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Challenging Your Home Insurance Settlement or Denial

Fri May 14th, 2021 on     Homeowners Insurance,    

Hire an Experienced Miami Insurance Claim Lawyer 

If you’ve sustained damage to your home and have submitted a claim to your insurer, you may be surprised to discover that your insurer is taking a “hostile” position towards this legitimate claim.

Insurers — particularly home insurers — often market themselves as friendly allies who will step up to support you in the worst of circumstances.  In truth, however, they are incentivized to undercut your claims, and potentially even deny your legitimate claims, to the degree that the facts allow them to do so.

If your insurer has denied your home insurance claim or has undercut your claim (by valuing the damages much lower than the claimed amount), then you could be put in a rather vulnerable financial position.  It’s important to understand your rights and how best to navigate such a dispute.

Here at Ver Ploeg & Marino, P.A., we encourage you to get in touch with an experienced Miami insurance claim lawyer at our firm for guidance on how to proceed.  We will identify strategic options and work with you to secure the damages to which you’re entitled.

For now, however, let’s take a closer look at home insurance denials and settlements.

Common Justifications for Denial

Insurers will often outright deny legitimate home insurance claims so long as there is some factual basis (even if that factual basis is vague and weak) to do so.  Some common justifications for denying a home insurance claim include, but are not limited to:

  • The loss is due to intentionally-caused damage or neglect
  • The loss is due to normal wear and tear
  • The exact cause of the loss is uncertain
  • The deadline for the claim already passed before it was filed
  • The damage is not in excess of the deductible
  • The claimant failed to pay their premiums in a timely manner
  • The damage was misrepresented or misreported
  • There were misrepresentations on the original insurance application
  • And more

For example, suppose that you entered into an insurance contract with a home insurer some years ago.  In the original application for coverage, you accidentally misreported something concerning defects in the home structure.  Later on, the structure collapses due to heavy flooding in the area (and this collapse may have been caused due to inadequacies in the condition of the home structure).

Given these facts, the insurer may argue that the insurance contract was invalid and unenforceable, and may deny your claim on that basis.  They would very likely be entitled to do so unless you could effectively counter their argument.

All would not necessarily be lost.  You could ostensibly argue against their denial by showing that you did not know (and could not have known) about the home structure defects, at the time that you submitted your original application for coverage.  Thus, you did not actually misreport or misrepresent the facts, and the insurance contract would have to be considered enforceable.

How to Counter the Insurance Adjusters’ Evaluation

In disputing a settlement offer from your insurer that is well below expectations, your attorney will attempt to build a case to support your claim — investigating the premises and the damages, and working with experts to accurately evaluate the losses.  Any new, relevant information can be sent to the insurance adjuster.

Unless the facts are so clear that the insurer cannot possibly justify their position, they may not move towards a more favorable settlement at this point.  As such, another effective option is to request that the insurance adjuster conduct another inspection, but this time alongside your own chosen experts.  With all the necessary investigators in the house at the same time, you will be able to have an open conversation about what the adjuster is “seeing” and “evaluating” in real-time.  This may lead to a fairer re-evaluation of the damages.

Of course, sometimes, the insurer will not budge despite all your best efforts to remain amicable.  In those situations, your attorney can work with you to file a lawsuit against the insurer.  Insurers are not entitled to make arbitrary decisions against your interest.  If they do not have a reasonable argument for undercutting your damage claim, then you can sue them for those damages.  And if the insurer has taken steps to make the process more difficult for you (i.e., unreasonably delaying the processing of your claims), then the court may even choose to award punitive damages, which could multiply your total recovery.

Given the complexities of disputing the insurer’s adverse decisions (with respect to your home insurance claim), it’s critical that you consult with a qualified attorney as soon as possible.

Contact a Miami Insurance Claim Lawyer at VPM Law for Assistance

Ver Ploeg & Marino, P.A. is a Miami-based insurance litigation firm, with a focus on providing client-oriented legal representation.  We are committed to securing positive outcomes for our clients — at every phase of litigation (from settlement negotiations to trial).

Over the years, our team has developed a trial-ready approach to navigating insurance disputes, including those that center around a home insurance dispute (i.e., the insurer has significantly undercut your claim for damages).  This thorough approach to litigation has helped us to achieve significant results for our clients, as we are able to put pressure on the insurer and often force their hand early on.

Home insurers may advertise themselves as “friendly,” but they are not your ally.  When it comes time to submit a claim, they will do whatever it takes to avoid paying out or to pay less than they have to.  This can be extremely frustrating if you do not have a trusted attorney in your corner.

We’re here to help.

If you’d like to speak to a seasoned Miami insurance claim lawyer about your dispute, we encourage you to contact us to schedule a consultation at your earliest convenience.  We look forward to speaking with you.

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