Property losses like water damage can be particularly stressful and complex for homeowners. Amid the chaos, there's a labyrinth of insurance jargon combined with time-sensitive responsibilities such as making prompt temporary repairs, retaining receipts, ensuring the property is dried out by a trusted company, and properly filing a claim without delay.
During these testing times, having an expert public adjuster on your side, such as Maria E Shalack from A&H, can provide invaluable peace of mind. Knowing a professional is dedicated to securing the best possible financial outcome for you can be a weight off your shoulders.
Water Damage Vs. Flood Damage
As a homeowner in Florida, understanding the distinction between water damage and flood damage is essential. Though both may seem alike, your homeowner's insurance policy treats them differently.
When it comes to homeowner insurance, understanding the difference between water damage and flood damage and the associated claims process is critical. Misunderstanding these distinctions can leave homeowners vulnerable to unexpected expenses.
On the other hand, flood damage arises from an overflow of natural water sources, inundating land that's usually dry. This could be due to heavy rainfalls, hurricane or storm surge, lake or river overflow, etc. You would typically require a separate flood insurance policy to cover flood damage.
Often covered by homeowners' policies.
Caused by factors like plumbing leaks, sudden water or steam discharge from appliances or sprinklers, and roof leaks causing water damage to the ceiling or walls.
Examples include:
Leaking washing machine damaging the laundry room.
Water heater explosions resulted in steam and water spread.
Not covered by typical homeowners’ policies:
Water coming from the ground, like from heavy rainfall.
Flooding from overflowing bodies of water.
Flood Damage:
Defined as the submersion of usually dry land by overflowing water.
Requires a separate insurance policy.
Evaluated separately from water damage by insurance companies.
Water Damage Claim Communication & Investigation
Acknowledgment and Response:
Insurance companies are required to acknowledge any communication about a claim within 7 calendar days.
The acknowledgment timeline has been shortened from 14 to 7 days, effective March 1, 2023.
Investigation:
Insurance companies must start investigating a claim within 7 days of receiving proof-of-loss statements.
Physical inspection of the property by the assigned adjuster must occur within 30 days.
A detailed loss estimate should be shared with the policyholder within 7 days of generation.
Modifications in Timelines for Claims
Several statutes in Florida have been amended to change timelines related to insurance claims:
Time for Insurer Action:
Insurers need to review claim communications within 7 days.
Insurers must start necessary investigations within 7 days of receiving proof-of-loss statements.
A copy of a detailed loss estimate must be sent to the policyholder within 7 days of its creation.
Payment Timeline:
Insurers have 60 days to pay or deny claims after notification.
The time for surplus line carriers to make payments has been reduced from 90 to 60 days.
Claim Reporting Deadlines:
The timeline for reporting new or reopened supplemental claims varies depending on the policy starting date. For instance, for policies starting after Dec. 16, 2022, the reporting time is one year for all perils.
Claim Definitions
Reopened Claim: This refers to a claim the insurer previously denied or paid but is reopened due to the insured's request for further compensation for damages or losses they had initially reported.
Supplemental Claim: A claim seeking additional compensation for damages from an already adjusted peril or for expenses incurred while carrying out repairs under an active claim that the insurer was timely informed about.
Statute of Limitations: Remains unchanged at 5 years from the date of loss.
Is There a Time Limit on Insurance Claims?
There is typically a time limit on insurance claims, which is known as the "statute of limitations." This time limit dictates how long a policyholder has to file a claim or file a lawsuit after an incident occurs. The exact timeframe can vary based on the type of insurance, nature of the claim, jurisdiction, and insurance policy.
It's essential to be aware of these deadlines because if you try to file a claim after the statute of limitations has expired, the insurance company has the right to deny your claim. Always check your policy and consult with your insurance agent or a legal professional to understand the relevant time limits for your claims.
New Prompt Pay Laws (Effective March 1, 2023)
Claim payment time has been reduced from 90 to 60 days.
Payment can be delayed due to factors like pending mediation or failure to provide necessary information.
Electronic methods may be used for loss investigations.
It's essential for homeowners to be aware of the differences between water and flood damage and to understand the newly amended timelines and processes for insurance claims. This knowledge will ensure a smoother claims process and safeguard against potential financial pitfalls.
Navigating the Claim Process: Know Your Rights and Responsibilities
Florida has specific statutes that dictate how insurers must handle claims. Here's what homeowners need to know:
Immediate Response: According to Florida Statute 627.71031, insurers must acknowledge any communication concerning a claim within seven calendar days unless there are uncontrollable factors preventing them. The response can be written, verbal, or any other form.
Quick Investigation: Insurance companies must begin investigations within seven days of receiving proof of loss statements unless there are uncontrollable factors. If the investigation requires a property inspection, the adjuster must conduct it within 30 days.
Estimate Sharing: After an insurer's adjuster generates a detailed loss estimate (estimate of the damages), the company must share it with the policyholder within seven days.
Prompt Payment or Denial: Insurance companies have 60 days to either pay or deny a claim from the day they receive notice of it. However, exceptions apply when there are factors beyond the insurer's control.
Right to Information: As part of the Homeowner Bill of Rights, you have the right to get a copy of the loss estimate within seven days after its creation and receive a full claim settlement or denial within 60 days.
Interest on Late Payment: If your insurance doesn't settle or deny your claim within 60 days, they owe interest from the day your claim was filed.
Water Damage Claim Denied
Navigating the intricacies of water damage claims requires keen attention to time-sensitive deadlines. Failure to adhere to these specific timelines can lead to complications in the claims process, often culminating in a Water Damage Claim Denied. Homeowners should promptly take all required steps to avoid unforeseen financial pitfalls associated with denied claims.
Why You Need a Public Adjuster in Florida
Navigating the intricacies of water damage claims can be overwhelming. A public adjuster in Florida can help you:
Understand your homeowner's insurance policy.
Aid in swift reporting of claims within the set timelines.
Ensure your rights are upheld during the claim process.
Maximize your claim payout.
Avoid getting a home insurance claim denied
Don't let water damage disrupt your peace of mind. Contact a Florida public adjuster today to ensure your interests are well-represented and protected.