Most property owners in Florida purchase homeowners insurance coverage that provides financial protection against loss, injuries and property damage that occurs on the premises of the covered property. When you submit an application for homeowners coverage, the transaction is understood to be an exchange in which the insurer will financially assist the homeowner under certain circumstances provided the insurer pays premiums. The essential product being purchased when you buy homeowners insurance is the transfer of the risk of loss from covered perils to the insurance company.
When a peril causes damage to your home or someone suffers injury on the premises, the process for pursuing a claim will depend on the circumstances. If there is a risk of further injury or damage, the policyholder should initially focus on mitigating the risk of future injury or property damage. The way to accomplish this goal will depend on the situation but might include vacating the premises, obtaining medical attention or securing damaged areas of the property. If the property has been secured and the risk of further injury has been averted, the insured should notify the insurance company of the claim.
Although the precise manner of submitting a claim will differ between companies to some extent, claims typically can be filed electronically, in writing or over the telephone. The insurer will require that certain basic information be provided which includes but is not limited to the following:
- Nature of the incident causing the loss or injury
- Type of claim (liability v. property damage)
- Basic background information about the homeowner
- Description of the damage or loss
Once the insurer has received notice of the claim, the insurer must assess the value of the loss. The insurer typically will request that the policyholder provide an inventory with estimated values of the items damaged or lost. Because the insurance company has a vested interest in lowballing the amount of any payout, you should not rely on the estimates regarding the loss or damage prepared by the insurance adjuster. If you have an independent contractor assess the loss, you will have a point of comparison against which to evaluate the insurance company’s determination of the value of the loss.
If the insurance carrier accepts the claim, the insurance company will determine the amount of the loss and send a check to the policyholder or another designated entity. If there is a mortgage on the property, the financial institution that holds the mortgage might desire to be named as a party on the check to ensure that the property is repaired or rebuilt. If you must temporarily relocate while your home is being repaired, your insurance company might pay you additional compensation to cover the additional living expenses associated with the relocation.
When the insurer denies the claim, the policyholder generally receives a letter providing an explanation in writing for the decision to deny the claim. The insurer will typically assert the policy does not provide coverage for the type of claim based on the type of peril or damage. Some denials are simple mistakes that you can appeal to the insurer, but this internal appeals process rarely works. When this internal appeals process is unsatisfactory, you should seek legal advice from an experienced Florida insurance claims attorney. An insurance attorney can help you negotiate a settlement or file a lawsuit if necessary.
If you have questions about Florida property insurance claims, you are welcome to contact my Miami insurance claims dispute law firm. My law firm represents policyholders in claims disputes in Miami and throughout Florida. The Law Firm of J.P. Gonzalez-Sirgo, P.A. offers free consultations and case evaluations. No Recovery, No Lawyer Fees. Call 305-461-1095 or Toll Free 1-866-71-CLAIM.