 Being a public adjuster, appraiser and umpire for 20 years in South Florida representing policyholders with property damage claims and disputes, I have witnessed a multitude of changes throughout the years on how insurance companies process and handle property damage claims.
Hurricane Season is around the corner, so let’s discuss catastrophic events specifically. During catastrophes, insurance companies are dealing with multiple claims and may be short staffed. I have often heard desk adjusters complain that they have so many claims they are working 7 days a week just to keep up. There have also been times when different desk adjusters have been assigned to the claim. When this happens, the new desk adjuster needs to review the claim before anything further can be done. When you file your claim, the insurance company will assign a desk adjuster who will contact you for details about your claim. Once ascertained, they will assign your claim to a field adjuster to complete an inspection of your property. There are duties within the policy that the insurance company may request you comply with in addition to asking for certain documentation to support your claim. You must comply with these duties and requests to avoid any delays or the possibility of a denial of your claim. Field adjusters are also inundated with multiple claims and inspections. They are supposed to take copious amounts of photos and details of the damage and then prepare a damage estimate to submit to the insurance company. For a less complicated claim, once they submit their estimate to the insurance company, the estimate will be reviewed by the desk adjuster and if no clarification is needed, she/he will request approval so that an “undisputed payment” can be issued. Once an “undisputed payment” gets issued, that buys the insurance company additional time to process any outstanding coverages and payments on your claim. When there are multiple coverages to address such as building, contents, loss of use, business interruption, mold etc., sometimes an expert or vendor will be required to assist. The insurance company may assign an expert who will then have to conduct another inspection. Let’s say the insurance company does not agree with the assessment of the field adjuster or their expert. They may once again assign another expert such as a contractor, engineer, contents specialist, accountant or mold testing company to review the claim. This will require more time and maybe additional inspections. If the insurance company has questions about a report that was submitted from one of their experts, they can request clarification about the report which will require additional time. With all the moving parts to a claim, I can certainly understand how policyholders may feel that their claim is being delayed. If there is a claim dispute and you disagree with the insurance company’s assessment of your damages, depending on the policy wording, there may be dispute resolution options such as appraisal, mediation or arbitration. All of these would require additional time and inspections before your claim may be resolved. Our knowledge and experience make a difference. We are diligent about representing our clients and making sure they comply with all policy requirements, which lead to property claim settlements. If you are unsure if you have a covered insurance claim, or you have a new, underpaid or denied insurance claim, we are here to help. Contact us today.
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Pre-Purchase Inspection Reports – Why They Matter When You Have A Property Damage Insurance Claim5/6/2025  Living in South Florida provides wonderful opportunities for potential property owners. When you locate that perfect property, you should always hire a reputable property inspector to perform a thorough inspection.
Whether it’s for a commercial or residential property, an inspection will show the condition of the property prior to your purchase. If there are any issues found, the inspector will provide repair options in the report and the seller will have the opportunity to make the repairs prior to closing. There are times when the seller is not in the position to complete repairs, and they will provide a credit to the purchaser for an agreed amount so the purchaser can make the repairs. If this is the case, it’s important that the repairs are completed and you maintain all the invoices as proof of repairs. Why is an inspection report important when you have property damage and need to file an insurance claim? When filing an insurance claim, you want to make sure that the damage you are claiming is covered under your insurance policy, but more important, that the damage is not pre-existing. Recently contacted by a property owner who was unsure if the damage they had to the interior of their property or the damage to their roof was covered. After inspecting the damage inside, I got on the roof to finish my inspection. I did see prior repairs, and an area with some damage. In my nearly 20 years as a licensed public adjuster, and a certified appraiser and umpire, I know the difference between new and old damage. To me, the roof damage didn’t appear new. The property owner said they purchased the property approximately two years ago, so I asked if they had a property inspection report. They did and while I was on the roof, I was viewing the report. As I suspected, the roof damage was exactly the same in the inspection report as the damage I was viewing. Here are three important takeaways: 1. Your insurance policy does not cover pre-existing damage 2. Always have a property inspection done when purchasing property 3. Make sure that repairs mentioned in an inspection report are completed Before filing an insurance claim, you should have an experienced and knowledgeable public adjuster inspect the damage and review your policy to see what the policy coverages, or if you should even file a claim. Not all damage is a covered damage. At Reliant Insurance Adjusters, we treat every client’s claim as if it were our own. We always put our client’s interests before our own, but we will never represent a client for an uncovered loss. If you are unsure if you have a covered insurance claim, or you have a new, underpaid or denied insurance claim, we are here to help. Contact us today.  When you need to file a residential or commercial property damage claim, the last thing on your mind is will my insurance company cover all the damage? After all, you pay your insurance premiums, you have coverage and it’s a covered loss. So why wouldn’t they cover the damage?
Our client sustained water damage to her property when her neighbor’s washing machine leaked. There was extensive damage to kitchen cabinets, baseboards, walls. In adjacent rooms, more walls, wallpaper and flooring was also damaged. There was plenty of damage to the lower portions of the wallpaper which was continuous throughout the living areas. During the inspection with the insurance adjuster, we showed her the damaged wallpaper and she said “we only pay for the wallpaper that’s damaged. Not the undamaged parts. There are no coverage restrictions in the policy, so how can they only pay for “what’s damaged” when the wallpaper is more than 15 years old and is no longer available? What about the upper portions of the wallpaper and the continuous wallpaper? After further discussion and explanation, she agreed that it all needed to be replaced. Now the question remains – will the insurance company stand by their adjuster’s report, or decide to restrict the coverage and change the adjuster’s estimate? When an insurance company does this, how can a policyholder feel they can trust their insurance company when they need them most? At Reliant Insurance Adjusters, our knowledge and experience matter. We never give up and work diligently to obtain everything our clients are entitled to receive for their damage. If you have a new, underpaid or denied insurance claim, we are here to help. Contact us today.  Before you file a property damage insurance claim for a commercial or residential property, you need to know what caused the damage and the date the damage occurred.
You then need to find out if the cause of loss is covered under your insurance policy. If you do not, it may result in a denied claim or additional inspections by the insurance company. Just because you see damage, doesn’t mean it is covered. Cause of Loss Our policies cover damage caused by certain losses like fire and smoke, hurricanes, and water damage, just to name a few. Some policies contain limits or exclusions within the policy for specific losses, or time limits for a leak that goes on for an extended period, rather happening suddenly or accidentally. If you do not know the cause of the loss, or the damage appears to have been going on for some time, the insurance company may send an expert to provide the causation and approximate timeline of when the damage occurred. Experts If your roof leaks and causes damage to the interior of the property, the insurance company may send an engineer to inspect the roof to determine what caused the damage and if there is damage to your roof. Some policies require there to be a wind created opening to the roof or building that allows water to enter for any interior damage to be covered. These are some nuances within a policy that can either limit or exclude coverage. Make sure you understand your coverage, and you know what is causing the damage before you file a claim. Insurance Coverage You need to know and understand your insurance policy and the coverage it provides. We receive many calls when a claim gets denied because the property owner had no idea what caused the damage or if the damage was covered. When you see damage to your property, ask the following: What caused the damage? Is the damage covered? Are there coverage limits in the policy? Are there specific exclusions in the policy? What is your deductible? How much damage do you have? Is it worth filing a claim or repairing the damage? Simply put, there are many factors that go into an insurance claim, and you shouldn’t file a claim without knowing your insurance policy or the coverage it provides. If you have a new or underpaid insurance claim, or you are unsure if you are covered, we are here to help. Contact us today for a free consultation.  When I receive a call from a policyholder who needs help with their property damage insurance claim, it frustrates me when I have to tell them they have limited coverage, that they have no coverage, or they have a high deductible.
To hear their surprise is astonishing to me. Policyholders really don’t know the coverage in their policies, or should I say the lack of coverage. Haven’t their agents discussed the policy with them? How can they be so unaware? As a follow-up to my past blogs about the Erosion of Coverage, I am frustrated that the Office of Insurance Regulation continues to allow insurance companies to make policy changes that are not beneficial to property owners, and more detrimental when they have to file an insurance claim. This Can Happen To You A recent call led me to write about this again. An elderly couple’s daughter asked me for help with her parent’s hurricane claim in Delray Beach, Florida. They had roof damage as well as a few rooms of interior damage resulting from the roof leaking. She could not understand how the insurance company’s first estimate included the full roof replacement, then in subsequent emails, the estimates changed, and they paid very little on her parent’s claim. In addition to an almost $20,000 deductible, the policy contained an endorsement for Matching of Undamaged Property, and it was limited to 1% of the Coverage A policy limit. The roof is damaged on a few slopes. At first the adjuster wrote to pay the entire roof replacement. In the subsequent “Estimate Change Forms” and “revised estimates” from the insurance company, they put the “undamaged” roof items, dumpster fees, and gutters under the “1% Matching of Undamaged Property” endorsement. The insurance company paid two separate checks. One check was for repairs to the damaged portions of the roof. A second check for about $3,700.00 was for the $67,000 worth of “undamaged” line items they listed in a separate section of the estimate under the 1% matching endorsement. Know Your Policy Coverage Most property owners do not have $67,000 sitting around to pay for property damage, especially when they pay insurance on their property and expect to be covered in the event they have a claim, especially a catastrophic claim. You need to know your policy and the coverage it provides before you have a property damage claim. Coverage Limits Between $10,000 water damage limits, roof depreciation schedules, 1% matching of undamaged property, and high deductibles, policyholders can be left with high out of pocket costs for repairs. Meanwhile insurance premiums have not decreased but continue to increase. Shop Coverage Not Price Due to the high cost of insurance, many people are trying to cut their costs and have more affordable insurance. Unfortunately, you may have less coverage if you do that. Depending on the age of the home or some of its components, you may have no choice and have limits placed on the policy. There still are insurance companies writing coverage, so I suggest you review your policy and see if you have any policy limitations. If you do, contact your agent and see if they can place you in a policy without limits, or if you can increase the limit. If you have any questions, a new or underpaid claim you need help with, we are here to help. Contact us today for a free consultation. We treat every client’s claim as if it were our own.  When your property is damaged, you believe you are protected and covered by your insurance policy. All you want is to restore your property as it was before and do it as quickly as possible.
Through the years, we have witnessed insurance companies implementing changes and limiting or excluding not only needed coverages, but also your options when it comes to resolving a claim dispute. Importance Of Documenting Damage A Public Adjuster plays an important role in your property damage claim. They represent and advocate for you as the policyholder, just like an independent or company adjuster represents the insurance company.An experienced public adjuster will work to properly assess and document your property damage, take detailed photographs, and prepare a detailed cost estimate to repair or replace the damaged property. They will attend all inspections and prepare the necessary forms for submission on your behalf. Claim Dispute Resolution Options Often when the insurance company issues an “undisputed claim payment”, there may still be unresolved damages not accounted for by the insurance company, or they simply refuse to properly settle your claim. Appraisal Throughout the years, there have been many changes to coverages, but also to your options when there is a claim dispute. The appraisal process has always been a professional means to resolve claim disputes and either party could demand appraisal. A policyholder would appoint their appraiser, the carrier would appoint their appraiser, and both appraisers would agree on a mutual umpire and the process would move forward. Once resolved, the signed appraisal award would be a binding settlement. Insurance companies have changed the appraisal language in their policies and many now must agree to participate in the appraisal process. Some carriers are including specific language which limits the process, making it almost impossible for the policyholder to comply. Mediation Mediation can also be a means of resolving a disputed claim, but it is not binding unless an agreement can be reached and settled between both parties. For this reason and because of the changes to the appraisal language, it seems as though the insurance companies are leaving the policyholder no choice but to litigate. Litigation Or Repair Your Property Before legislative changes were made to remove one way attorney’s fees, litigation was an option for policyholders if their claim could not be resolved, and the insurance company would be responsible to pay the policyholder’s attorney’s fees during a claim dispute. This became a costly expense for insurance companies. Now it is the responsibility of policyholders who must now incur their own litigation costs. Coming out of pocket for litigation costs is a costly option for any policyholder, especially when you need to repair your property. Depending on the unresolved amount of your claim, and the costs it would take to litigate your claim, it may not make sense to litigate but just to repair your property. Our skilled professionals have outstanding customer service and treat every client’s claim as if it were our own. We are by your side every step of the way. You don’t need to navigate the claim process alone. Reliant is here to help. Contact us today for a free consultation.  Whether you own a commercial or residential property in West Palm Beach, Florida, you will need to have insurance to cover your property in the you sustain property damage.
Understanding your policy and the coverage it provides is critical when it comes to filing a property damage insurance claim. What is Depreciation? Although your policy may provide for replacement cost coverage (RCV) when you have property damage, your insurance company can deduct depreciation before they apply a deductible when issuing payment for the claim. This is considered an Actual Cash Value (ACV) payment. Depreciation is usually based on the age of the damaged items and their expected life span. Items like drywall, paint, and cabinets for example. When the depreciation is withheld from the claim payment, the insurance company will provide instructions on how to recover that amount. Recoverable Depreciation In most cases, the depreciation will need to be incurred for the insurance company to release the withheld amount. Insurance companies vary when it comes to what they request for proof of repairs to release the withheld amount. Some may only require that the repairs be completed and that you provide photos showing proof that repairs were done. More often than not, you will probably be required to provide more extensive documentation that not only shows proof that the repairs were completed, but also proof that the repairs were completed for the amount the insurance company estimated, before the deduction of the depreciation and applied deductible. Non-Recoverable Depreciation Some policies are issued with non-recoverable depreciation which means that the depreciation that is deducted cannot be recovered or released. We have seen property owners choose to have this kind of policy to help lower their insurance premiums. This sometimes comes in the way of ACV coverage for their personal property. As I wrote in a prior blog, there can also be endorsements or limits within the policy that would place ACV coverage on the building, such as a roof deprecation schedule, that limits the recovery based on the age of the roof. If you have a new, underpaid or denied insurance claim, we provide free claim reviews and may be able to help. Contact us today.  You may need professional help with your insurance claim for many reasons. The three most common reasons are claim delay, underpayment of a claim, or no response from the insurance company.
Additionally, property damage claims can be difficult for a policyholder to navigate. There are different policy coverages, limitations, and sometimes exclusions within the policy you may be unaware of. In some commercial insurance policies, there may be a separate deductible for each coverage limit. There are also instances when the deductible is higher than the damage, and it may not be beneficial to file a claim. Claim Delays The insurance company has sixty (60) days from the date they receive your claim to provide you with a coverage decision and either pay or deny the claim. There are circumstances when further investigation of a claim is requested by the insurance company. When the claim is filed but the source of the damage is unknown, they can request an additional inspection by their expert to determine the cause of the loss. This does not mean that you will be covered for the damage. If you do not know whether you are covered or what has caused the damage, you should hire an experienced and licensed public adjuster to see if you have a covered claim. Underpayment Of Insurance Claim We receive many calls from policyholders, largely in part because they have not received enough money for their damage and cannot repair the property. This can happen after a catastrophic event when insurance company resources are limited, and claim payments are being made without further investigation. Also, there may be additional coverages, such as Personal Property or Additional Living Expenses that have not been addressed. Lack of Communication Per Florida Statute 627.70131, an insurance company is required to respond to your claim inquiry within seven (7) days. This includes emails, phone calls, and/or letters. If you have not received any communication from your insurance company, you have the right to file a complaint with the Department of Financial Services at the below link: https://apps.fldfs.com/ESERVICE/Default.aspx If you are unsure if your damage is a covered claim, or what the cause of damage is, you should hire a licensed public adjuster. An experienced and knowledgeable public adjuster will have the resources and tools to determine if you have a covered claim. If you have any questions about coverage or a new or underpaid claim, Reliant Insurance Adjusters have the knowledge and experience you need. Call us at (561) 288-6434 or contact us here.  I had an interesting communication with a friend the other day when she received her insurance policy renewal packet … specifically the endorsements page list.
A residential insurance policy should include the policy jacket, declarations page, checklist of coverage and forms and endorsements to the policy. The endorsements are critical, and there are some who do not realize that these endorsements change the coverage that is listed within the body of the insurance policy. It is important to understand them and know what is covered, limited and excluded. After reviewing her listed endorsements, some of which were standard, I noticed she had a roof coverage endorsement and a matching endorsement. Roof Coverage Endorsement The roof coverage endorsement limits coverage for their roof based on the condition of their roof at the time of the loss and whether a hurricane or named stormed damages the roof. Due to the exclusions within the endorsement, there is very little roof coverage and leaves it wide open for the insurance company to exclude the roof and not provide coverage. Roof Depreciation Schedule Depending on the insurance company, there may be a Roof Depreciation Schedule that lists the type of roof, age of roof, and the amount of depreciation that will be deducted due to these factors. The depreciation is not recoverable. If you sustain roof damage and your roof needs replacement, the insurance company will arrive at a replacement cost figure for the roof replacement. They will then deduct the depreciation based upon the roof type and age, then deduct your deductible. For example, if your roof is 23 years old, there will not be much coverage if it were damaged, and you would be out of pocket for a large sum of money to replace the roof. Matching Endorsement The matching endorsement is a relatively new endorsement included in insurance policies within the last few years. More and more insurance companies are utilizing it in their policies. What this means if you have this endorsement … Let’s say you file an insurance claim for property damage from a plumbing leak and it damages the floor in your living room. The floor is not repairable and needs to be replaced. This same flooring runs continuously from room to room throughout your property, but those other rooms are not affected by the loss and were not damaged by the loss. This endorsement will limit the payment to 1% in the undamaged rooms of your property. Request Your Policy You should always have a full and complete copy of your insurance policy. Never discard it. If you are insured with the same insurance company for a few years, you will more than likely only receive a renewal packet before the policy term expires, not the full policy. I cannot say this enough … do not discard your original policy because the renewal is only a few pages in comparison to the full policy and does not contain all the policy language, forms and endorsements. Our team at Reliant has the knowledge and experience to understand insurance policies. If you have a new, underpaid, or denied insurance claim, we can help. Contact us today and let us do the hard work for you.  Whether you own a commercial or residential property in Naples, Florida, or anywhere in the state, you should have a complete copy of your insurance policy.
Understanding coverage is critical when it comes to filing a property damage insurance claim. I cannot tell you how many times we request a copy of the policy from a client, and they only send the declarations page. Why You Need The Full Policy Although the declarations page of an insurance policy will sometimes list forms and endorsements that are within the policy, it does not provide the full language written within your policy explaining the coverages, exclusions, and the wording in those specific forms and endorsements. What many do not realize is that the forms and endorsements can change your coverage. So, the policy language may read one way in the body of the policy, but the forms and endorsements change the actual coverage and supersede the policy's language. Understanding Your Policy & Coverage We just met with a gentleman who had water damage to multiple rooms of his home, which was the result of his roof leaking. Upon review of his policy, there was specific language in his policy that was a condition for coverage. He was convinced that no matter what, his claim should be covered and felt the insurance company was obligated to pay his claim after all the years he paid insurance premiums. In the land of make-believe, it would make sense, and coverage would be afforded just because he paid his premiums. However, in the real world, that’s not how insurance coverage works. Having inspected his roof, I could clearly see where coverage would be afforded, and I explained how and why the insurance company should cover the claim. Request Your Policy You should always have a complete copy of your insurance policy. If you are insured with the same insurance company, you will receive a renewal before the policy term expires. Never discard the original policy because the renewal is only a few pages in comparison to the full policy. Our team has the knowledge and experience to understand complicated insurance policies. If you have a new, underpaid, or denied insurance claim, we can help. Contact us today. |
