Source: http://alanpalma.com/faqs/
Timestamp: 2020-07-08 13:23:17
Document Index: 33258855

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FAQs - Property Damage Insurance Claim Attorney in Miami - Alan Palma
1680 Michigan Avenue - Suite 700, Miami Beach, Florida 33139
Under Florida law “Property insurance” is insurance on real or personal property of every kind and of every interest therein, whether on land, water, or in the air, against loss or damage from any and all hazard or cause, and against loss consequential upon such loss or damage, other than noncontractual legal liability for any such loss or damage. Property insurance may contain a provision for accidental death or injury as part of a multiple peril homeowner’s policy. See § 624.604, Florida Statutes (2018).
Under Florida law a “Policy” is a written contract of insurance or written agreement for or effecting insurance, or the certificate thereof, by whatever name called, and includes all clauses, riders, endorsements, and papers that are a part thereof. See § 627.402, Florida Statutes (2018).
What are the policy declarations pages?
The Declarations pages are the parts of the policy (usually the first few pages) that indicate the name of your insurance company, your insurance policy number, the limits of your insurance, your applicable deductibles, and what standard forms comprise your policy.
I don’t even know if I have a property insurance policy. How do I find out if I do?
If you have a mortgage on your property, then you most certainly will have a property insurance policy on the mortgaged property because your bank will require it. Contact your bank or the servicer of your loan and ask them directly.
I don’t have a copy of my property insurance policy. How may I obtain it?
It is imperative that you possess a copy of your property insurance policy, so that at a minimum you know: 1) exactly what types of property and damage are covered under your policy; 2) what your deductibles and policy limits are; and 3) you know what obligations and duties are owed to your insurance company. The easiest way to obtain a copy of your property insurance policy is to request it from the agent that sold you your property insurance policy. In addition, under Florida law your property insurance carrier is required to provide you with a copy of your policy within 30 days of a written request or 60 days in the cases of a surplus insurer. See §§ 626.9372, Florida Statutes (2018) and 627.4137, Florida Statutes (2018).
Can my property insurance company cancel or not renew my policy due to an act of G-D?
Under Florida law Claims on property insurance policies that are the result of an act of God may not be used as a cause for cancellation or nonrenewal, unless the insurer can demonstrate, by claims frequency or otherwise, that the insured has failed to take action reasonably necessary as requested by the insurer to prevent recurrence of damage to the insured property. See § 627.4133, Florida Statutes (2018).
Can my property insurance company cancel or not renew my policy due to a single claim, which is the result of water damage?
Under Florida law a single claim on a property insurance policy which is the result of water damage may not be used as the sole cause for cancellation or nonrenewal unless the insurer can demonstrate that the insured has failed to take action reasonably requested by the insurer to prevent a future similar occurrence of damage to the insured property. See § 627.4133, Florida Statutes (2018).
What is an “Independent adjuster”?
Under Florida law an “independent adjuster” means a person licensed as an all-lines adjuster who is self-appointed or appointed and employed by an independent adjusting firm or other independent adjuster, and who undertakes on behalf of an insurer to ascertain and determine the amount of any claim, loss, or damage payable under an insurance contract or undertakes to effect settlement of such claim, loss, or damage. See § 626.855, Florida Statutes (2018).
May I cancel a contract with a public adjustor?
Under Florida law an insured or claimant may cancel a public adjuster’s contract to adjust a claim without penalty or obligation within 3 business days after the date on which the contract is executed or within 3 business days after the date on which the insured or claimant has notified the insurer of the claim, whichever is later. The public adjuster’s contract must disclose to the insured or claimant his or her right to cancel the contract and advise the insured or claimant that notice of cancellation must be submitted in writing and sent by certified mail, return receipt requested, or other form of mailing that provides proof thereof, to the public adjuster at the address specified in the contract; provided, during any state of emergency as declared by the Governor and for 1 year after the date of loss, the insured or claimant has 5 business days after the date on which the contract is executed to cancel a public adjuster’s contract. See § 626.854(6), Florida Statutes (2018).
How much may a public adjustor lawfully charge me for their services?
Under Florida law a public adjuster may not charge, agree to, or accept from any source compensation, payment, commission, fee, or any other thing of value in excess of: 1) 20 percent of a reopened or supplemental claim payment; 2) 10 percent of the amount of insurance claim payments made by the insurer for claims based on events that are the subject of a declaration of a state of emergency by the Governor; or 3) 20 percent of the amount of insurance claim payments made by the insurer for claims that are not based on events that are the subject of a declaration of a state of emergency by the Governor. Insurance claim payments made by the insurer do not include policy deductibles, and public adjuster compensation may not be based on the deductible portion of a claim. See § 626.854(10), Florida Statutes (2018).
Must a public adjustor provide me with a written estimate?
Yes. Under Florida law each public adjuster must provide to the claimant or insured a written estimate of the loss to assist in the submission of a proof of loss or any other claim for payment of insurance proceeds. The public adjuster shall retain such written estimate for at least 5 years and shall make the estimate available to the claimant or insured, the insurer, and the department upon request. See § 626.854(11), Florida Statutes (2018).
What are the legal responsibilities of a public adjustor?
Under Florida law a public adjuster must ensure that prompt notice is given of the claim to the insurer, the public adjuster’s contract is provided to the insurer, the property is available for inspection of the loss or damage by the insurer, and the insurer is given an opportunity to interview the insured directly about the loss and claim. The insurer must be allowed to obtain necessary information to investigate and respond to the claim. In addition:
A public adjuster may not restrict or prevent an insurer, company employee adjuster, independent adjuster, attorney, investigator, or other person acting on behalf of the insurer from having reasonable access at reasonable times to any insured or claimant or to the insured property that is the subject of a claim.; and
A public adjuster may not act or fail to reasonably act in any manner that obstructs or prevents an insurer or insurer’s adjuster from timely conducting an inspection of any part of the insured property for which there is a claim for loss or damage. The public adjuster representing the insureds may be present for the insurer’s inspection, but if the unavailability of the public adjuster otherwise delays the insurer’s timely inspection of the property, the public adjuster or the insureds must allow the insurer to have access to the property without the participation or presence of the public adjuster or insureds in order to facilitate the insurer’s prompt inspection of the loss or damage. See § 626.854(14), Florida Statutes (2018).
May a public adjustor control who performs repair work on my property?
No. Under Florida law a public adjuster, a public adjuster apprentice, or a person acting on behalf of an adjuster or apprentice may not enter into a contract or accept a power of attorney that vests in the public adjuster, the public adjuster apprentice, or the person acting on behalf of the adjuster or apprentice the effective authority to choose the persons or entities that will perform repair work in a property insurance claim or provide goods or services that will require the insured or third-party claimant to expend funds in excess of those payable to the public adjuster under the terms of the contract for adjusting services. See § 626.854(17), Florida Statutes (2018).
May a public adjustor repair my damaged property?
No. Under Florida law A public adjuster may not participate, directly or indirectly, in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the licensee; may not engage in any other activities that may be reasonably construed as a conflict of interest, including soliciting or accepting any remuneration from, of any kind or nature, directly or indirectly; and may not have a financial interest in any salvage, repair, or any other business entity that obtains business in connection with any claim that the public adjuster has a contract or an agreement to adjust. See § 626.8795, Florida Statutes (2018).
What information must be in a public adjustor’s contract?
Under Florida law a public adjuster contract relating to a property and casualty claim must contain the full name, permanent business address, and license number of the public adjuster; the full name of the public adjusting firm; and the insured’s full name and street address, together with a brief description of the loss. The contract must state the percentage of compensation for the public adjuster’s services; the type of claim, including an emergency claim, nonemergency claim, or supplemental claim; the signatures of the public adjuster and all named insureds; and the signature date. If all of the named insureds’ signatures are not available, the public adjuster must submit an affidavit signed by the available named insureds attesting that they have authority to enter into the contract and settle all claim issues on behalf of the named insureds. An unaltered copy of the executed contract must be remitted to the insurer within 30 days after execution. See § 626.8796, Florida Statutes (2018).
Should I hire a public adjustor?
First, if your property damage insurance claim is denied by your property insurance carrier or your property insurance carrier refuses to pay you additional benefits for your property damage claim, then in my opinion there is absolutely no justifiable reason to hire a public adjustor. If your property damage insurance claim is denied by your property insurance company or your property insurance carrier refuses to pay you additional benefits, then in my opinion the only way you may obtain additional compensation from your property insurance carrier for your property damage is by filing a lawsuit against your property insurance carrier. A public adjustor who is not a licensed attorney in Florida may not practice law in the State of Florida, and may not file a lawsuit against your property insurance company. Consequently, if your property damage insurance claim is denied or your property insurance carrier refuses to pay you additional benefits, then it us my opinion that your best option is to hire a property damage attorney to help you, and ideally a property damage attorney who has experience representing property insurance companies and litigating against them.
Second, if your property damage insurance claim has not been denied or your property insurance carrier has not refused to pay you additional benefits, then the answer really comes down to whether and to what extent you trust the individual whom will be representing you with your property damage claim. There exist qualified and professional public adjustors as there are qualified and professional property damage lawyers.
Whomever you decide to retain I highly recommend that you vet them properly. In addition, you have nothing to lose by contacting a public adjustor and a property damage litigation attorney and deciding for yourself whom you should hire. I guarantee you that if you contact me, I will give you an accurate assessment of your matter, and if you retain me, I will diligently respond to any and all of your inquiries and aggressively prosecute your rights.
How much notice must an insurance company or their agents provide an insured before conducting an inspection of the insured’s property?
Under Florida law a company employee adjuster, independent adjuster, attorney, investigator, or other persons acting on behalf of an insurer that needs access to an insured or claimant or to the insured property that is the subject of a claim must provide at least 48 hours’ notice to the insured or claimant, public adjuster, or legal representative before scheduling a meeting with the claimant or an onsite inspection of the insured property. The insured or claimant may deny access to the property if the notice has not been provided. The insured or claimant may waive the 48-hour notice. See § 626.854(13), Florida Statutes (2018).
How do you get paid for your representation of your clients in property damage insurance claim disputes?
I handle property damage insurance claim disputes on a contingency basis, which means that the client pays me nothing unless and until there is a recovery from the insurance carrier via settlement or judgment. No recovery, no fees or costs.
Further, if we are forced to file a lawsuit against your insurance company for failing to pay all property damage benefits which you are entitled under your policy, then your property insurance carrier may be obligated to pay a reasonable sum as fees or compensation for the attorney prosecuting the lawsuit for which recovery is awarded. See §§ 626.9373, Florida Statutes (2018) and 627.428, Florida Statutes (2018).
If I settle my property insurance claim with my property insurance company when can I expect my payment of the settlement proceeds?
Under Florida law in any case in which a person and an insurer have agreed in writing to the settlement of a claim, the insurer shall tender payment according to the terms of the agreement no later than 20 days after such settlement is reached. The tender of payment may be conditioned upon execution by such person of a release mutually agreeable to the insurer and the claimant, but if the payment is not tendered within 20 days, or such other date as the agreement may provide, it shall bear interest at a rate of 12 percent per year from the date of the agreement; however, if the tender of payment is conditioned upon the execution of a release, the interest shall not begin to accrue until the executed release is tendered to the insurer. See § 627.4265, Florida Statutes (2018).
The insurance adjustor for my property insurance company is not responding to my calls and emails. Are they allowed to simply ignore me?
No, they are not. Under Florida law upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 14 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgment. Such acknowledgment shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgment reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgment shall provide necessary claim forms, and instructions, including an appropriate telephone number. See § 627.70131, Florida Statutes (2018).
I have damage to the floor or roof of my home, and I can’t find matching materials to repair the damage. Am I entitled to compensation to replace the undamaged portions of my property as well?
Under Florida law when a homeowner’s insurance policy provides for the adjustment and settlement of first-party losses based on repair or replacement cost, and when a loss requires replacement of items and the replaced items do not match in quality, color, or size, the insurer shall make reasonable repairs or replacement of items in adjoining areas. In determining the extent of the repairs or replacement of items in adjoining areas, the insurer may consider the cost of repairing or replacing the undamaged portions of the property, the degree of uniformity that can be achieved without such cost, the remaining useful life of the undamaged portion, and other relevant factors. See § 627.9744, Florida Statutes (2018).
May my property insurance company withhold insurance benefits from me because I have not agreed to settle the entire insurance claim with them?
No. Under Florida law an insurance company may not withhold undisputed amounts, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage, in order to influence settlements under other portions of the insurance policy coverage. Insurance companies should pay as soon as they can, even for partial amounts. See § 624.155 Florida Statutes (2018) and § 626.9541, Florida Statutes (2018).
May my property insurance carrier deny my claim without conducting an investigation?
No. Under Florida law your property insurance company may not deny your claim without conducting a reasonable investigations based upon available information, and must then promptly provide you with a reasonable explanation in writing of the basis in the insurance policy, in relation to the facts or applicable law, for denial of your claim or for the offer of a compromise settlement. See § 626.9541, Florida Statutes (2018).
How quickly must I notify my insurance company of a claim?
Under most property insurance policies an insured must provide prompt notice of a loss or damage sustained to their property to their property insurance company and without waiting for the full extent of the damages to become apparent.
What information must I provide to my insurance company when I make a claim, and generally what are my duties that I owe my property insurance carrier with respect to my claim?
Policy holders possess a duty to cooperate with their property insurance company, which includes allowing their property insurance company to inspect the property damage, and conduct an investigation of the loss. In addition, a policy holder possesses a duty to provide documentation and information reasonably related to the property damage and the claim to the property insurance carrier. It is beneficial for a policy holder to document the damages, photograph and videotape the damaged property, obtain estimates for repair or replacement, itemize the personal property damage and keep receipts for everything spent for repair, replacement, protection of property, and other expenses incurred or caused by the loss. In addition, a policy holder possesses a duty to mitigate damages to the property, and at the request of the property insurer appear for an examination under oath and submit executed sworn statements in proof of loss.
What is a sworn statement in proof of loss?
A sworn statement in proof of loss is a document, which identifies the total amount of your claim. It must be sworn and notarized by you and returned to your property insurance carrier within a time period stipulated in your policy at the request of your insurance company. The form for the sworn statement in proof of loss must be provided by your property insurance company to you.
An examination under oath or “EUO” is where your property insurance company requests that its insured submit to questioning before a court reporter to answer questions and provide sworn testimony regarding the insured’s property damage claim. Usually, the property insurance carrier will request an EUO when there exist unexplained questions relating to the property claim or where the property insurance carrier suspects fraud.
What does actual cost value mean (ACV)?
ACV is defined in most insurance policies as the amount of monies necessary to repair or replace the damaged or destroyed insured property less an amount for depreciation.
What does replacement cost value mean (RCV)?
RCV is defined in most insurance policies as the amount of monies necessary to repair or replace the damaged or destroyed insured property with materials of like kind and quality, without deduction for depreciation.
1680 Michigan Avenue - Suite 700