Frequently Asked Questions
HOW DO I REPORT A CLAIM?
Although you may be able to report the claim through your insurance agent, it is typically best to contact the claims department of your insurance company directly. Most insurance companies have a link or portal for policyholders to report a claim. If you do not have contact information for your insurance company, ask your agent to provide the name of the insurance company, your policy number, and a contact number for the company. If you are directed to leave a message with the insurance department, include your name, policy number, property address, and notification that you are reporting damage and would like the insurance company to contact you to open a claim.
WHAT IS THE DEADLINE TO REPORT MY CLAIM?
Most insurance policies require “prompt” notice following a loss. There are also statutory deadlines to report a claim. It is always best to contact your insurance company immediately after discovering a loss.
WHAT DO I TELL THE INSURER WHEN REPORTING MY CLAIM?
You should provide a general description of the damage, including the type (water, mold, etc.) and location. You may also be asked to advise when the damage occurred, although with hurricane damage, the insurer is usually already aware of the date of loss. If you have a copy of your insurance policy, identify the Policy Number in your declaration pages so you can provide that to the insurance company. You do not need to have a copy of your policy in order to report a claim to your insurer. By providing your name and property address, the insurer should be able to identify your policy information.
HOW DO I OBTAIN A COPY OF MY POLICY?
Ask your insurance agent. If your insurance agent is unable to provide you with a complete copy of your current policy, contact the insurance company directly and ask for a “certified” copy of the policy. It is important to specify that you want a “certified” copy, which means it is a sworn and true copy of your policy. Your policy provides various provisions outlining your coverages, the duties and obligations of you and the insurer, the policy limits, deductibles, and other pertinent information.
WHAT SHOULD I DO AFTER I REPORT THE CLAIM?
Take steps to protect the property from further damage. This may involve tarping your roof or boarding up broken windows to prevent further water intrusion. It is also a good idea to photograph and video the damage. For more information on protecting your property, see the Helpful Tips For Pursuing Your Claim section above.
WHAT AM I REQUIRED TO PROVIDE TO THE INSURANCE COMPANY DURING THE CLAIM INVESTIGATION?
The insurance company will likely request information and documentation during the claim process. This may include written or verbal requests that should be reasonably related to the claim. For example, photographs, videos, repair estimates, invoices, documents related to the pre-loss condition of the property (e.g. home or appraisal inspection reports), a damaged personal property inventory, proof of temporary relocation expenses, and other pertinent documents may be requested.
As referenced below, the insurance company may also request a Proof of Loss form, a recorded statement, and an Examination Under Oath. The insurer is permitted to request these under the terms of the policy.
WHAT IS A PROOF OF LOSS?
A Proof of Loss is a sworn and formal submission of the damage and amount(s) claimed. Most policies only require an insured to submit a Proof of Loss if it is requested by the insurance company. However, in recent years, many insurance companies have changed their policies to require the policyholder to submit a Proof of Loss, even if the insurance company does not request it, within a certain time period following a loss, often within 60 days. It is imperative that you review your policy, or ask an experienced attorney to review your policy, to determine when a Proof of Loss is required as part of your claim.
If your insurance company requests a Proof of Loss, or the policy requires you to submit it following a loss, you are required to timely submit it. It is always best to ask the insurance company to provide you with the Proof of Loss form it wants you to submit, and to request that the insurance company advise you in writing is you are required to submit the Proof of Loss. Once a Proof of Loss is submitted, the insurance company usually must respond to it within 30 days.
WHAT IS AN EXAMINATION UNDER OATH?
An Examination Under Oath (“EUO”) is sworn testimony that will be transcribed by a court reporter. During the EUO, your insurer will ask you questions about your claim and may also ask you to bring any documentation supporting that claim. You are entitled to bring an attorney to represent you at your EUO. This is a serious proceeding not commonly invoked, and you should consider consulting with an experienced property insurance attorney if your insurer has requested an EUO.
DOES MY POLICY COVER TEMPORARY LIVING EXPENSES IF I AM FORCED TO MOVE OUT OF MY HOME DUE TO THE DAMAGE?
Most homeowner’s policies contain coverage for Additional Living Expenses (ALE) if you are forced to move out of the home while the damage is repaired. This coverage is only available if you are reasonably forced to vacate your home because of a covered loss. Also, most policies require you to incur these costs before they are covered.
DOES MY POLICY COVER FLOOD DAMAGE?
Most homeowner’s policies exclude flood damage. However, you may have a policy in place through the National Flood Insurance Program that is separate from your homeowners’ policy that covers flood damage. Flood policies contain very strict requirements that must be complied with in order for coverage to apply.
DOES MY POLICY COVER MOLD DAMAGE?
Most policies contain an endorsement providing coverage for mold damage, but only if the mold resulted from a loss that is covered under the policy. Typically, if a hurricane is the cause of loss, the mold should be covered. However, most policies limit mold coverage to $10,000 even if the cost necessary to remove and remediate the mold exceed this amount.
DOES MY POLICY CONTAIN A HURRICANE DEDUCTIBLE?
Most homeowner’s policies contain a separate deductible for hurricane losses based on a percentage of the policy limits. The percentage should be noted on the declarations pages at the front of your policy.
HOW DO I KNOW IF WHAT MY INSURANCE COMPANY IS PAYING ME FOR THE LOSS IS REALLY THE TOTAL AMOUNT OWED?
This can be difficult to determine. The insurance company is required to pay you for the amount of loss that is covered by the policy based on the loss payment conditions in the policy. Depending on the language in the policy, the insurance company may be permitted to deduct depreciation from certain items of damage and pay you on an actual cash value (ACV) basis. This means you may not be paid the full amount needed to repair or replace the items. Alternatively, the insurance company may be required to pay you the full amount of the loss on a replacement cost value (RCV) basis, which means you are owed the amount necessary to repair or replace the items of like kind and quality, without any deduction for depreciation.
The terms of the policy govern these issues, which is why it is so important to obtain a certified copy of your policy. If you are unsure about whether the insurance company is paying you the correct amount for your loss, it is a good idea to seek legal advice. Also, use great caution before signing any release as a condition to claim payment.
MY INSURANCE COMPANY HAS PAID MY CLAIM ON AN ACTUAL CASH VALUE BASIS. WHAT IS THIS?
Actual Cash Value (“ACV”) is the amount of the necessary repair or replacement of the damaged or destroyed property less an amount for depreciation. It contemplates the age and condition of the damaged property among other things.
WHAT IS REPLACEMENT COST VALUE?
Replacement Cost Value (“RCV”) is the amount of the necessary repair or replacement of the damaged or destroyed insured property with materials of like kind and quality, without deduction for depreciation. It contemplates repair/replacement of new property, and does not take into account the age or condition of the damaged property.
WHAT SHOULD I DO IF MY INSURANCE COMPANY DENIES MY CLAIM?
An insurance company is required to conduct a thorough investigation of your claim prior to making a claim decision. If the insurance company denies your claim, it is required to provide you with a written explanation of the basis for the denial. If you receive a written denial letter, you should seek legal advice to determine if the denial was proper. Oftentimes, the insurance company will deny your claim even though the policy clearly provides coverage.
IS THE INSURANCE COMPANY REQUIRED TO COVER ANY ATTORNEY’S FEES IF I HIRE A LAWYER?
Florida law provides that your insurance company may be required to pay for your attorney’s fees if you are forced to file a lawsuit and you prevail with a judgment against your insurer.
The attorneys at Nutter Law Group will provide you with free and thorough consultation at any point in the claim process. If you hire us to make sure you are paid everything you are owed by your insurance company, our fees are only paid if we recover for you.