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Let our Experienced Miami Insurance Claim Lawyer Help Today In many cases, property insurance claims are denied because the insurance carrier argues that the policyholder failed to provide “timely notice of the loss” — even in extreme situations involving hurricane damage.  Lack of prompt notice is a common excuse justifying claim denial, but it can be somewhat confusing and stressful for policyholders — after all, at what point does a delay go from reasonable-to-unreasonable? Given the complexity of prompt notice issues, we encourage you to contact an experienced Miami insurance claim lawyer here at Ver Ploeg & Marino, P.A. for guidance.  We are committed to thorough, client-focused advocacy.  Our team will help you navigate the dispute and secure the benefits you deserve. It’s worth noting that Florida law is relatively policyholder-friendly.  Though you should always seek to provide notice without delay, minor (and sometimes even major) delays do not necessarily justify a claim denial.  There are a number of persuasive arguments you can make to overcome the insurance carrier’s excuses. Let’s take a closer look at prompt notice as a concept under Florida law. Prompt Notice Requirements Under Florida Law In Florida, property insurance policies require prompt notice of the claim to the insurance carrier.  Failure to provide prompt notice will result in a forfeiture of benefits that might otherwise have been available. There are two aspects to a violation of the prompt notice requirement: Lack of timely notice of the claim to the insurance carrier, and The insurance carrier […]

Leading Insurance Law Firm in Miami, FL Homeowners’ insurance coverage can often lead to confusion down the line when policyholders are attempting to secure a payout after having experienced property damage to their home.  As with other types of insurance plans, homeowner’s insurance payouts are manipulated cleverly by insurance companies to minimize their liabilities — wherever possible (so long as the language of the plan supports it, and even when it doesn’t), the insurance company will attempt to argue against coverage. Here at Ver Ploeg & Marino, P.A., our attorneys can help.  We are highly engaged with clients throughout the claims process, from submitting an initial claim to navigating the internal appeals hearing, to litigating the case in Florida courts.  Over the years, we have seen how insurance companies bully policyholders into accepting a denial, delay, or undervalued claim payout.  Homeowners are already under significant pressure when they are dealing with property damage, and the additional problems created by an adverse insurance decision can lead many policyholders to simply “give up.”  It’s natural to feel overwhelmed, but it’s important that you keep your head held high and that you work with a Miami insurance law firm that will doggedly pursue your rights. Among the many arguments put forth by insurance companies — in the homeowners’ insurance context — is that they do not have to payout because the “property damage” at issue does not qualify as such pursuant to the plan language.  Instead, they may argue that the damage is […]

Floridians are well aware of the importance of homeowners’ insurance.  Planning ahead for the possibility of hurricanes, windstorms, sinkholes and other disasters, as well as individual losses such as home invasions or fires, can bring peace of mind and help minimize the disruption to your personal and professional lives. As Miami property insurance lawyers, we are experienced in assisting homeowners in maximizing their recovery following a loss.  The first step to a successful outcome for your claim is understanding what is covered under your policy and how the claims process works. What Does My Policy Cover? Generally, a homeowners’ insurance policy provides coverage against specific perils or events that cause damage to the property (such as fire, windstorm, theft) or the following: Structure (the dwelling itself) Other structures (such as sheds and fences) Personal property (the contents of the structures) Loss of use (also known as “Additional Living Expense,” which may pay some extra expenses if damage to your home prevents you from living there during repairs) Personal liability (against a claim resulting from injury to others on your property) Medical payments to others (for persons accidentally injured at your home, not included residents of the home) Most homeowners’ insurance policies cover damage caused by windstorms, hurricanes and hail, unless you sign to waive the coverage.  Importantly, however, you cannot obtain new or additional coverage when a tropical storm or hurricane watch or warning has been issued for your area.  You shouldn’t wait until the last minute to purchase your […]

Florida has more sinkholes than any other state; thousands of sinkhole insurance claims are reported here every year.  Unfortunately, not all homeowners’ insurance policies provide coverage for damage to your home resulting from sinkholes.  Florida law, which defines a “sinkhole” as “a land form created by subsidence of soil, sediment or rock as underlying strata are dissolved by groundwater,” only requires insurance companies to cover “catastrophic ground cover collapse.”  What’s the difference between coverage for sinkholes and coverage for “catastrophic ground cover collapse?”  As Miami Property Insurance Lawyers, we have experience with both.  As for sinkhole coverage, while all insurance companies licensed in Florida must offer it, the coverage is usually an endorsement to an existing policy and costs an additional premium.  Moreover, insurance companies may require a property inspection before extending coverage, and if sinkhole activity is present on the property, or even within a certain distance of the property, the insurer may refuse to provide sinkhole coverage. If you do not purchase sinkhole coverage, or it is declined, the only coverage you have is for “catastrophic ground coverage collapse.”  Importantly, four conditions have to be met before this coverage kicks in.  They are: Abrupt collapse of the ground cover A depression in the ground cover clearly visible to the naked eye Structural damage to the building including the foundation; and The insured structure is being condemned and ordered to be vacated by the applicable government agency. All four of these criteria are necessary for coverage.  If, for example, […]

Miami Property Insurance Lawyer In Florida, and elsewhere, property insurance policyholders frequently have their claims denied due to the existence of “concurrent causes” of loss.  A concurrent cause is one of multiple causes that contributed to the damages at-issue.  For example, if your house is damaged in a severe tropical storm, some of the losses may be due to water, and some due to wind.  The wind conditions and the water damage might each be reasonably defined as concurrent causes. Property insurance policyholders (i.e., homeowners, real estate developers, condo associations, small and large businesses, and more) may be put into a vulnerable position if their insurer denies a legitimate property insurance claim or pays out only a portion of the claim on the basis that there are concurrent causation issues. So, how might concurrent causation affect your own property insurance claims?  Let’s take a closer look. Florida Applies the Concurrent Causation Doctrine In Florida, the concurrent causation doctrine allows policyholders to recover for both covered and non-covered losses if they happen concurrently.  This prevents insurers from engaging in attempts to define some portion of your losses as non-covered (and therefore denying your claim on that basis), and only paying out the covered loss portion. For example, suppose that your home is damaged in a fire.  As a result, your water lines are damaged, which causes leakage and further losses to your home.  Even if your policy excludes water damage, but covers fire damage, you would be entitled to recover benefits […]

In the homeowner’s insurance context, insurers deny claims for a variety of reasons, some reasonable, some not so reasonable.  Fundamentally, insurers are incentivized to deny claims and minimize their payouts.  For example, if you are entitled to recover $100,000 in a homeowner’s insurance claim, but the insurer’s initial denial convinces you not to bother pursuing the insurance claim, then the insurer will have saved a substantial amount of money by simply acting adversely to your interests. It’s important to understand, however, that if the denial was wrongful, then you may be entitled to challenge their decision and secure the benefits that you’re owed.  Let’s take a closer look at the common justifications underlying a homeowner’s insurance claim denial. Loss Does Not Exceed the Deductible Most homeowner’s insurance policies include a deductible for various claims.  If you are attempting to make a “small” claim, the insurer may deny it on the basis that the loss is not significant enough to exceed the deductible amount. Loss is Not Due to a Sudden Event Losses caused by long-term issues — maintenance-related and otherwise — are generally not covered by homeowner’s insurance.  For example, if your home develops wood rot, the damage caused is often not accounted for by standard homeowner’s insurance coverage.  You may have to obtain supplemental coverage for such issues. There is Third-Party Liability In the event that a third-party is responsible for the damage to your house, your insurer is very likely to deny coverage — it is the third-party […]

In Florida — as in other states — attempting to recover fully for your property losses can be quite a challenge.  Insurers understand that you may be in a vulnerable position, and they may take advantage by undervaluing your property losses or by otherwise appraising the property at issue in a way that creates an even more lopsided dynamic. If you find yourself disagreeing with your insurer over the value of your property losses, then you may want to explore the insurance appraisal process.  “Appraisal” is an alternative dispute resolution process that is included in many property insurance policies as a voluntary option in the event of a disagreement.  It’s important to note that appraisal is not a panacea — it is problematic in many ways, though (depending on the circumstances) you may want to consider the option. Let’s take a closer look. Understanding the Appraisal Process The appraisal clause in a property insurance policy allows the policyholder to demand an appraisal of the loss when there is a disagreement.  Each party selects a competent and impartial appraiser to separately evaluate the amount of the loss at-issue.  A neutral umpire is also selected — this umpire will determine the correct amount of the loss if the two impartial appraisers cannot come to an agreement. Appraisal is binding, which is to say that the amount determined by the umpire must be accepted by each disputing party (the policyholder and the insurer). Given the high stakes of appraisal, it’s important to work […]

Property insurance claims can leave many policyholders feeling vulnerable, and for good reason.  Whether they have had their home destroyed in a natural disaster, or have had their vehicle totaled in an accident, the policyholder may find that the property insurer is rather aggressive in denying, undervaluing, or otherwise mishandling their claim for benefits — given how difficult their circumstances may be at such a time, the adverse decisions of their insurer can deepen the already-significant emotional challenge. Let’s take a look at the benefits that you might be entitled to receive as a property insurance claimant. Property Insurance Benefits May Cover a Range of Losses Property insurance policies vary significantly from plan-to-plan, so there is really no “one size fits all” explanation that will be suitable for all claimants.  If you paid for a high-end homeowner’s insurance plan, for example, then your plan may feature a provision that grants you loss of use benefits, whereas if you paid for a cheaper plan, then it may lack such coverage. Loss of Use Loss of use coverage will grant you benefits to cover losses associated with: Having to rent another property to use in the interim period (until repairs can be performed, or a replacement is found) Costs for relocation Increased costs of living Storage costs For example, if you lose access to your house due to a natural disaster that destroys most of the home, then you may submit a claim and receive benefits for loss of use to cover […]

If you are involved in a dispute with your insurer over benefits owed in the event that your property has diminished in value (following an accident), then you may be entitled to bring an action against the insurer to secure the desired benefits.  Effectively bringing a diminished value claim can be quite a challenge, however, given that Florida law does not allow such benefits recovery by default unless the insurance policy specifically empowers the claimant to recover benefits for diminution in value. What is diminution in value? Generally speaking, property — such as a motor vehicle — tends to lose value after an accident.  If it has not been adequately repaired, then the loss of value is quite obvious.  On the other hand, even if it has been repaired perfectly and returned to a condition that is otherwise impossible to differentiate from “new,” the property will lose at least some of its original value.  Purchasers who become aware of the fact that a motor vehicle has an accident history are less likely to pay as much for the vehicle than if it had not been involved in accident.  This is a fairly well-studied trend in purchasing. Given the likelihood that your property has diminished in value, adequate compensation must account for such loss.  If you are submitting a benefits claim with your insurer, then you may be wondering whether you are entitled to recover benefits that cover the diminished value of your property. Let’s take a look. Availability of First-Party […]

In Florida, where hurricanes, tropical storms, and other natural disasters are a regular feature of life, property insurance claims frequently involve “loss of use” coverage issues.  Standard property insurance coverage does not necessarily cover all the various losses suffered by a policyholder.  Loss of use coverage — which may be its own separate policy, or simply a provision built into an existing homeowner’s insurance or renter’s insurance policy — helps fill in the gaps, so to speak. What is the Purpose of Loss of Use Coverage, Exactly? Loss of use coverage is rather straightforward in terms of its function — simply put, it is designed to account for losses related to the policyholder’s inability to make normal use of the property.  What constitutes “use” will vary depending on the policy and depending on the particular nature of the loss. Generally speaking, most loss of use coverage makes provisions for benefits in three different and broadly-applicable situations: Heightened cost of living Loss of rental income Legal prohibition on access All this legalese may seem confusing at first glance, so let’s do a brief walk-through of some examples to clarify how it all works. Suppose that you have loss of use coverage through your existing homeowner’s insurance policy.  One day, your primary residence is severely damaged by a hurricane, and as a consequence, you are forced to move out and seek out an alternative residence (at least temporarily). The damage to your residence is significant enough that it will take up to […]