In the News
The team at Merlin Law Group are out in the community helping victims of natural disaster navigate a complex industry
Chip Merlin the “Master of Disaster” shares the top things you must do post-hurricane
Will your insurance rates go up and should you file a claim?
Tips for hurricane preparedness – document your property ahead of a storm
Chip Merlin provides advice on Fox News ahead of Hurricane Irma making landfall
Featured on Fox Business, Chip Merlin makes the case for obtaining Flood Insurance coverage to protect yourself from disaster
- What to Do After a Storm
- Hurricane Insurance 101
- Overview of FEMA
- Bad Faith and Other Insurance Obstacles
What To Do After a Storm
Tip 1: File a Claim With Your Insurance Carrier
What you should do right now is file a claim with your insurance carrier. The sooner the insurance company can start the process, the better. Ensure that you document the damage as thoroughly as you can with photographs or video to show how extensive the damage is. The old saying “A photograph is worth a 1000 words” rings true in this case.
Once you file the claim, document all correspondence, provide honest answers to the insurance carrier when asked, write down the names of the people you speak with and the dates when you spoke with them.
Tip 2: Consider a Second Opinion
Most likely, an insurance carrier will send someone to your property to understand and evaluate the damage first hand. They may also bring in experts to review the damage and assist with the evaluation and estimates of loss. If you don’t agree with these estimates, look for a licensed professional to help you. A good resource might be a public adjuster.
Tip 3: Don’t Discard Damaged Items
Throughout the process, make sure you don’t discard any damaged items. The more proof you have, the better your position will be. It’s also critical that you don’t prematurely begin repairs to your property or make even temporary repairs. If you have to make temporary repairs, take pre-repair photographs, keep your receipts, and the information of the company or person that’s repairing the damage.
You might feel overwhelmed during this part of the process which is natural. But due diligence and dedication to this process will ensure you have the proper legal recourse should your claim eventually be denied. If it is denied, delayed, or underpaid, Merlin Law Group is here to help.
Hurricane Insurance 101
Policyholders are often faced with complicated issues and complex decisions after a hurricane. The claim information that is presented can be crucial and the strategy used can be paramount in your settlement.
Here are some frequently asked questions posed by policyholders involved in the hurricane insurance claims process.
I have a loss. Where do I start?
Get the insurance policy. It may be multiple policies such as flood, wind and all-risk peril policies. But the insurance policy provides the framework for determining how much is going to be paid, by whom, and what you need to do to get paid.
After I report the loss, what else should I do while waiting for an adjuster?
Protect the property from further damage. You have an obligation to take reasonable steps to minimize, or mitigate, the loss after it happens. Most policies will reimburse you for those costs. For example, getting a tarp on a roof following a hurricane to protect the structure and contents from further damage is a type of mitigation.
What if my agent is slow to respond?
After major hurricanes, agents are deluged with requests for policies. It is important to get the name of your insurance company, the policy number, the limits of coverage, and call your insurance company asking for an adjuster to come out as soon as possible.
What are insurance policy Declarations Pages?
These are the unique portions of the policy that indicate the name of the insurance company that insures you, the insurance policy number issued, how much you are insured for, the deductibles chosen, and what standard forms are issued, including the endorsement forms. The Declaration Page is very important and you must at least get this even if the rest of the policy is provided later.
How do I find out how much coverage I have?
The Declaration Page lists the basic policy limits for each coverage and the basic deductible -But do not stop there. Additional coverages and extensions within the policy may also exist. For example, many people purchase “Guaranteed Replacement Coverage.” This extension of additional coverage is usually found in the policy forms, or as an endorsement. You must read the policy to find out the various additional coverages you have. These are quite valuable and are often overlooked.
What is a Proof of Loss?
Virtually every standard insurance policy has mention of providing a Proof of Loss. It is the formal submission of your claimed amount. We suggest you obtain from your insurance company the form it wants you to use. Once a Proof of Loss is submitted, the insurance company usually must respond to it within 30 days. Many times insurance companies do not require a Proof of Loss to be submitted. Ask the adjuster if they will pay without submitting a Proof of Loss. Flood Insurance ALWAYS requires a Proof of Loss completely and timely filled out even if the adjuster says otherwise.
How does a hurricane deductible work?
The typical policy today contains a deductible as a percentage of the policy limit. This hurricane deductible kicks in when your property is damaged by a “named” storm. The question has arisen whether an insurance company can rely on multiple hurricane deductibles in a season where an insured has sustained damage from multiple storms. Unfortunately most polices are silent on this question.
What does the adjuster do, and how does my insurer decide if my claim is covered?
Other than payment, the insurance policy is silent about what the insurance company adjuster is supposed to do. Statutes, regulations and industry standards require the adjuster to promptly and fully determine the coverages applicable, evaluate the amount of the loss and pay the claims. The adjuster is supposed to fully advise the policy holder of all policy conditions and available benefits. The adjuster is supposed to treat the policyholder in the utmost of “good faith” and make sure the policyholder is provided good claims service after the loss occurs.
What is the difference between a public adjuster, a company adjuster and an independent adjuster?
A company adjuster is employed by your insurance company. An independent adjuster works for a company separate from the insurance company, but is hired by an insurance company to act as its adjuster. There is very little legal distinction between the two as it affects a policyholder. However, the practical effect is that an independent adjuster usually has to send reports to the insurer, and there is often more claim delay. Public adjusters only represent policyholders. They should do the same things company and independent adjusters do, but they do it for the policyholder.
My insurer is requesting an Examination Under Oath (“EUO”). Must I agree to give one?
Yes -Your insurance policy contains certain conditions you must comply with in order to receive payment for your claim. One of these conditions is the requirement to appear for an EUO, which is a sworn statement taken by a court reporter. At this EUO, your insurer will ask you questions about your claim, and may ask you to bring any documentation supporting that claim. You are entitled to bring an attorney to represent you at your EUO. This is a serious proceeding not commonly invoked.
How do I know if I’ve suffered a total loss to my property, entitling me to receive policy limits from my insurer?
If your damages exceed 50% of the appraised value, pursuant to your county’s property appraiser’s office, you may be entitled to receive the policy limits for that insured property, and potentially additional monies for building ordinance or law coverages. If your structure is demolished, you normally have a “total loss” even if it can be rebuilt for less than the policy limits.
Can my insurance company withhold insurance monies from me because I have not agreed to settle out the entire insurance claim?
No. 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.
May an insurance company deny my insurance claim without any investigation?
No. An insurance company may not deny an insured’s claim without conducting a complete and reasonable investigation based upon available information.
If my insurance company denies my insurance claim, what must it provide me when denying my insurance claim?
An insurance company must promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise.
What does Actual Cash Value (ACV) mean?
Many policies indicate that ACV is the amount of monies necessary to repair or replace the damaged or destroyed insured property less an amount for depreciation. There is no exact measure to determine this figure and Florida allows for various measures to help determine “Actual Cash Value.”
What does Replacement Cost Value (RCV) mean?
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.
What is an Appraisal?
Most insurance polices contain an appraisal condition to resolve disputes regarding the amount of loss between the insured and insurance company. Generally, an appraisal condition provides for the insured and insurer to each to select an appraiser, and for those two to select a third person called an umpire with agreement by any two of the three being binding. Insurance companies should pay the undisputed amounts and only appraise the disputed amounts. Either party may demand appraisal.
Overview of FEMA
The Federal Emergency Management Agency (“FEMA”) coordinates the federal government’s role in preparing for, preventing, reducing the effects of, responding to, and recovering from disasters, whether natural or man-made, including acts of terror.
How does FEMA help?
- Temporary housing
FEMA can assist you with at least one month’s rent at a new place and help provide financial assistance to make home repairs.FEMA can provide money to replace personal belongings that were damaged or destroyed during the disaster, such as vehicles, furniture, appliances, and other important personal property.
- Medical support
If you have medical or dental expenses, funeral expenses, transportation expenses, and other serious needs caused by Hurricane Harvey. They will not be covered unless they were caused by the storm.
- Money before claim payment
FEMA can also help you while you are waiting for insurance money to be paid out. You may need to give FEMA a copy of your insurance policy but keep in mind, they will not pay for your insurance deductible. You will also need to pay FEMA back after you receive your insurance money for the losses covered by your insurance.
How do I apply for FEMA aid?
Online Registration: The quickest way to register for FEMA assistance is by applying online at www.DisasterAssistance.gov.
Phone: There is also a FEMA app which can be accessed from your mobile device. If you’d prefer to call FEMA for aid, you can contact FEMA toll-free at 1-800-621-3362/TTY or 1-800-462-7585 to apply during standard hours of operation (7 a.m. to 11 p.m.), 7 days a week.
When contacting FEMA they will require your social security number, contact information, types of insurance held, a description of the loss, your annual household income, and banking information if you have one.
Bad Faith and Other Insurance Obstacles
We assist policyholder’s right to recover up to the policy limits, in addition to attorneys’ fees and punitive damages. We also ensure that insurance companies emphasize fair, prompt, and honest conduct, or pay for the damages they cause. But what is insurance bad faith? Here’s an explanation:
- Refusal to investigate claims thoroughly, properly, and in a timely manner
- Unreasonable delay in payment / slow payment, or stall tactics
- Refusal to pay the full value of a claim
- Unreasonable claim denials
- Unreasonable interpretation of policy language
Unfortunately, insurance claim adjusters often find their hands tied — limited by restrictive claims processing guidelines designed to cut costs and increase profits for the insurance company. Insurers may use various tactics to avoid prompt or full payment, or to justify a denied claim may engage in bad faith claim practices.
If you think bad faith may be a factor in the handling of your Hurricane Irma claim, then contact our experienced staff at Merlin Law Group.