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Insurance Claims Blog
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The Homeowner Claims Bill of Rights
The Homeowners Claims Bill of Rights is published by the Florida Division of Consumer Services (DCS) to educate homeowners and to hold insurance companies accountable. The bill of rights is specific to the claims process and does not include all the policyholder’s bill of rights under Florida law regarding an insurance policy.
You have the right to:
- Receive acknowledgment of your claim within 14 days after the claim was communicated to the insurer.
- Receive communication from the insurer as to the claim being covered in full, partially covered, or denied, or a written statement that your claim is being investigated, within 30 days after the company receives the policyholders completed proof of loss form.
- Subject to any dual interest noted in the policy, receive full payment of the claim, the undisputed portion of the claim, or the denial of the claim within 90 days.
- Free mediation of your disputed claim, offered through the Division of Consumer Services, under most circumstances and subject to certain restrictions.
- Neutral evaluation of a disputed sinkhole claim if the claim is due to sinkhole damage and is covered under the policy.
- The availability of assistance with any insurance claim or questions pertaining to the handling of your claim from the Division of Consumer Services. They must provide the direct and toll free number and website of the Division on the notice.
Contact us today if you feel your rights have been disregarded by your insurance company.
Frequently Asked Questions
What are the exclusions in a property insurance policy and when do they apply?
Exclusions in an insurance policy are the things that are not covered by that policy. What that means is the policy normally starts out in broad coverage and then starts taking away some of that coverage through those exclusions. And whether an exclusion applies or not is very dependent on the facts of the particular loss. In fact, sometimes some of those exclusions even have exceptions which give coverage back. What does that all mean? It means that insurance policies are complicated and if you don’t deal with them regularly, you should probably look to an insurance law attorney to help you understand what your policy really covers and what the insurance company is responsible for.
Who is an insured under the policy?
An insured under an insurance policy is that person or those people who actually have coverage under the policy. The term insured is a defined term in most insurance policies, so it’s important in some cases where that may come into question, to go to the definitions provided in the policy and really understand that. Typically, it’s the owner of the property, along with his or her family and other people under the age of 21 who may live there. Also, you should keep in mind that if you have a mortgage on your property, the mortgage company may not technically be an insured, but they may be entitled to benefits as being an additional payee, or a loss payee, or a mortgagee under the policy. So that would be something we would want to look at and understand as well.
What is proof of loss?
Proof of loss is a sworn written statement that details the amount of damages that you think that you’ve incurred because of the event that occurred to your property. Some insurance policies require, automatically, that an insured has to provide a sworn proof of loss. Other policies say that the insured has to provide it only if requested. So to begin with, it’s important to realize the difference and to know whether you must do that or whether it’s only at the insurance company’s option. But, in either case, if you have to do it or if the insurance company requests it, it’s important that you comply because this is a post-loss condition that if you don’t do, the insurance company may deny you coverage.
The insurer is asking for my sworn statement. Why? Do I need to make myself available for the sworn statement?
When an insurance claim is filed, the insurance company has the opportunity to investigate the claim. That means that they need to be able to find out more facts and get more information about the whole situation. Under your insurance policy, you usually have the obligation to cooperate with the insurance company, and some of that cooperation includes giving them sworn statements about what happened. If you don’t cooperate with the insurance company, including failing to give a sworn statement if requested, the insurance company could deny coverage under your policy. So it’s important that you do cooperate and that you do tell the truth when you do cooperate. You may also want to look to retain the services of an attorney, particularly if you think that the insurance company doesn’t like something about your claim.
My house was damaged and I cannot live in it. Do I need to pay my mortgage?
If your house is damaged and you can’t live in it, you definitely still need to pay your mortgage. Your mortgage is a completely separate responsibility from the benefits that you hope to be able to get from your insurance policy. Your mortgage company does have an interest in your insurance policy often, but it’s important that you keep making your mortgage payments so that you don’t end up risking being in foreclosure or in default with your mortgage company. You may want to reach out to the mortgage company and talk with them and let them know that your house has been damaged and see if there is any involvement that they want to have in the process, but you should definitely keep making those mortgage payments.
What if the insurance company denies my claim or offers me less than I think I am entitled to receive?
If the insurance company denies your claim or offers you less than you think you are entitled to receive, you shouldn’t necessarily accept that as the final answer. There’s a lot of reasons why insurance companies may think that they should deny a claim that end up being incorrect if we fight with them and show them the facts are actually different and that the law applies not how they think it does. And if the claim is underpaid, there may be serious questions about the value that’s involved and we may be able to put together a much more comprehensive view to be able to show the insurance company differently or prove it through the court system.
Do I have to pay any fees if my claims results in no settlement?
Florida law says that if you prevail in a lawsuit against your insurance company, the insurance company has to pay for your attorney’s fees. For those claims though that don’t involve a lawsuit, our work is normally done on a contingency basis – that means that if there is no recovery, that our clients have no out of pocket expenses for our work.
What does the additional living expense part of my policy cover?
Additional living expense is a coverage that exists under a lot of homeowners’ insurance policies. It will provide for you to be able to live according to your normal standard of living, in the event that your property is damaged so that you can’t live there. You should be able to make arrangements to live someplace else, either for a fixed amount of time that’s provided for in your policy, or the time necessary to be able to repair your home so that you can live there again.
If my insurance company denies payment for my business loss, can I appeal their decision?
If your insurance company denies payment for your business loss, there’s not usually an appeal process under the policy itself. What you should do in that circumstance is not give up, but talk to a good insurance law attorney. The attorney will be able to go through the facts of your case, the coverage that’s provided by your policy, and the law in order to be able to figure out what your next steps are. The next steps may involve filing a lawsuit against the insurance company where you and your attorney will be asking the judge to make a good assessment of what should happen in that case. You may end up being able to get coverage and recover from your loss.
What if I live in a condominium and have property damage?
Take Charge of Your Property Insurance Claim
Contact us today for a free consultation if your insurance company has given you a low offer or has altogether denied your claim.