A news report on www.nbcmiami.com tells the story of several South Florida homeowners who were struggling with their homeowners’ insurance carrier years after their homes were allegedly damaged in an explosion. A “grow house” (a house used for growing and cultivating marijuana) located in the neighborhood exploded in 2012, allegedly causing damage to about a half-dozen nearby residences. The homeowners involved in the story were all dealing with the same insurance company. After an inspection of the damaged properties, the insurance company allegedly determined that the damage was caused by some other non-covered event, leaving the homeowners to continue to live for years in homes that are damaged.
We see this occur with some regularity: a homeowner suffers a loss to his or her property that he or she believes is caused by a covered event only to have the insurance company, upon receipt of the homeowner’s claim, assert that there is another cause for the damage. The homeowner’s claim then gets denied. That is where an experienced insurance claims lawyer can step in and help a homeowner get the claim approved and/or pursue other legal remedies so that the homeowner can move forward with his or her life.
Common Tactics Used After Homeowners’ Insurance Companies Deny a Claim
It is common to feel angry or stunned when your insurance company will not pay a claim. It is important to know that in these situations you generally have legal rights but must assert them in order to derive any benefit from the policy. When speaking with our legal team, you can learn about the specific rights you have in any given insurance-denial situation.
After a denial of a claim, some additional steps that can be taken to obtain payment on the claim include:
- Learning the reason for the denial: Sometimes a denial is truly a mistake, and upon pointing this out to the carrier, the carrier promptly pays the claim. Alternatively, the carrier might simply be waiting for a specific piece of paperwork or documentation. Other times (as in the news story), there truly is a disagreement as to whether the loss is caused by a covered event. In those situations, homeowners can expect a more protracted fight.
- Arbitration and/or mediation: Some insurance policies require the homeowner to attempt to resolve his or her dispute with the insurance company through alternative dispute resolution measures before bringing a lawsuit. In certain situations, these forums constitute a good opportunity for the parties to resolve their dispute without expending the time and money necessary for litigation. It is important that you have legal counsel available if you elect to attempt to resolve your dispute this way. An arbitrator’s award can be binding on the parties. There may be other legal rights (depending on your situation) that can be waived or given up if you are not careful.
- Attacking the insurance company’s evidence. Depending on the reason for the denial, you may wish to obtain an outside expert’s opinion. For example, it is unclear if the homeowners in the story had hired an outside expert to examine the damage to their homes, this step might help convince the insurance company to reevaluate its position.
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].