While homeowner’s insurance coverage is a costly expense, such coverage is often critical if your home suffers damage during a fire, storm or other covered peril.  Generally, homeowners expect their insurance company to honor its obligations to pay legitimate claims, but a significant number of homeowner’s receive notices in the mail indicating that their claim is denied.  This denial often will be preceded by a nominal investigation of the claim and a specious rationale for denial.  Below we outline five of the most common reasons that a homeowner's insurance claim might be denied.

Exclusion Clause Denials: Every homeowner’s insurance policy contains an “exclusion clause” that enumerates a litany of perils and damages not covered by the policy.  Some types of perils that are excluded from coverage under this provision of a standard policy include earthquake and flood.  Many of these items can be covered, but you will need a rider or supplemental policy.  For example, flood damage can be covered by a policy through the National Flood Insurance Program.

Non-Payment of Premiums: Predictably, your claim will be denied if your policy is canceled for non-payment of premiums.  However, Florida insurance law as well as the law in most states requires the insurance company to send notice prior of cancellation.  If policyholders cure the arrearage amount prior to expiration of the grace period, the insured will not lose his or her coverage.

Claim Exceeds Policy Limits: While your homeowner’s policy generally covers personal property contained within your residence, the standard homeowner’s policy will be subject to limits for certain high ticket items.  The items that might be subject to a coverage limit include jewelry, art, rare coins, cash, etc.  For example, you have a coin collection appraised at $20,000, but your policy limits coverage for rare coins to $2,000. You will be capped at $2,000.   

Misrepresentation on Application for Insurance: When you make a claim, the insurance company will carefully scrutinize your initial insurance application to identify any misrepresentations.  If the insurance company determines that you lied or exaggerated about information in your policy application, the insurance company might use such inaccurate statements to deny the claim.  However, Florida law recently changed to provide limited protection to homeowner’s in this situation.  Prior to the change, insurance companies were scrutinizing credit information in the public domain after claims were filed to justify a denial.  Insurance companies now have a limited time window to “rescind” a policy for this reason, so they cannot simply sit back and collect premiums until you submit a claim.

Negligent Maintenance and Repair: If you do not perform necessary maintenance on your property that might prevent damage in a windstorm, for example, this failure to properly maintain the premises might be used as a basis for a denial.  When the insurance company inspects the premises, they might discover a pre-existing termite problem in the attic.  The insurance company will likely claim that the homeowner’s “negligence” in addressing the termite problem caused the collapse of your roof.

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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