Denial of Claim

You expect your insurance company to have your back when you’ve experienced unforeseen property damage. Unfortunately, insurers often deny claims to save themselves money. They may claim you did the damage yourself or state certain pre-existing conditions were the cause. No matter the circumstances, insurance companies who deny valid claims should be challenged.

Insurance companies should cover their policyholders who have paid their premiums on time. Fight back by contacting an experienced insurance claims attorney. An insurance lawyer can assess the evidence and prove why your claim is viable in court. If your property claim was denied recently, then it’s imperative you seek a skilled lawyer.

Tampa Attorney for Denied Claims in Florida

Has your insurance company recently denied your claim? You may want to speak to an experienced insurance claims attorney. They can analyze the denial letter from your insurance company and spot anything suspicious. In addition, your attorney can collect more evidence and file a more effective claim if you drafted the initial one.

Contact Germain Law Group, P.A., for a knowledgeable and dedicated insurance attorney. Michael B. Germain has represented numerous people who have had their claims denied in court. He can utilize his resources and experience to help maximize your settlement. Call us now at (813) 835-8888 and set up an appointment today.

Germain Law Group, P.A. accepts clients throughout the greater Tampa Bay area and surrounding cities including St. Petersburg, Brandon, Bradenton, Temple Terrace, and New Port Richey.

Overview of Denial of Claim in Florida

Reasons Why Your Insurance Company Denied Your Claim

Insurance companies have various reasons why they’ve decided to deny your claim. Some are contractual such as excluded losses listed in your policy. However, other reasons are simply pointing fingers at the policyholder such as stating “pre-existing conditions” is the reason for the damage. The following are some possible reasons why your claim was denied.

Exclusions in Your Policy

Your insurance policy should outline what’s covered in case your property sustains unforeseen damage. It will also include what perils are excluded from the policy, which are referred to as exclusions. For example, most homeowner’s insurance doesn’t include coverage for flooding. You will need a separate insurance policy to cover damages made by a flood.

However, some exclusions are not as explicit. Most homeowner policies don’t cover structures outside the home such as garages or sea docks. One common exclusion people don’t consider are damage done to porches. In some policies, the interior and exterior of your house will be covered but not the porch. Your porch won’t be covered even if the damage done to the home was caused by the same event that damaged your porch.

Pre-Existing Conditions

Insurance companies may state the damage don’t to your property already existed before you experienced the unforeseen event. The insurer may claim you didn’t notice the damage beforehand or that you’re attempting to commit insurance fraud.

For example, if your roof sustains water damage because of a hurricane, your insurance could claim that the hurricane had nothing to do with it at all. They may argue that your roof had exposed sheeting and the water damage happened over time instead of the hurricane. This can be extremely hard to discredit if you don’t have photos of your roof or home before the actual hurricane occurred.

Wear and Tear

Insurance covers your property from unexpected damage such as a natural disaster or a crime. It doesn’t, however, protect you from damage that occurred due to normal wear and tear. The term wear and tear is when a property is damaged from ordinary use and exposure over time.

Wear and tear is different from damaged property because the damage done was inevitable. Items and property value degrade over time and is expected. This is different from damaged property, which is unexpected and doesn’t stem from everyday use. For example, stains on a carpet or faded flooring due to sunlight would be considered wear and tear.

Insufficient Evidence and Questionable Inquiries

Some claims are denied because the insurance adjuster deems there is insufficient evidence to support your claim. This means there wasn’t enough documentation of the event or the losses you’ve experienced. For example, you may file a claim for fire damage, but you didn’t provide the police report of the event. The insurance company could deny your claim because they don’t believe there is enough evidence that a fire occurred.

In some cases, the insurance company may question your motives. If they believe you acted strangely before or after the damage, they may deny your claim because they believe it’s fraudulent. For example, if your home sustained water damage from a burst pipe but you didn’t obstruct the pipe or contact your insurance company immediately, your insurance could deny your claim.  This may be because they believe you broke the pipe yourself or it sustained minor damage and you intentionally made it worse so you could collect a monetary award.

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Challenging a Denied Claim in Florida

Your claim may have been denied, but you don’t have to give up. A great option is to appeal your insurance denial with effective legal representation. An experienced insurance claims attorney can create a plan for an effective appeal by gathering documentation for your case.

If your appeal is overturned, then you can file a lawsuit against your insurance company. Your policy may limit the amount of time you have to sue, so it’s recommended you review it before you do anything else. Some policies only permit a year to file a suit before they’re considered immune.

Your goal during trial will be to prove your insurance company acted in bad faith when they denied your claim. You can do this by hiring skilled legal counsel who can prove why your claim was valid such as deposing structural engineers, contractors and other expert witnesses. They can even analyze the history of the insurance company to see if viable claims were intentionally denied in the past.

If you win your case, then you will be granted a monetary award. The award will cover any losses you’ve experienced from the damaged property such as repairs, additional living costs, and compensation for temporary housing.

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Additional Resources

Homeowner’s Claims Bill of Rights in Florida – Visit the official website for the Online Sunshine, a collection of Florida’s state laws. Access the site to learn more about the Homeowner Claims Bill of Rights to see what you’re advised to do and what your rights are as an insured person.

Facts and Statistics about Homeowner’s Insurance – Visit the official website for the Insurance Information Institute (III), a non-profit dedicated to educating the general public of insurance practices. Access their site to find more information on facts, statistics, and trends found in homeowner’s insurance.

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Insurance Lawyer for Denial of Claim in Tampa, Florida

There’s no reason your insurance company shouldn’t cover your damages if your claim is legitimate. Learn more about your options by contacting Germain Law Group, P.A.. Michael B. Germain is a reputable attorney and has years of insurance law practice. He can assist you with your appeal and even a lawsuit if necessary.

Contact him now at (813) 835-8888 to set up a free consultation. Attorney Germain will sit with you and analyze your denied claim for any suspicious activity. Michael B. Germain accepts clients throughout the Hillsborough County area and surrounding counties including Paso County, Polk County, Sarasota County, and Pinellas County.

This article was last updated on June 21, 2019.