Previously, in Documentation of Prior Repairs Can Be Important, I wrote about the importance of keeping relevant information such as receipts and pictures from prior maintenance and repairs to support a future insurance claim. Aside from the work that your association does, another important source of information is your insurer’s underwriting and claims files. While most for-profit insurers will not easily part with these files, if you are insured by Citizens Property Insurance Corporation, you have a right to these files as a matter of law.

Underwriting files can be important if there is a question about the status of the property before a loss occurred. One of the most common arguments that carriers make is that the property was previously damaged or was not in good condition before the loss occurred. Despite the fact that they gladly accept the risk and the premiums that come with it, insurers often take the position that the property was basically falling apart before the loss occurred.

Underwriting files can evidence the conditions of an association’s property when the policy was issued, as well as before any renewals. Evidence of previous inspections that occurred prior to underwriting the risk, such as pictures, reports, notes, etc., can help a policyholder show that the property was in good condition before the loss, and that the insurance company knew it.

Previous claims files can be equally important to support a current claim. These claim files will generally contain pictures of previous damages, log notes from the previous adjusters that detail the inspections performed and the damages found, reports containing general descriptions of the damaged and undamaged property, any engineering reports that were performed and just about any other information obtained during the earlier adjustment.

As we saw from the 2004-2005 hurricane season, multiple losses can happen within a short period of time. Often, insurers argued that the damages found were the result of a previous storm and were either not found or not repaired after the storm. For example, most associations that suffered roof damage after Hurricane Wilma were told that the roof damage was likely pre-existing.

Prior claim files can play an important role in supporting your current claim. Previous engineering reports can help prove that the roof was in good condition before a loss. Previous adjuster notes and pictures can help prove that a previous loss did not damage a certain part of the property or that the damages sustained were minor and repaired.

While many insurers are reluctant to part with underwriting or previous claim files, Citizens Property Insurance Corporation policyholders have an absolute right to them. Florida Statute 627.351(6) provides:

(x)1.The following records of the corporation are confidential and exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I of the State Constitution:

a.Underwriting files, except that a policyholder or an applicant shall have access to his or her own underwriting files. Confidential and exempt underwriting file records may also be released to other governmental agencies upon written request and demonstration of need; such records held by the receiving agency remain confidential and exempt as provided herein.

b.Claims files, until termination of all litigation and settlement of all claims arising out of the same incident, although portions of the claims files may remain exempt, as otherwise provided by law. Confidential and exempt claims file records may be released to other governmental agencies upon written request and demonstration of need; such records held by the receiving agency remain confidential and exempt as provided herein.

Every Association insured by Citizens now, or in the past, should request a copy of its underwriting and previous claims files. They may provide the support needed to resolve a disputed claim in the future.

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Founded in 1985, our law firm continues to be dedicated to representing insurance policyholders throughout the United States. Collectively, our lawyers are licensed to practice in 25 states. In fact, many of Merlin Law Group’s attorneys worked for the insurance industry before joining the firm, so they bring a strong understanding of insurance company practices. Anyone can file a claim, but it takes experience, knowledge, and savvy to achieve a truly successful outcome. As The Policyholder’s Advocate®, Merlin Law Group aims to drive positive change within the insurance sector by obtaining justice for our clients and educating policyholders on how to navigate insurer bad faith tactics.

When we handle property insurance claim disputes, we hire the most experienced and qualified expert witnesses to evaluate your insurance claim and testify on your behalf. In most cases, we can advance the fees for this. Typically, we hire experts such as engineers, contractors, independent roofing consultants and other professionals to perform a thorough assessment on all possible causes of damages. This is a process that provides us with a very detailed and all-inclusive estimate for determining and justifying a proper settlement. Our use of these professional expert witnesses sets us apart from other insurance law firms.

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