or state relief funds. They don’t understand the significant differences between business/commercial insurance and residential/homeowner’s insurance and separate flood insurance (and even umbrella insurance policies that might provide additional coverage).
You should secure certified/verified copies of each of your insurance policies, including such coverages as:
- Comprehensive (Property) Damage Coverage (For Homes, called Homeowners or Condominium, separate Wind Policies, “Excess” or “Umbrella” policies, etc.; and for Business/Commercial Property, sometimes called “Comprehensive General Liability Insurance” or “CGL” and “Excess” or “Umbrella” or other similar policies).
- Flood Coverage
If you don’t have full copies of each insurance policy, secure copies of each policy by calling your insurance agent or insurance broker If they are not available, call each insurance company directly. It is important to secure full copies of the policies because there are often additions (referred to as “riders” or “endorsements”) that often can modify the conditions of the policy and the amount of money available. On the cover page of the policy, you will be provided with a Declarations Page (often called the “Dec Sheet”) that details the various coverage amounts.
For example, in a residential insurance policy (homeowners, condominium, etc.), you will have sections and specific amounts assigned to Dwelling (“Coverage A”), Other Structures (“Coverage B”), Personal Property (“Coverage C”), Loss of Use/Additional Living Expenses (“Coverage D”), as well as other categories such as liability and medical payments. In other words, insurance claims vary in the types of damages you may recover. Depending upon your specific policy, you may be entitled to coverage for damages to your dwelling, including roof, structure, walls, interior, plumbing, paint, furniture and personal property, as well as outside fencing or other structures, trees and shrubs, expenses for hotels or other places that require you to expend moneys.
Recognize that wind/rain/storm events involve various potential causes (wind v. flood v. other causes). You should also notify each insurance company for which you pay a premium that may cover your claim: such as homeowner’s insurance, or business insurance or separate flood insurance carriers.
You need to notify the insurance company directly, not through your local agent. Also remember that once you notify them, they have a duty to inspect the premises immediately. Ask them on the phone – when you first give notice of your claim – to give you the next available day when they will be visiting your property to inspect the damages. Confirm in writing whatever they say. In most cases, the intake person who answers your initial call to open the claim is not the person who will be handling the claim (i.e., they take basic information and will assign the claim to a “desk adjuster” who is responsible for processing your claim).
The process is for them to send out an “adjuster” to evaluate the damages and issue a report (“adjust the claim”) to the insurance company and you about the damages they confirm and what will be paid when. Often, that “adjuster” may be a third-party vendor contracted by the insurance company to simply do an estimate of the claim/damages. They are not the person who decides whether to pay your claim. Thus, you would be well-served to speak with them and get an understanding of the company they work for, and you should get a written promise from them to provide you with every picture/video they take and any communications or reports they issue on the day they issue them. Or walk along with them and take the exact pictures or video they take and confirm before the adjuster leaves that you have the same thing they do. Or ask them to download a copy of what pictures or video to your phone of all the pictures/video they took. There is absolutely no reason for them not to provide you with what they will be using to determine the claim or cooperate with you in every way. If they refuse for any reason, you should be worried and should immediately call and write the insurance company for a proper explanation.
You may have multiple insurance companies to notify, based on how many policies you have. For example, you might have a homeowner’s or condominium or renter’s policy; you may also have a separate flood policy, and you may even have a separate business policy or multiple business policies, and you also may have what is commonly referred to as “umbrella” or “excess” policies on any of those risks.
As explained further below, you must be aggressive with pursuit of your insurance claim, constantly calling and writing the insurance company, supplying them with pictures, photographs/video, estimates, and other information.
Take many pictures and video of every aspect of your house from different angles, including those showing damages. Detail on the video or write on each picture (or state on the video) exactly where the room or damaged item is located. If adjusters or inspectors come out to inspect your property, you should consider videotaping/audiotaping the proceeding by walking around with them (and have your chosen expert present).
Hopefully, you have taken pictures and videos before the storm event also, so that you can verify the damages, but regardless, combine whatever pictures/videos and the specific estimates (discussed below) from your licensed contractors (general contractor, roofer, plumber, engineer, etc.) to make a compelling case for immediate payment of moneys.
If you intend to perform repairs, get multiple estimates for licensed (well-known) contractors, and notify each insurance company in writing of anticipated repairs, informing them of the date and list of repairs (with pictures, repair estimates, expert reports included), offering to have them visit or revisit the premises or to speak directly to your contractor or make suggestions on repairs before you repair. This way, they can’t later complain that you somehow violated the insurance contract – such as you otherwise didn’t properly cooperate, or your actions somehow prejudiced them because they claim they needed to see the damaged premises or know about the actual repairs because they were made.
It is also important to take pictures/video or and retain samples of damaged property (such as shingles or other roof materials, wood from floors, pieces of a wall, stucco, pieces of doors or windows, etc.). This information may prove useful later for the insurance adjuster, for the insurance company, for forensic testing or for showing other contractors or experts, for lawsuits if needed, etc.
As noted below, if repairs are to be made, make sure they are done by licensed contractors who provide you with copies of their license and copies of their insurance showing it is valid right now. Make sure you have a specific contract that details everything they are doing, what timelines and provides penalties for non-completion and does NOT require you to pay a substantial amount in advance before completion of all work. You will need to consult with a lawyer to ensure you have appropriate releases of lien or other legal documents.
Make sure you have a full and detailed estimate of all possible damages, by experts who understand how property damage claims work. You often don’t know all the damages that you have. Your windows might not be broken, but they may have failed due to the mass winds. Your roof or structure may have suffered damage that you cannot see. You may have water trapped behind walls or under floors are in the attic or basement that may cause other damage or lead to mold or other problems. One of the most common items missed is window damage. People mistakenly believe because they have impact windows or the windows aren’t broken, there is no damage. There’s almost always significant hidden damage that if you don’t identify now, you are likely to start having problems in the coming year(s) and have to pay much more out of your own pocket.
Thus, consider retaining the best experts who have specific and substantial experience in handling storm claims. You may need a special kind of engineer, roofer, window inspector, field adjuster or all of them.
There are certain kinds of reports and estimates that must be produced to maximize getting the most money the quickest. Generally, simple contractor estimates alone don’t help you much. The best experts will know the exact kinds of detailed forensic reports that persuasively tell your story. Generally, you will have to pay for these services, unless you hire a disaster-recovery-experienced law firm who will front all those expenses for you.
- IF YOU DON’T HAVE INSURANCE, IMMEDIATELY NOTIFY FEDERAL AND STATE ASSISTANCE (NOTIFY FEDERAL EMERGENCY MANAGEMENT AGENCY = “FEMA”)
FEMA can be utilized to secure low-cost loans. It can also be utilized to secure emergency moneys. Once a federal disaster has been declared (such as EM-3385 for Hurricane Irma), you should immediately seek federal assistance from FEMA (“Federal Emergency Management Agency”) through their Individual Assistance Program (IAP) at www.DisasterAssistance.gov or www.FEMA.gov. If you have problems with the process, you can also call FEMA at 800-621-3362. Florida has resource links/information through www.FloridaDisaster.org and 800-342-3557, and those noted above.
For FEMA-related relief (which is for those who don’t have insurance coverage), you can apply online, or print the forms and mail or fax them directly to the FEMA office. You should apply online, but if you have any problems online, then fill out the forms and fax or mail them – because there are delays in filing online claims because the IAP is not yet approved by FEMA (i.e., sometimes there are incomprehensible delays in FEMA approving the online process, either because of delays associated with counties or the State requesting IAP for their individual county/city, computer glitches, staffing problems with processing or other delays.)
FEMA allows emergency moneys to be paid for such things as temporary alternative housing, food and shelter, immediate repairs (electricity/electrical work, fuel for energy sources, plumbing, etc.), and other necessaries. FEMA relief is ONLY available if there is no insurance company relief available. In other words, FEMA relief must not duplicate insurance company relief, but it CAN be used to pay for things like your deductible and other items determined by the insurance company to not be covered.
If you have insurance coverage, FEMA doesn’t pay you. Thus, while you are immediately making claims with FEMA if you don’t have any insurance, you can still register a claim with FEMA in case you do have insurance but it doesn’t cover the specific loss that FEMA may otherwise cover. Thus, you must immediately make all insurance claims so that you can secure a determination from your insurance company as to the relative coverage that may be provided. FEMA provides an added benefit, in that you can receive a low-interest rate loan to cover most repairs that insurance doesn’t pay (enough) for.
Do not rely on oral representations from anyone. Write letters or emails (“correspondence”) after every discussion with an insurance company or adjuster, whenever a representation is made, a promise provided or a number stated.
Correspondence should be in sufficient detail as to properly reflect who you spoke to, the date and time, what specifically has been represented, promised, completed, not completed, etc. and request that they let you know in writing if there is any inaccuracy in what you have written. You should have dozens and dozens of letters along the progress of the claim.
Write every day or every week, after you speak to anyone and after you receive any representation or promise from anyone or also when you intend to perform anything that the insurance company might need to know (repairs, getting rid of property, etc.). In addition to making the insurance company more responsive to you, and more likely to perform and pay, it also helps to create an organized timeline of what has occurred and eliminates insurance agents or others claiming they or you said something different.
It is also helpful for any complaints you need to file with the State. In each State, there is a Department of Insurance that regulates insurance companies. If any insurance company does not timely investigate your claim, or delays in processing your claim, or treats you unfairly, or pays you less than you deserve or later than you deserve, you can file a complaint with the State – and the State will investigate.
You can continue to file multiple complaints for each wrongful act they engage in. When you file such complaints, you can imagine how much more powerful it will be when you include the timeline, written communications, pictures and/or the insurance company agent’s misstatements or other evidence … And if you have to hire a lawyer, your chosen legal counsel will love you for having such great accompanying evidence.
The insurance companies know that individuals and business owners don’t know the nuances of how to understand complicated insurance policies or what specific requirements you MUST complete or you get nothing.
Thus, while individuals can handle the claims themselves if they follow all the steps, the data shows that insurance companies pay sooner and in larger amounts when you have an experienced attorney who has handled many storm (property damage) claims. They often work on what is referred to as a “contingency fee” (meaning they agree not to take any fee unless they recover money for you).
While there are fine public adjusters out there, there are disadvantages. For example, the public adjuster can’t file suit like a lawyer, and insurance companies know that. Additionally, there are many circumstances where (after a suit is filed) you can recover virtually all the money charged by a law firm. For example, Florida Statute §627.428 provides a right for the lawyer to recover all reasonable attorney’s fees and costs if a recovery is achieved after a suit is filed. For example, let’s say you have a $20,000 roof claim. If a lawyer handles the case and wins a judgment for you for $20,000 (for example), you could receive $20,000 and the court separately awards the lawyer all or most of the fees and costs to be paid directly by the insurance company.
If you get an attorney, make sure they have handled hundreds or thousands of claims to success. Don’t hire any lawyer that isn’t thoroughly experienced. Ask for their credentials; make them show you their successes. Have them explain how they will specifically advocate for your claim.
Don’t hire a public adjuster who doesn’t have insurance. Make sure there is a specific clause in the contract that allows you to terminate the contract without penalty. In other words, make sure that it’s clear that if you terminate them, they don’t make silly claims of entitlement to future moneys you might receive once you hire lawyers or others to help you. If you have retained a public adjuster, make sure you get them to write you about their specific experience with handling storm claims, and that their contract requires them to perform by a specific date, to write you weekly on what specific tasks/writings they have completed, and to agree to retain experts and front any associated expenses, and that their right to fees ends if they cannot secure money or you need to hire a lawyer (unless the public adjuster is working with a lawyer).
Lawyers already have specific regulatory requirements in detailing the description of all the things they will perform for you.
DON’T GIVE UP!
Don’t give up in the pursuit of your claim just because you get a ludicrous or other unfair denial. Just because an insurance company says they are not paying you, this doesn’t mean your claim is over (or they won’t eventually pay with more information or support being provided to them). Get the right reports that document each damaged item in a way that looks ridiculous for the insurance company to deny you. Get the best expert help and remain committed to getting your money. The more aggressive and documented your route, the more likely you are to receive the most money the quickest.