FORT LAUDERDALE, Florida. Every insurance policy is different in terms of what is covered and what your responsibilities and duties will be. However, most insurance policies include a list of “duties after loss” and conditions that must be met for the policy to be valid. Failure to meet these duties or to meet these conditions can result in denial of coverage and benefits. What are some common duties after loss?
According to the American Bar, two of the most common duties and conditions include requirements for the policy holder to provide notice of loss and to cooperate with adjusters. What do these two clauses mean for you?
- Notice Clauses: In order for your insurance company to investigate damage and pay for your claim, the company must be notified that damage has occurred. Don’t assume that just because Hurricane Irma damaged 99% of the houses in your neighborhood that your insurance company will automatically know that your home was also damaged. You must inform the insurance company that damage occurred in a timely manner. What is a timely manner? Some policies specify time limits, but these time limits must be reasonable. Others have requirements that the carrier be notified before any water or mold mitigation companies begin work and an opportunity to inspect first. Failing to comply with the obligations can give the insurance company a reason not to pay all or a portion of what may otherwise been covered. Additionally, if other factors, such as lost power or a serious storm limited your communication methods for an extended period of time, the insurance company may have to show that your failure to communicate affected the claim and/or you may be able to defend the issue by showing they were not prejudiced. As a general rule, try your best to let your insurance company know about damage as soon as possible. However, if your claim is being denied because you missed a deadline, you may still have rights under the law. Contact Leader & Leader, P.A. Fort Lauderdale, Florida insurance claims lawyers today to learn more about how we may be able to help in this case.
- Cooperation Clauses. Many insurance policies include provisions that require homeowners to cooperate with an adjuster’s investigation into a claim. However, insurers can’t just call any old action “non cooperation.” An insurer would have to prove in court that your actions limited their ability to close the case and settle the claim. This is more than not being home on a workday to open your front door to an inspector. However, if you are facing a denied claim because your insurer is using the “cooperation clause” against you, you may want to speak to Leader & Leader, insurance claims lawyers in Fort Lauderdale, Florida today. Generally, it is a good idea to act reasonably and to cooperate to avoid the carrier for having reasons to deny your claim.
There are other cases where insurers can get out of settling a claim. Some insurers place minimum limits on which claims they’ll settle. It’s called “excess” according to Investopedia. If this provision is in your contract, your claim will have to reach a certain threshold for insurers to pay your claim. If your damage is below the deductible, you may also have to pay your entire repair bill out of pocket.
If you are not sure about which provisions apply to your insurance contract, now might be a good time to read the contract. However, sometimes these contracts can be wordy and contain quite a bit of fine print. If you are not sure what is or isn’t covered, consider speaking to an insurance claims lawyer. Better to check your coverage now, before storm season really picks up. Wait too long and coverage can sometimes take weeks to go into effect.
Leader & Leader, P.A.
633 South Andrews Ave.
Fort Lauderdale, FL33301