Homeowner Insurance Claims: Six Things You Need to Know

Homeowner Insurance Claims: Six Things You Need to Know
You’ve notified your insurance company, what’s next?

Mark Wolfe, Attorney

“Many homeowner and commercial property insurance policies have a dispute resolution provision for valuation disputes. However, these provisions vary from policy to policy and often have legally binding requirements that must be complied with in order to resolve the dispute.”

As thousands of us along the Alabama and Florida Gulf Coast begin the recovery process after Hurricane Sally, many of us will be having to make insurance claims for damage to our homes and property. Here are some important things you need to know about your property damage and/or homeowner insurance claim. Keep in mind an insurance policy is a contract between you and your insurance company that details what each party must do related to a loss. Your failure to comply with these requirements can be grounds to void coverage! Also, when you are making an insurance claim it is your burden to prove the loss with proper documentation and credible evidence.

 

1. Notify Your Insurance Company Immediately. Most insurance policies require notification of a potential claim as soon as possible. A delay in notifying the insurance company of a potential claim could result in a denial of coverage.

2. Document & Mitigate Your Damages. There is no such thing as too many photographs or videos of your damage. Also, your policy requires you to undertake reasonable steps to help minimize the loss. This may mean putting a tarp over roof damage to prevent more damage or putting plywood over broken windows. Failure to mitigate your damages can result in the denial of benefits or reduced benefits. If you can not get to your property to assess and/or mitigate your damages because of government restrictions, make sure to print or screen shot the restriction.

3. Review Your Policy. There are several important things to know about your policy and the coverage it provides. While there is no “uniform” homeowner policy, most contain the following sections and parts. The starting point in your review is the Declarations Page. This tells you the amount of coverage available for the various losses and should document what real property is covered by the policy. It should also document the deductible for each claim. The Terms and Definition sections defines a “covered loss” and any exclusions as well as all the other relevant terms used in the policy. The Property Damage section of your policy outlines the what real property and personal property will be covered under the policy and it usually explains the loss of use coverage. The Personal Liability portion of the policy explains the personal protection afforded to you for liability claims made against you or a member of your household for negligence or careless actions. The Additional Terms & Conditions section of the policy may contain legal provisions such as assignment of benefits, subrogation and dispute resolution procedures.

4. Be Careful in Your Conversation with the Insurance Company. Always be truthful but only provide facts you know to be true. After a storm, insurance adjusters are working hard and moving quickly. Often when reporting your damage the insurance company will ask about other damage. If you assume you have no other reportable or claimable damages and say you have no other damage then the adjuster may not give your house a full inspection when he or she comes to adjust your loss and write an estimate. Always ask that the adjuster give your home or property a full and complete inspection. They are trained to identify damage and they may see storm damage that you did not realize.

5. What to do if  You and the Insurance Company Don’t Agree. Generally, there will be two potential areas for disagreement: coverage and valuation of the loss. If your insurance company is denying coverage for the damage then you have a right to have the denial in writing. Generally, you should ask for a written explanation of the denial and ask for a specific reference to the policy provision that supports the denial. E.g., A policy may exclude flood or rising water damage. Have the written denial letter and the policy reviewed by an experienced insurance claims attorney as soon as possible. If you disagree on the valuation of the loss, e.g., repair vs. replace, then you may want to consult with an experienced insurance attorney. Many homeowner and commercial property insurance policies have a dispute resolution provision for valuation disputes. This allows for a resolution without having to file a lawsuit! However, these provisions vary from policy to policy and often have legally binding requirements that must be complied with in order to resolve the dispute. Some States even allow for the recovery of attorney fees if you are successful

6. Consultations are Free! Almost all lawyers who represent people who have a dispute or disagreement with an insurance company provide free consultations. Many of these lawyers will represent a claimant under a contingency fee contract; that is, no money recovered for you, no fee owed. However, the percentage charged can vary greatly from law firm to law firm. Some may charge 15% of the total recovery while others may charge 25% of the amount in dispute. Also, some lawyers may advance the expenses related to the matter while others may require you to pay those expenses directly and as incurred. If you hire an attorney to assist you with your claim, you should know exactly how the fee will be calculated and how expenses will be handled. You should always get a copy of the representation agreement. If you don’t get a copy of the agreement at least send a written confirmation of your understanding as to how fees and expenses will be handled.

If you are an Alabama or Florida Gulf Coast resident and you have a question about your insurance claim, please contact Boteler Richardson Wolfe – Attorneys at 251 433-7766. We’ve been helping Gulf Coast residents with insurance claims since 1987. Offices in Mobile, AL  and Foley, AL

 

REQUIRED DISCLAIMERS: Alabama Rule of Professional Conduct 7.2: No representation is made that the quality of legal service to be performed is greater than the services provided by other lawyers. The Mississippi Supreme Court advises that a decision on legal services is important and should not be based solely on advertisements. Free background information is available upon request to a Mississippi attorney. The listing of any area of practice by a Mississippi attorney does not indicate any certification of expertise therein. See Mississippi Rules of Professional Conduct Rule 7.2(d), Rule 7.4(a), Rule 7.6(a) (1997). Statement in compliance with Florida Bar Advertising Rules: “The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience. [Florida Rule 4-7.2(d)]. General Disclaimer: This information is posted for general information purposes to help those interested parties or persons with potential civil claims better understand their rights and potential causes of action. If readers are currently represented by an attorney on the subject matter of this post then they are encouraged to continue with said representation. No attorney-client relationship is established by this post.

 

Can Boat Owners Rely on an Act of God to Avoid Hurricane Sally Liability?

Can Boat Owners Rely on an “Act of God” to Avoid Hurricane Sally Liability?

With boats strewn all over the Alabama and Florida coastline from the unsuspecting ferocity of Hurricane Sally, many are asking the question: Is a boat owner liable to a landowner for damage caused by the unmoored boat in a hurricane? An unpublished 5th Circuit Court of Appeals opinion provides a well written analysis to answer this question. In Simmons v. Berglin, 2011 U.S. App. LEXIS 23499, a sailboat became unmoored from its dock during Hurricane Katrina, washed ashore, and damaged the Plaintiffs’ property. Finding for the sailboat owner, the 5th Circuit Court of Appeals concluded the unmooring and resulting damage was an Act of God.

In reaching its conclusion, the Simmons Court, first, acknowledged a presumption that has existed in admiralty law for well over 150 years – there is a presumption that when a moving vessel causes damage to a stationary object, the moving vessel is at fault. This said, the Court, also, pointed out a drifting vessel may overcome this presumption with evidence that “the accident could not have been prevented by human skill and precaution and proper display of nautical skill.” In other words, if a boat owner undertook reasonable preparations in anticipation of an impending hurricane, the boat owner will be relieved from liability as the damage resulted from an Act of God.

The facts found in the Simmons case are analogous to the stories being shared following Hurricane Sally. As such, the factual analysis in Simmons can be readily applied to those seeking claims against boat owners in the aftermath of Hurricane Sally. In that case, the Court’s recognition of the high storm surge recordings in the area where the sailboat was docked was, undoubtedly, a significant factor in its decision. Too, an important factor in the Court’s rationale was its acknowledgment of the testimony from the two men who made hurricane preparations to the sailboat – both were found to be well experienced mariners. Finally, the Court assessed the devastation inflicted upon the docks and boats in the area where the sail boat was moored in finding the damage resulted from an Act of God.

In conclusion, for a landowner to present a claim against a boat owner for damage caused by his/her’s unmoored boat in a Hurricane Sally, it will, first, be necessary for the landowner to prove the boat owner failed to undertake reasonable preparations. For example, those boats that were poorly anchored resulting in damage to landowners may be liable for damages. However, know the court may balance a mariner’s inexperience with the fact Hurricane Sally brought a significant storm surge in Alabama and Florida causing devastation upon docks and boats throughout the area in finding for the boat owner, instead of the landowner. Simply put, the landowner will have to overcome an assumption that Hurricane Sally subjected all local mariners to an Act of God. (AP Photo/Gerald Herbert)

Knox Boteler
Boteler Richardson Wolfe
knox@brwlawyers.com
(251) 433-7766

 

REQUIRED DISCLAIMERS: Alabama Rule of Professional Conduct 7.2: No representation is made that the quality of legal service to be performed is greater than the services provided by other lawyers. The Mississippi Supreme Court advises that a decision on legal services is important and should not be based solely on advertisements. Free background information is available upon request to a Mississippi attorney. The listing of any area of practice by a Mississippi attorney does not indicate any certification of expertise therein. See Mississippi Rules of Professional Conduct Rule 7.2(d), Rule 7.4(a), Rule 7.6(a) (1997). Statement in compliance with Florida Bar Advertising Rules: “The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience. [Florida Rule 4-7.2(d)]. General Disclaimer: This information is posted for general information purposes to help those interested parties or persons with potential civil claims better understand their rights and potential causes of action. If readers are currently represented by an attorney on the subject matter of this post then they are encouraged to continue with said representation. No attorney-client relationship is established by this post.

Personal Injury Claims: What Are “Value Drivers?”

Today most major automobile insurance companies use some form of Computer Assisted Claim Evaluation Program to help them establish a “value” for a personal injury claim. These programs evaluate data about the injury claim and then provide the adjuster with a value or compensation amount they should pay the victim. Depending on the company, adjusters may have to strictly follow the evaluation or they may be able to offer more than the program’s “evaluation.”  Desktop Computer Free vector in Adobe Illustrator ai ( .AI ), Encapsulated PostScript eps ( .EPS ) format for free download 3.28MB

Central to all of these programs are value-drivers. These are certain facts or factors that are input into the program. A value-driver can be either positive or negative. Meaning they can either increase the amount of compensation the victim receives or reduce the amount of compensation the victim receives. These programs can evaluate thousands of different value drivers. Even for a simple auto-crash injury claim there can be over 100 value drivers analyzed by these programs.

Obviously the diagnosis code for an injury is an important value driver but so are the treatment codes as well as the timing of the treatment. The “value” of a diagnosis code may also depend on what type of doctor made the diagnosis. A delay in care or a gap in treatment can be a negative value driver as well as inconsistent pain complaints in the medical records. Many times these negative value drivers can be limited or overridden by the adjuster but he or she has strict criteria or guidelines on what documents and/or facts must be presented to limit the negative value driver.

If you have a serious injury claim from a car crash, you need a law firm that understands Computer Assisted Claim Evaluation programs and knows how to properly document all of the positive value drivers and limit the negative value drivers. At Boteler Richardson Wolfe we’ve been helping car crash victims present and prosecute their insurance claims for over 30 years. We know and understand Computer Assisted Claim Evaluation Programs better than most attorneys. We can help you get the full compensation you deserve! Give us a call today: 251 433-7766 or email Mark Wolfe at mark@brwlawyers today for a free consultation.

REQUIRED DISCLAIMERS: Alabama Rule of Professional Conduct 7.2: No representation is made that the quality of legal service to be performed is greater than the services provided by other lawyers. The Mississippi Supreme Court advises that a decision on legal services is important and should not be based solely on advertisements. Free background information is available upon request to a Mississippi attorney. The listing of any area of practice by a Mississippi attorney does not indicate any certification of expertise therein. See Mississippi Rules of Professional Conduct Rule 7.2(d), Rule 7.4(a), Rule 7.6(a) (1997). Statement in compliance with Florida Bar Advertising Rules: “The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience. [Florida Rule 4-7.2(d)]. General Disclaimer: This information is posted for general information purposes to help those interested parties or persons with potential civil claims better understand their rights and potential causes of action. If readers are currently represented by an attorney on the subject matter of this post then they are encouraged to continue with said representation. No attorney-client relationship is established by this post.