FAQs

Frequently Asked Questions

Do I need to hire an attorney for my insurance claim?

In some cases, property insurance claims are handled promptly and fairly. These instances do not require an attorney, as insurance companies are honoring their obligations to the policyholder under the conditions of the policy. When an insurance company wrongfully delays, denies, or underpays your claim, it is recommended you consult with an experienced insurance claim attorney to review your options.

How much does it cost to retain Merlin Law Group?

Merlin Law Group attorneys work on a contingency fee basis, so there is no cost to you unless we win your case. In many cases, Merlin Law Group will hire industry experts, among other resources, to build the ultimate case for you, the policyholder. In these cases, costs can accumulate greatly and quickly. Merlin Law Group attorneys know that these in-depth, unbiased expert analyses can make or break your insurance claim. Merlin Law Group is dedicated to obtaining the maximum settlement for our clients and will advance most costs pre-settlement.

What resources does Merlin Law Group have?

The attorneys at Merlin Law Group will choose top industry experts tailored to your specific type of claim and in most cases, the firm fronts all costs for experienced experts in order to build the strongest case for you, the policyholder. We also have a dedicated trial team should your case head to trial.

From engineers to contractors to independent professionals, Merlin Law Group retains qualified experts to adequately assess your insurance claim. The utilization of these professional expert witnesses sets Merlin Law Group apart from other insurance law firms.

How do I get started with Merlin Law Group?

Merlin Law Group asks you to please provide the following documents if applicable and available.
For Residential and Commercial Property Claims:

  • Insurance policy or copy of declaration page of insurance policy
  • Denial letter
  • Any and all correspondence to and from the insurance company
  • Any estimates of items to be replaced/repaired

You can fill out our Free Case Review form to provide any relevant information regarding your claim. Our staff will reach out to you with available options.

Hurricane Damage FAQs

What to do if your property sustains hurricane damage?

  1. File a claim with your insurance company.
  2. Take photographs of any damage to the interior and exterior of your home.
  3. Compare new photos with those taken before the storm.
  4. Have a public adjuster, contractor, or damage expert assess the property.
  5. Understand your insurance policy and what is and isn’t covered.
  6. Contact an experienced hurricane damage attorney if your insurer is wrongfully delaying, denying, or underpaying your claim.

Does my insurance cover hurricane damage?

This depends on whether your insurance policy covers the full scope of potential hurricane damage. For example, many policies exclude flood damage, which is ironic given that flooding can often lead to the most significant type of damage suffered by a home during a hurricane. Most standard homeowners policies separate water damage from flooding, so you will need to secure flood coverage through either the National Flood Insurance Program, FEMA, or another authorized private carrier.

Is flood damage included In hurricane coverage?

Oftentimes no. Policies will include wind damage and in some cases, water damage, but damage from flooding is another element that is typically excluded from most policies. Homeowners will need to obtain flood damage coverage through an authorized private carrier or public entities like the National Flood Insurance Program or FEMA.

What are policy limits?

An insurance coverage limit determines the maximum amount of money an insurance company will pay for a covered claim. There may also be time limits within which you have to file a claim for incurred damage(s). We strongly recommend you go through your policy thoroughly to figure out what limits are present.

What are anti-concurrent clauses?

Anti-concurrent clauses prohibit recovery when a covered peril and non-covered peril combine to cause a loss. For example, if your home sustains wind (covered) and flooding (non-covered) damage due to a hurricane, your insurer will deny your claim regardless of the existing wind coverage. Be sure to read through your policy to determine whether there are any of these clauses.

Replacement cost coverage or actual cash value coverage?

In order to avoid underinsurance, we recommend you adopt Replacement Cost Coverage [RCC] over Actual Cash Value [ACV]. RCC equates to the cost to replace the damaged property with materials of similar kind and quality without any sort of deductions for depreciation. ACV payouts can be broken down into three ways:

  1. The cost to repair or replace any damaged property, minus depreciation
  2. The “fair market value” of the damage property
  3. By using what is known as the “broad evidence rule,” which is when insurers consider all relative evidence of the value of the damaged property. We recommend RCC because you stand to receive fairer compensation when filing a claim.

Where can I find a hurricane insurance claim lawyer?

We have experienced hurricane insurance claim attorneys practicing nationwide. View our directory of attorneys here.

Water Damage FAQs

What is the difference between flood and water damage?

Damage from water and damage from flooding fall under two different forms of coverage in an insurance policy. The former is typically included in standard homeowners insurance policies while the latter falls under its own flood insurance policy from a separate insurer.

FEMA defines flooding as:

“A general and temporary condition of partial or complete inundation of 2 or more acres of normally dry land area or of 2 or more properties (one of which is the policyholder’s) from:

  • Overflow of inland or tidal waves; or
  • Unusual and rapid accumulation or runoff of surface waters from any source; or
  • Mudflow; or
  • A collapse of subsidence of land along the shore of a lake or similar body of water because of erosion or undermining caused by waves or currents of water exceeding anticipated cyclical levels that results in a flood as defined above.”

How do I know if my policy covers flood damage?

In most states, flood damage is excluded from a standard homeowners insurance policy. You will be required to obtain flood coverage through a public entity such as the National Flood Insurance Program or FEMA. You can alternatively obtain flood coverage through an authorized private carrier.

Does my policy cover damage resulting from sewer backup?

Most policies will not provide coverage for damage because of a sewer or drain backup or a failed sump pump. Your policy may include added endorsements that allot coverage for sewer, drain, or sump pump backups up to a limited amount of money. It is important to read through your policy to determine the scope of your water damage coverage and any possible exclusions that may exist. Another option is to purchase a rider for sewer backup damage.

What are anti-concurrent clauses?

Anti-concurrent clauses prohibit recovery when a covered peril and non-covered peril combine to cause a loss. For example, if your home sustains wind (covered) and flooding (non-covered) damage due to a hurricane, your insurer will deny your claim regardless of the existing wind coverage. Be sure to read through your policy to determine whether there are any of these clauses.

Does my policy cover frozen pipes or damage from an appliance?

Water that accidentally discharges from a broken appliance may be covered under your homeowners insurance policy. Frozen pipes may also fall under your policy’s coverage, but there are often conditions attached such as maintaining heat in your home or properly winterizing your home.

What is a water exclusion cause?

A water exclusion clause restricts certain forms of water damage from being covered under an insurance policy. These clauses limit the water-related claims an insured can successfully make. Damage caused by flooding, standing water, groundwater, and drain or sewage backup typically fall under exclusion clauses.

Is damage from rain or snow covered?

Damage from snow, collapsed roofs from ice dams, and wind-driven rain may potentially be covered if the damage is proven to be a cause of a covered peril or weather condition.

What to do if your property sustains water damage?

  • Indicate any urgent repairs needed at your property. Water can leave your home susceptible to further damage if not properly dealt with. Be sure to document any expenses incurred from temporary repairs.
  • Take photographs of any damage in its original state. This information is helpful toward filing a successful claim.
  • Consider hiring a public adjuster or damage assessment expert to assess the conditions of the damage. The insurer will likely send out their own adjuster, but it can be helpful to have an independent appraisal.
  • Be aware that this type of damage can lead to subsequent damages in the form of weakened doors, walls, windows, appliances, and other structural issues.

Where can I find a water damage insurance claim lawyer?

We have experienced water damage insurance claim attorneys practicing nationwide. View our directory of attorneys here.

Wind Damage FAQs

What to do if your property sustains wind damage?

  1. You should photograph any damages to your property as soon as possible after the peril. If you can prepare for any potential damaging winds, having “before” photos is helpful in building out a strong claim.
  2. You should address any and all damages to your property. Keep an eye out for any exposed entryways or another potential sources for further damage as a result of wind hitting your property. Temporary repairs may be necessary to address these. If you make any repairs, be sure to track any expenses toward them.
  3. File your claim as soon as possible. Upon filing your claim there will likely be an insurance representative or independent adjuster coming out to assess the damage to your property. Be sure to keep track of any correspondence between you and your insurance company, including written damage assessment reports.
  4. Consider hiring a public adjuster or damage assessment expert to look at any windstorm damage. It is recommended you obtain a second opinion, as a public adjuster’s estimate may differ from the independent adjuster. An outside opinion could lead to more money for your claim.

Is damage caused by wind covered under homeowners insurance?

Wind damage is generally covered under homeowners insurance policies, unless you live near the coast. We recommend you review your insurance policy to confirm that wind is noted as a covered peril, if your policy is “all-risk,” or if there is any explanation for windstorms. If it is not covered, consider modifying your policy or obtaining supplemental coverage through another insurer.

Which types of protection are there for damage caused by wind?

If your policy covers wind damage, there are two primary types of protection to look for regarding your property. The first is dwelling coverage, which protects your home’s structure. Dwelling coverage assists with repairs to your home’s roof, windows, or siding, for example.

The other primary protection to look for in your policy is personal property coverage. This assists with the cost of replacing any personal contents damaged by wind within your home’s structure. Bear in mind that each protection type may carry a limit regarding the amount your insurer will cover.

Are there deductibles and coverage limits for wind damage?

If wind damage is covered under your policy a deductible will typically apply. A deductible is the amount you pay out of pocket toward damage or a loss prior to the insurance company paying for a claim. You can find your deductibles outlined in your homeowners insurance policy declaration page. There may be an option to adjust the amount of your deductibles to better fit your needs.

Coverage limits apply to each type of coverage in your policy. If your policy covers wind damage, for example, it will only pay up to the limit you selected when you purchased the policy. As with your deductibles, coverage limits can be adjusted to align with your current needs.

Are there any exclusions with wind damage coverage?

There can be many different exclusions laid out in your policy. A common exclusion arises with determining whether the damage in question was caused by wind. Insurers may argue that damage is excluded because they consider it a result of wear and tear, defect, improper maintenance, or improper repairs as opposed to wind. This is where a public adjuster’s assessment of the damage may help.

How can anti-concurrent causation clauses affect my claim?

Insurance policies often contain something known as anti-concurrent causation clauses. These clauses say when two perils occur simultaneously and the homeowner is only covered for one, the insurer will not cover the damage.

For example, if you file a wind damage claim but your property also sustained water damage your insurer could deny the claim on the grounds that water damage is excluded from your policy. Supplemental coverage can help with avoiding this type of situation. We recommend reviewing your policy to pinpoint any anti-concurrent causation clauses that exist.

Is there a Merlin Law Group wind damage attorney near me?

With offices located nationwide, we have an experienced wind damage insurance claim attorney near you. View our directory of attorneys and practicing states here.

Hail Damage FAQs

What is hail?

Hail is a form of solid precipitation where frozen rain forms into layered pellets and falls in showers from cumulonimbus clouds. The individual balls or irregular lumps of ice are referred to as hailstones. While ice is often associated with colder temperatures, it is possible for hail to form in warmer climates.

We had a hailstorm months ago, but I just realized the severity of the damage—is it too late to make an insurance claim?

Policyholders are obligated to meet certain post-loss conditions in order to file a successful claim. A common condition requires policyholders to provide prompt notice of the loss to their carrier. Your policy language may outline a specific period to file a claim after suffering a loss. You could lose your chance to file if that period elapses. Be sure to read your insurance policy to determine any time constraints related to filing a claim after a loss.

Which part of my property is most vulnerable to hail?

Your roof is most vulnerable to hail damage. If you live in an area where hail damage is more frequent, keep in mind that insurance will likely cost more due to the increased risk and prevalence of damage from hail.

Are there separate deductibles for damage caused by hail?

In regions with a propensity for hail, it is common for insurers to have a separate deductible for hail damage. You can determine this by reviewing the policy language. Hail deductibles are typically a percentage of your property’s dwelling coverage limit. You can set your hail deductible when you obtain the policy. These deductibles can be adjusted at any time by contacting your insurance agent.

How can I mitigate the cost of roof damage?

The best way of avoiding higher costs with damage from hail is to stormproof your roof with impact-resistant shingles. Some insurance companies offer discounts for policyholders that install impact-resistant shingles. Another way to mitigate cost from hail damage is to verify whether your insurance company has any endorsements or additional roof coverage options. For example, a Better Roof Replacement endorsement would pay to replace your damaged roof with stronger materials if it is damaged by a covered peril like hail.

What are the top states for hail?

Verisk, an analytics firm providing data for insurance and financial companies, published a 2019 report that outlines Texas, Illinois, Missouri. Minnesota, Oklahoma, Kansas, Indiana, Virginia, North Carolina, and Colorado as the top 10 states affected by hail damage.

How can I find a hail insurance claim attorney near me?

Merlin Law Group has you covered for hail insurance claims. Explore our many office locations and submit your case review here.

Fire and Smoke Damage FAQs

What to do if your property sustains fire damage?

  1. Document any damages to your property by taking clear photographs. Be sure to document any smoke damage, as this type can often be overlooked.
  2. Consult with an independent adjuster or damage assessment expert to get a second opinion regarding whether you are dealing with a partial or total loss. Partial losses are often delayed, so it is important to determine what your case is in order to properly measure expectations.
  3. Keep track of any receipts or expenses regarding home repairs.

Why might my fire and smoke damage claim be denied?

  • Allegation of arson
  • Valuation differences
  • A violation in terms of the insurance policy conditions
  • Fraudulent accusations/charges

What is smoke damage?

Smoke damage is a strong cause for concern for damage to both your property and personal health. The fine particles that make up smoke can lodge themselves into your skin, eyes, or respiratory system and create several health issues. If you have any pre-existing medical conditions, particularly related to your heart or lungs, you may be more susceptible.

Is smoke damage covered under my policy?

Most often, smoke damage is considered covered peril under a typical insurance policy. However, disputes may arise as to the severity and applicability of that smoke damage regarding your claim.

What disputes may arise regarding smoke damage?

Smoke damage is particularly tricky because it can affect porous materials like fabrics, rugs, curtains, etc. It can also cause discoloration in marble, tile, and other foundational materials. Insurers will often pay for cleaning services, but there can be discrepancies over whether you your items need cleaning versus replacing.

What is the difference between a partial and total loss due to smoke or fire damage?

A partial loss situation arises when the property is not completely destroyed. Partial loss situations tend to carry hidden damages, which can include a variety of things including any inadequate or improper repair or cleaning methods, smoke and/or ash remnants, diminished air quality, or air duct destruction. Another issue with partial loss claims is insurer delay, as most insurers consider these low priority cases.

A total loss is when the property is destroyed. The insurer deems the case a total loss, not the insured. Bear in mind you have the right to hire a public adjuster to assess the damage and determine whether it meets the criteria for a total loss prior to submitting your fire and smoke damage claim. A strong sign of a total loss is considerable structural damage. If any core components of the property are damaged, thus rendering the foundation as hazardous or otherwise, the property may be considered a total loss.

Which areas of a home are most commonly associated with fire and smoke damage?

It is important to perform a thorough inspection of your property after sustaining fire and smoke damage. You do not want to leave any stone unturned regarding identifying damaged areas. Therefore, it is important to have an independent damage assessment in addition to your insurer’s inspection. Some areas to specifically look out for are your roof, any structural steel or iron, stucco, siding or concrete, windows, plumbing and heating systems, and any interior walls/framing.

How do I find a fire damage attorney near me?

Our experienced team of attorneys practice fire and smoke damage insurance claim law nationwide. Submit your case review and view our many office locations here.

Are you looking for help?

Let us help you. Call now: (877) 449-4700

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Why choose Merlin Law Group?

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 22 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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