Archive: August 2021

Even when an insurance company agrees to provide coverage for damage to a home, they will often challenge the extent or cost of the insurable loss. This then forces the homeowner to take legal action to protect their contractual rights. Such litigation then often ends up being a “battle of the experts,” with each side offering qualified testimony to establish the true extent of the damages involved.

Federal Court Revives Homeowners’ Lawsuit Over Hurricane Irma Damage

A recent decision from the U.S. 11th Circuit Court of Appeals, Izquierdo v. Certain Underwriters at Lloyd’s London, provides an example of such a dispute. The plaintiffs in this case own a South Florida home that sustained roof damage due to Hurricane Irma in 2017. According to the plaintiffs, their roof had no leaks prior to the storm. Post-Irma, however, they noticed roof leaks and water damage inside their home.

A public adjuster inspected the property and recommended replacing the entire roof. Together with other damages, the adjuster valued the plaintiffs’ insurance claim at about $230,000. The plaintiffs later obtained an estimate for just the cost of replacing the roof, which came to $109,300.

If you have ever filed an insurance claim, you have no doubt dealt with an adjuster, i.e., the person employed by the insurance company to review your case. But there are also individuals known as public adjusters who are licensed by the State of Florida to represent individuals, such as yourself, in protecting your interests during the claims process. Remember, the insurance company’s adjuster is there to protect the company, not you. A public adjuster can thus help to level the playing field, as they understand how insurance policies and laws work better than you.

Of course, public adjusters are not free. They work on a contingency basis. That means you do not have to pay them any upfront fees, but they are entitled to an agreed-upon percentage of whatever settlement you ultimately receive from the insurance company. This makes the public adjuster an interested party in resolving your insurance claim favorably.

After a bad storm, a homeowner might notice damage to their property and assume that the weather was responsible. From the insurance company’s perspective, however, correlation does not necessarily mean causation. In other words, the evidence may show that the damage to the property was the result of normal wear and aging and not a specific weather event.

When these type of disputes arise, the homeowner may assume that a judge will simply “take their word for it” that the storm was responsible and thus the insurance company is responsible for the damages. But that is not how insurance law works. If the homeowner disputes the insurance company adjuster’s findings, they need to respond with credible evidence beyond their own say-so.

Judge Strikes “Expert” Testimony Due to Unreliable Methodology

A recent decision from a federal judge in Jacksonville, Dias v. GeoVera Specialty Insurance Company, provides a helpful illustration. In this case, a homeowner filed a claim with an insurance company, alleging that his roof was damaged in a storm that occurred on December 20, 2018. More precisely, the homeowner told the insurer the damage “may have been due” to this particular storm.

When a home sustains water damage, the property owners understandably want to take immediate action to mitigate the problem. But sometimes this means they do not take the time to read–or follow–the terms of their homeowner’s insurance policy. Many insurance contracts require advance notice or approval before undertaking even emergency repairs to a property. Such provisions help protect insurers against fraudulent or exaggerated damage claims.

A recent decision from the Florida Fourth District Court of Appeals, Restoration v. Citizens Property Insurance Corporation, provides a case in point. A condominium unit in Palm Beach County sustained some water damage. The homeowners hired a restoration company to provide water removal and remediation services. Under the terms of the homeowner’s insurance policy, coverage for “reasonable emergency measures taken solely to protect covered property from further damage” was limited to $3,000 or 1 percent of the policy’s liability limits. The owners could ask to exceed the limit of the cap by asking for approval, which the insurer was required to grant or deny within 48 hours of receiving such a request. If the insurer did not answer the request within the 48-hour period, the homeowner was entitled to reimbursement for the full amount of any reasonable emergency measures.