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 actually a construction defect and therefore not covered.
Let’s take a closer look at how this argument works, and what the law says about it.
Understanding the Four Trigger Theories
Throughout the United States, there are generally four main theories for when property damage coverage is triggered under a homeowner’s insurance policy due to a construction defect:
- Exposure: the property damage occurs the moment a defective product has been installed in the home
- Manifestation: the property damage occurs from the date of its discovery (or the date that a reasonable inspection would have discovered it)
- Continuous trigger: the property damage occurs continuously, from the moment the defective product was installed to the time damage is actually discovered
- Injury-in-fact: when the property is obviously damaged, then the occurrence is the date of such damage
These can each be somewhat complex in their application, but not to worry — Florida insurance law (with respect to homeowners’ insurance and construction defects/property damage) centers around just two theories, the manifestation theory and the injury-in-fact theory.
Florida Insurance Law is Not Quite Settled
Florida insurance law is not entirely settled, with some commentators believing that there is disparate application of the two theories — manifestation and injury-in-fact — and other commentators believing that Florida has mostly thrown its hat into the ring as a manifestation state.
Whether a court applies manifestation or injury-in-fact, or any other trigger theory, will largely depend on the language of the insurance policy (and whether it provides explicit guidance on whether the property damage occurs).
Without such guidance, Florida courts do have a tendency to apply the manifestation trigger theory. Interested in how the manifestation trigger theory could be applied to your claim for property damage? Let’s walk through a simple but clarifying example.
Suppose that a portion of your home collapses due to a leaky pipe causing long-term water damage to some of the walls, weakening them and setting the stage for the structure to collapse. The property damage is significant. You attempt to file a claim with your current homeowners’ insurance provider, but they deny the claim on the basis that their insurance policy explicitly triggers on “exposure.” As such, it is not applicable to your case, where the defect (leaky pipe) was installed prior to you signing onto the new insurance policy.
You then attempt to secure a payout with the previous homeowners’ insurance provider, whose policy had ambiguous plan language. As such, the manifestation theory applies. That provider might argue, however, that the damage did not actually “occur” — it did not manifest as the collapse — until after the policy term had already completed. This would ostensibly prevent you from recovering.
Now, one option you have is to argue that, under the manifestation trigger theory, you could make a claim against the previous provider on the basis that a reasonable inspection would have discovered the leaky pipe issue sooner (during the time that the policy was active). The provider might eventually agree but find that they should only have to payout for losses at that time, not for the losses sustained due to the structural collapse.
Seem complicated? An experienced attorney at our Miami insurance law firm can help you navigate these difficult arguments.
Contact VPM Law for Insurance Dispute Assistance
Whether you’re in the process of submitting a property damage claim or have already submitted a claim and have received a denial from the insurance company, our team here at Ver Ploeg & Marino, P.A. can provide the assistance necessary to challenge an adverse decision and secure the benefits to which you’re entitled.
VPM Law is a Miami insurance law firm, fielding a deep bench of attorneys who bring to bear decades of experience: investigating, submitting, and litigating insurance claims throughout the state of Florida. We understand the challenges faced by policyholders, and just how important it is to position yourself advantageously when attempting to secure a payout under the insurance plan.
Our litigation team is committed to relentless, detail-oriented advocacy, and over the years, have developed great insight into the strategies utilized by insurance companies to avoid having to payout legitimate claims. This has given us substantial negotiation leverage vis-a-vis the insurance companies.
If you’d like to speak to a qualified attorney at our Miami insurance law firm, we encourage you to get in touch with our team directly. Contact us to request a consultation.Share