A news report on NBC Miami tells the story of several South Florida homeowners who were struggling with their homeowners’ insurance carrier years after their homes were damaged in an explosion. A “grow house” (a house used for growing and cultivating marijuana) located in the neighborhood exploded in 2012, 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 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.

It is important to know that in the face of a claims denial you generally have legal rights but must assert them in order to derive any benefit from the policy.  

After a denial of a claim, some additional steps that can be taken to obtain payment on the claim may 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.
  • Appraisal 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 appraisal 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 basis of 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].

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