Original Article can be found at : https://www.palmbeachpost.com/marketing/denial-property-damage-claims/WsqthOGz7dwXZMbHFryuHM/
Hurricane Irma wreaked havoc for homeowners throughout South Florida. For many, it was the first occasion to make an insurance claim. This was the situation for a family that made a claim with their insurance company for roof damage and water damage to the inside of their home. Their insurance company sent an adjuster to inspect the damage which included missing shingles on various parts of the roof and water stains on their ceiling and walls.
The adjuster was friendly, took pictures, and told the homeowners that he would report back to the insurance company with all the information needed to pay their claim. A few weeks after the inspection, the homeowners received a letter from the insurance company. The letter came with an estimate showing the cost of the repairs that needed to be done, along with an explanation that the damage observed by the adjuster was not enough to exceed the homeowner’s $5,000.00 hurricane deductible.
The insurer told the homeowners that damage was observed to the roof and inside of the home, but the only work that needed to be done was replacing various shingles and repainting the ceiling and walls inside. The cost to do this, according to the insurance company, was just a few thousand dollars, and not enough to exceed the applicable deductible. At the end of the letter, the insurer concluded that no payment would be made and the claim was denied.
The homeowners initially thought their insurance company sent them the wrong letter. After all, the adjuster had taken pictures of all the missing shingles on the roof, and even told the homeowners that the ceiling inside would have to be completely refinished, and new drywall would be needed to repair the walls. They called the insurance company to ask why the estimate was substantially different from what the adjuster had seen, but they could not get through to a representative, and no one returned their calls.
The homeowners contacted an attorney to ask what their options were. Common sense told them that there was more damage to their roof and the insurance company’s denial did not seem right. They were also informed by a roofing contractor that the cost to properly fix their roof was over $20,000.00.
The quote they got from a general contractor for the inside of the home was over $10,000.00. They were surprised to find out that law firms, like Spicer & Chambers, P.A., would investigate their claim, let him know what their options were and represent them at no out-of-pocket cost.
This is possible because, in many situations, Florida Statute 627.428 requires the insurance company to pay for an insured’s attorney’s fees. Ultimately it was determined that the damage to their roof was substantial and that to properly restore their property the entire roof would have to be replaced. The homeowners learned that the partial shingle replacement would not be sufficient because Florida Statute 626.9744 requires the insurance company to cover the cost of matching any replaced shingles with materials that match adjoining portions of the roof.
Their shingles were old and new shingles would not match. They also learned specific building code requirements must be met when repairs are made to the roof. Because of these statutes and code provisions, the insurance company was responsible for paying for the entire replacement cost of the entire roof, not just the specific shingles they had told the homeowners could be replaced. With a law firm’s involvement, the insurance company reversed course of its denial and agreed to pay for the repair to the client’s roof to be replaced and for the ceiling and walls to be repaired.
The insurance company also paid for the client’s attorney’s fees and costs. In another situation, a homeowner’s claim was made, and the insurance company agreed to cover the repairs. However, the insurance company sent a letter to the homeowner explaining that it would be using its own network of contractors to do the work, and that no monetary payment would be made to the homeowner.
Concerned that the insurance company’s contractors would not properly fix her home, the homeowner requested that the insurance company allow her to pick a contractor of her choice. In response, the insurance company informed the homeowner about an endorsement to her policy which specifically gave the insurance company the right to repair her home instead of making any payment to her.
With a law firm’s help, the homeowner ultimately received payment from the insurance company so she could hire her own contractor that she trusted to properly fix her home. The insurance company was also responsible for paying the homeowner’s attorney’s fees for the work they did in getting the insurance payment.