If your hurricane-insurance claim has been denied or delayed—or if you’ve been offered less money than you need to repair the damages to your home and property, read more.
Trying to appeal the denial or underpayment of an insurance claim for hurricane damage all by yourself—without the help of a hurricane attorney who is proficient in hurricane insurance claims—substantially raises the chances that you’re going to wind up with less compensation than you deserve.
Keep in mind that no matter how warm-and-friendly the insurance company’s “claims adjuster” might sound, she is not on your side. And there’s another thing going on. It’s something that psychologists call “projection.”
Projection is the tendency to think that others will act and feel the same way you do. You think to yourself, “I would never try to fake someone out of something that’s rightfully his, especially after he’s had a disaster.” And so you “project” that the warm-and-friendly claims adjuster wouldn’t either.
If that sounds like a bad assumption, you’re absolutely right.
And speaking of psychology, if your house is presently in pieces, you might be feeling that you should just “move on” and take what the insurance company offers. That’s another reason that you shouldn’t try to go it alone.
Remember: You’re not asking for charity. You paid to be fully insured. You deserve to be adequately compensated.
What hurricane damage does a homeowner policy cover?
Before arguing with a claims adjuster, you need to read up on exactly what your insurance policy is supposed to cover: info that’s listed in the paperwork you received after you purchased the policy.
Also, check out those glossy brochures or sales materials that you were given when you bought the policy; these might include language that shows the company promised more benefits than they’re now offering.
Often enough, where one adjuster might deny coverage for a certain kind of damage, a different adjuster from the same company might allow it. (And after a hurricane, you might be dealing with more than one adjuster.)
This can happen because there’s a lot of vague wording and legalese in insurance contracts, and many adjusters—no surprise—read their policies with a bias that’s excessively favorable to their employer (and against you).
Familiarizing (or refamiliarizing) yourself with your insurance policy allows you to jump on any inconsistencies put forward by a claims adjuster—before the process gets any farther down the road to cause you more time and grief.
What are the most common complaints about insurance reimbursement?
In a word: delays. Delays (1) because the adjusters are overwhelmed with work after a hurricane and can’t get to you. Delays (2) because of “rotating adjusters,” one who might give a different assessment from the other. And delays (1 + 2) because you consequently have missing and/or conflicting information about what’s covered and what’s not (source).
Other complaints are lowball repair estimates and settlement offers, which together add insult to injury, especially if this is an insurance company that you’ve been trusting for lots of years, all the while paying their escalating premiums on time and without complaint.
In fact, there’s a name for all this. Victims refer to it as “the second nightmare” after a destructive hurricane. And it adds to the psychological trauma that can make you want to “just settle and get it over with.”
How does “bad faith” result in an insurance claim being denied?
“Bad faith” is an attempt on the part of an insurance company to renege on its promises, either by refusing to pay your legitimate claim or by prolonging the process to wear you down, especially when you’re psychologically weakened in the aftermath of a natural disaster (source).
Insurance companies might also be acting in bad faith if they misrepresent contract language to avoid paying a claim if they fail to disclose policy limitations and exclusions before you purchase the policy, or if they make unreasonable demands for a proof-of-loss.
How does “depreciation” affect insurance claims?
Depreciation refers to the fact that possessions decrease in value over time. So a refrigerator that’s brand new is worth more than one that’s ten years old. But depreciation is subjective. Different claim adjusters make different decisions about how much and which items to depreciate. So you’re left to argue for fair and reasonable numbers.
Also, if you have an RCV (replacement cost value) policy and not an ACV one (actual cash value), then the insurance company must reimburse the difference between what they paid you for the item’s actual cash value versus what it actually cost you to get a new one—if you have the receipts to prove it.
Why are hurricane-damage claims denied?
Here are some of the things you might get told:
1. What damage isn’t covered by a homeowner policy?
2. What is “credible evidence” of damage?
3. What if my insurance company wants to underpay me for damages?
4. What are insurance-company pricing guidelines?
5. What are insurance coverage limits?
6. Are damage exclusions enforceable?
1. What damage isn’t covered by a homeowner policy?
“You’re not covered” is the most frequent and notorious excuse for a hurricane insurance claim being denied. But don’t just accept this. Consider the frequent case of floodwaters (aka “flood insurance”).
“Floodwaters” are those that rise from the bottom up, like from the overflow of a pond or lake, or from a storm surge. And sure enough, most homeowner insurance policies don’t cover floodwater damage, which typically requires a separate policy.
But such damage that comes from wind-driven rain is covered by homeowner insurance, as are waters that enter your home through storm openings in the roof, windows, doors, or storm-caused holes in the walls (although your deductible might be higher than for other insured causes of damage).
So you need to make sure that you and the claims adjuster are talking about the same thing.(And then there’s your car. If in addition to “liability” you have “comprehensive insurance” against physical damage to your car not caused by an accident, then flooding is covered, no matter where the water comes from.)
2. What is “credible evidence” of damage?
You might be asked if you have credible evidence of the damage.
Of course, be sure to hold on to any paperwork that will help you prove the loss (e.g. receipts, estimates, local news articles, etc.). And you’ll possibly be told that you need before-and-after photos of what’s happened
“After-photos” should show the damage from various angles. Make sure you take snapshots of damage before you make temporary repairs, which insurers usually want you to do ASAP to prevent further damage. (E.g. putting up tarps or nailing plywood over shattered windows).
“Before-photos,” on the other hand, can be a bogus issue that only complicates your life when you’re already stressed, making you want to “settle” and be done with it. However, bogus issues tend to disappear when you hire an insurance-claim attorney—someone who’s on your side.
3. What if my insurance company wants to underpay me for damages?
Remember that insurance company claims adjusters don’t make money for their company when they pay you what you’re entitled to. Therefore, they may typically underpay you. If you forget that, then you’re leaving money on the table (assuming the table isn’t in pieces, blown out the window, and strewn across your front lawn.)
If you disagree with the estimate of your property’s worth and losses, most insurance companies will allow you to ask for a second opinion.
You can also appeal directly to your insurance company, asking them to re-examine the claim. But you need to do so within the timeframe of appeals and provide descriptions of all the facts and documents you’ve collected to support your argument.
4. What are insurance-company pricing guidelines?
Insurance companies adhere to “pricing guidelines,” which are estimates of what it will cost to repair or replace your property after a disaster—as if you’re the only one experiencing that disaster. But given the laws of supply and demand, the cost of labor and materials skyrockets in the aftermath of a hurricane that takes out a whole neighborhood, town, or city.
Up to your policy limits, you should expect your insurance company to compensate you for the actual cost of your insured damages, not just what was predicted before the disaster ever happened.
For example, if the company providing your hurricane insurance is pricing a new roof at $250 per square foot, but the market price is $350, keep your receipts and demand the difference, including whatever the insurance company “held back” due to ACV rules.
Also, remember that it’s not fair (and could be considered bad faith) for the insurance company to effectively “drag their feet” in the hope that prices will stabilize—and they can get off more cheaply.
5. What are insurance coverage limits?
We hope you’re reading this blog as an ounce of prevention, and not in the aftermath of a hurricane. In either case, when insuring your home, it’s important to purchase a level of coverage that’s adequate to completely replace your house and restore your property.
Remember, insurance companies can only pay the amount specified in your policy. The difference between that and the actual cost of replacement & repair is totally up to you.
6. Are damage exclusions enforceable?
Absolutely, if you knowingly purchased a homeowner policy that has an exclusion for “high wind” or “hurricane” damage. But if you live near a coast and the insurance agent hid this in small print and didn’t tell you about it, there’s a decent chance that it’s an “unenforceable exclusion.”
How is a hurricane insurance claim denied by an anti-concurrent causation clause?
Insurance companies typically try to limit their payouts after a natural disaster, and their chief weapon against you is something called an anti-concurrent causation clause, which is common to homeowner policies, albeit buried in the fine print.
This clause stipulates that your insurance company will not pay for a covered event that happens at the same time as a noncovered one. For example, they won’t pay for wind damage (which is covered) if it occurs at the same time as one that isn’t covered (e.g. floodwaters).
There are ways to negotiate or disprove your qualification for the exclusion clause. And exclusion clauses are illegal in some states. So it’s crucial that you deal with your insurance company as cautiously and strategically as possible.
What can you do about denied hurricane insurance claims?
If you’ve filed a claim for damages that have been denied, simply ringing up your insurance company and trying to change their mind puts you in a poor negotiating position. Remember, a big part of the job for claim adjusters is saving money for their company, and they’re typically an expert at getting you to say things that will diminish the credibility of your claim.
At Galindo Law, we have experienced hurricane lawyers who are accomplished at assisting people with denied hurricane damage issues. They’re knowledgeable at defending the integrity of your damage claim and negotiating with insurance companies to get you the settlement you need and deserve.
How much does it cost to dispute a denied insurance claim?
Galindo Law doesn’t charge any upfront or out-of-pocket fees. We’re only paid a percentage of the settlement we’re able to secure for you. So by working with Galindo Law, you incur zero financial risk—with nothing to lose and everything to gain.
It bears repeating: You’re not asking for charity. You have paid to be insured. You deserve to be adequately compensated.
Or, if you prefer, email us. And thank you for reading our blog!