Although most homeowners insurance claims involve some form of destruction to the home that impacts the “structure” or “function” of the home, a pure cosmetic loss caused by a covered peril also should be covered. This might become an issue when hail storms cause physical damage to a copper roof in terms of dents but the damage is entirely an issue of the physical appearance of the roof. Homeowners should be aware that they can pursue a claim under their homeowners insurance policy even when there is no structural damage or functional impact caused by a covered insurance peril.
This issue typically arises when insurance companies hire engineering experts who produce reports that indicate no structural damage to the home. When engineering experts inspect the roof of a covered property following a hail storm, they may produce a report that emphasizes that no functional or structural loss was suffered by the insured. The insurance company and the lawyers representing the carrier sometimes contend that it will not pay the claim because the insured did not experience any structural loss.
While this position is frequently asserted by insurance carriers in this scenario, the claim is ridiculous when placed under closer scrutiny. If a home suffers damage caused by taggers who use spray paint to spray graffiti across the entire exterior of the home, the damage is purely cosmetic. Nonetheless, insurance companies and insurance defense lawyers would not claim that this type of damage is not covered despite the fact that the loss is purely aesthetic in nature.
While dents to a copper roof may amount to only an aesthetic loss rather than an impairment of the function or integrity of the roof, the damages still amount to a direct loss for the homeowner. Because Florida homeowner policies do not contain an exclusion for purely cosmetic loss, the damage to the roof should be covered just as the spray painted exterior of the home would be covered. Although the coverage does not result in destruction that impairs the function of the roof, the dents in the roof are a form of loss because the roof is worth less than it was without dents. Since the purpose of insurance coverage is to restore the homeowner to the position he or she was in before the loss, such as having a home with a roof that is not aesthetically damaged with blemishes, the claim should be covered.
This is just one example of the strategies employed by insurance companies to avoid paying the full value of a claim. Many homeowners presume that there is little that can be done to dispute a denial of coverage or proposed underpayment of a claim. There are a range of potential remedies available that can include demanding appraisal or pursuing a lawsuit for breach of contract. If the insurance company uses unethical or unreasonable practices when handling your claim, you might even have a right to pursue a lawsuit for insurance bad faith.
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].