Pop-HurricaineHome

Hurricanes are a fact of life for all of us that live, work and love Florida. It isn't a matter of IF, but a matter of WHEN you will have a hurricane damage claim. Most of the time, your insurance company will attempt to quickly and efficiently pay your claim to your satisfaction. However, many times they will not. Unfortunately, when they do not, it comes at the worse possible time and when you need it most. At the PANTAS LAW FIRM, we take on the insurance companies every single day and would be happy to discuss your situation with you personally.

If my insurance company denies my hurricane damage claim, do I have any rights?

Absolutely. If an insurance company fails to honor its contract and pay a valid claim, you have the right to bring a civil action for damages against that insurance company. In addition to suing for a "breach of contract", in Florida you may bring a lawsuit and seek to recover not only your damages but attorneys fees and costs.

What do I do if my insurer refuses to pay my hurricane damage claim or its evaluation of the damages or reimbursement is too small?

If your insurer refuses to pay your claim, or pays too little, your first step, as the insured, is to immediately review the policy. While legal assistance from an attorney is not necessarily required at the initial levels of an insurance dispute, it is strongly urged as soon as possible if the amount involved is large, or the insurance company totally denies the claim. Secondly, you should seek out evaluations from licensed and insured contractors to estimate the actual amount of the damages and take lots of photos of the damage. Lastly, when dealing with the insurance company make sure you do NOT give a statement unless it is in the presence of your attorney, and get it in writing! This will generally put you in a better position later if there needs to be a lawsuit filed against the insurance company.

What Types of Damages Can I Claim?

Failure of the adjuster to fully compensate on a "fair market value" basis due to sudden increase of material and labor costs due to a regional or national catastrophe. The insured is entitled to have the damage restored based on prevailing market rate.
Loss of Power. If the insured lost power, they are entitled to compensation for loss of food in the refrigerator as well as the cost of an electrician to survey the wiring in the house.
Carpeting. Once there is water penetration or glass breakage, the insurance company has a duty to compensate for the replacement of the carpet. You are entitled to carpet replacement for the entire affected area, not just a portion thereof, including "extra waste". You are entitled to replacement of the padding.
Asbestos. You are entitled to have replacement (or abatement cost) of any structure if it has asbestos. typically, if the structure is built prior to 1978, it will have asbestos.
Mold contamination. Insurance companies typically denying tests and payment of mold contamination claims. These types of claims can be complex and require the testimony of experts to be successful. In addition to repair or replacement of the affected areas, you may be entitled to the cleaning or replacement (or payment) of all of the contents in the house.
Painting of the interior of the home if it is affected. Painting also includes the labor for moving furniture, etc.
Repair of walls and insulation. Damaged walls and insulation are covered. If damaged by water intrusion, typically the insurance adjuster fails to pay for replacement of moldings, insulation and incidentals. The insured has a right to payment for these items as well.
Landscaping. The insurance company is responsible to compensate for damage to landscaping including trees, lawns, etc. under most circumstances. The insurance companies rarely, if ever, voluntarily pay for these items.
Additional Living Expenses (ALE). A typical homeowners policy also covers additional living expenses for the time it will take to repair the house, as well as extra incidentals associated with the inconvenience (i.e. extra food costs, transportation costs, etc.)
Dumpster/Labor Costs. The insured is entitled to be compensated for their labor to clean up yard debris from the hurricanes as well as making their own repairs as well as, associated expenses for clean up including dumpster rental cost.

What Should I Do if My Insurance Company Is Denying Coverage or Delaying Payment?

You should seek legal advice immediately. Some cases are easy and quick to handle while others may require aggressive legal actions against the insurance company. If you or someone you love has a bad faith insurance claim in Florida, you need our experienced bad faith insurance attorneys on your side to help you get the compensation you deserve.

The insured person promises to pay premiums and abide by the conditions of the policy. In return, the insurance company promises to compensate the insured for a loss, also according to the conditions of the policy. When an insurance company fails to meet its obligations both according to Florida state law and the policy itself, they are said to have committed "bad faith" and can be held liable for both the original claim and punitive damages. At the Pantas Law Firm, we help Florida residents who have been victimized by an insurance company contract breach to recover compensation, regardless of whether the dispute is the result of:

Delays and Stalling - compelling you to accept a smaller claim or no claim at all.
Impossible Conditions / Stonewalling - requiring excessive documentation or verification of a claim.
Unreasonable Expectations - requiring you to resubmit information / gather new information that has already been established.
Adjuster / Estimate Disputes - changing adjusters or requiring multiple adjusters / quotes.
Failure to Indemnify or Defend - failure to pay a claim when a judgment is made against a Florida homeowner's insurance policy.
Deceptive Practices - making statements that are later contradicted during a claim / claim denial based on incorrect - incomplete information on original policy application.
Fraud / Misrepresentation - including evaluations, appraisals and adjustments.

Our firm has helped countless Florida residents who are struggling after an insurance claim is delayed or denied. We will deal with the insurance company so you don't have to and recover compensation for property damage or personal injury as well as attorney's fees and punitive damages when the abuse is systemic and deliberate. State and federal laws are very specific about your rights but the prospect of extended litigation with a large insurance company is intimidating - and the insurance companies know it.

How much is this going to cost?

At the PANTAS LAW FIRM it costs you nothing, unless there is a recovery. The firm takes these types of cases on a pure “contingency fee and cost” basis. We will seek both fees and costs FROM THE INSURANCE COMPANY. If we lose, we work for free and we lose our costs that have been advanced.

Will the case settle or will we have to go to trial?

Approximately 90-95% of cases settle before an actual trial. Settlements may happen at any point in the action from as early as pre-suit (before a lawsuit is filed) to mediation (a formal settlement conference), to as late as “on the courthouse steps.” The main thing to focus on is not if and when a case settles, but on being prepared to have a trial. Once the insurance company and defense attorney realizes that a case is well prepared and ready to be tried if need be, they are more willing to settle for a reasonable amount without the need for a jury to decide the case.

Is there anything in particular I should remember when I am making a claim or when I am dealing with my insurance company?

The best thing to remember when you are dealing with an insurance company is "put it in writing" and "ask for it in writing."

Phone calls are great for quick contacts or easy answers (like "yes, we received your claim" or "yes, your premiums are current"), but you should always remember to put it in writing. This includes not only the claim itself (generally a specific requirement under most policies), but also all contacts with the insurer, ideally with the name of the person you spoke with, the time and an understanding of what was said during the conversation. This is called creating a paper trail or documenting your conversations. By documenting the ‘story’ of your claim, you can ensure that the insurance company cannot subsequently change the ‘story’ to fit their rationale for denying your claim.

If you speak by phone with someone at the insurance company, make a written note of it and keep it in a separate file. If someone is rude to you, make a note of what s/he said, his or her name, and date the note. WRITE IT DOWN. If necessary, consider sending a letter to the insurance company after each verbal contact confirming the substance of the conversation. Fax confirmations are helpful to prove receipt by the insurance company, as are letters that are sent return receipt requested.

After I filed a claim, the insurance company offered me a settlement. It looks to me like it's a lot less than the actual damages I suffered. Do I have to accept it?

No. You have the right to recover the full value of your loss. While insurers often seek to settle claims for less than their full amount, no bad faith can be shown if the offer is a reasonable one. However, when the carrier offers a settlement that is completely out of line with your actual damages, or attempts to take advantage of your difficult financial situation in order to settle your claim far below its true value, that may be found to be an act of bad faith. Don’t accept it; call the PANTAS LAW FIRM for a free consultation instead.

What do I do if my insurer refuses to pay my claim or its reimbursement is too small?

If your insurer refuses to pay your claim, or pays too little, your first step, as the insured, is to immediately review the policy or plan information as it relates to claim or benefit denials and also as it relates to appeals and grievance procedures.

Most often, there is a requirement that the insured appeal a denial of a benefit or service with a written appeal within a period as short as 15 to 60 days. In addition, there are typically multiple levels of appeal or grievance, which are mandatory and which involve subsequent short time limits. Appeal or grievance procedures, depending on the policy or plan, either require that final determinations of entitlement to benefits or services be made by required arbitration, or they allow the insured or member to file a lawsuit, but only after exhausting the appeal or grievance procedures set forth in the policy or plan. Additionally, plans provided to an individual by an employer may be subject to a Federal Law, ERISA, which contains its own sets of rules and procedures.

While legal assistance from an attorney is not necessarily required at the initial levels of an insurance dispute, it is strongly urged as soon as possible if the amount involved is large, or the insurer is denying that you are "disabled" under the terms of a total disability contract or the matter is going to arbitration or lawsuit.

Rest assured that the insurance company would have a lawyer who's paid to ensure that your claim is denied. It may not be a bad idea to have a zealous, aggressive advocate on your side.

What does the term insurance "bad faith" mean?

In Florida, "bad faith" refers to an unreasonable or unfair conduct by an insurance company.

What Are Some Examples of Bad Faith Conduct?

Unreasonable denial or termination of an insurance claim that should have been paid.
Unreasonable delay in making payments to the policyholder.
Unreasonable failure to defend a policyholder.
Unreasonably attempting to under-settle or low ball the payment of a claim.

How Do I Know I have A Bad Faith Insurance Claim?

When you purchase an insurance policy, whether for life insurance, disability insurance, homeowners insurance, or any other type of policy, you are entitled to the full benefits of the policy if you have a covered claim. If the insurance company refuses to pay or if it delays your payment, you may have a bad faith insurance claim.

If I retain an attorney to represent my claim, will my insurance company cancel my policy?

Your policy cannot be canceled by virtue of presenting a claim or multiple claims. If your policy is canceled or your premiums increased, such conduct by the insurance carrier may be retaliatory in nature and subject to bad faith laws.

What if I did not make a claim because I only have a little damage?

You have 5 years from the time of the damage to make a claim. Our firm can handle your insurance disputes NO MATTER THE AMOUNT OF YOUR CLAIM.

Are my premiums going to increase?

Premiums generally increase each year no matter if you make a claim usually as part of approved increases in general rate. However, your policy may not increase simply because you made a claim or hired an attorney. Such conduct by the insurance carrier can be classified as retaliatory in nature and subject to "bad faith" claims.

What if the damage does not exceed the deductible?

If your damages are less than your deductible then the insurance company does not owe you any compensation. However, more often than not, once ALL of your claims are tallied, the damage more that exceeds the deductible.

Can I cash the checks I have received from my insurance company?

Yes. By cashing a compensation check from your insurance carrier, are not waiving any rights. However, you should not agree to any waiver or release of any claims you may have.

Want to ask your questions over the phone? Use our free service or call us at Toll Free (888) PANTAS-LAW. Want to ask your question by e-mail? Use our free "online advice service" at Info@PantasLaw.