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Guardian Adjusting Blog
Tips and information on all types of property damage claims.

 

Water Claims Spike and AOB

Rick Tapanes - Tuesday, July 26, 2016

Insurance Industry Deals with Spike in Water Claims and Assignment of Benefits Lawsuits in South Florida

In South Florida, the type of property loss most frequently reported to insurance companies is water related. According to the Florida Department of Financial Services, and Chief Financial Officer, Jeff Atwater, water related loss insurance claims are on the rise. Insurance companies believe the situation is out of control and are looking to not only raise rates to deal with the issue, but to also further reduce coverage on property policies. Since water damage claims happen so frequently, Florida property owners should be concerned.

Insurance Fraud or Industry Ploy?

The insurance industry, as well as Kevin McCarty, the former Florida Insurance Commissioner, have, on more than one occasion, suggested that the steep rise in water loss claims may be the result of fraud. One fact pointing in that direction is that while not limited to Miami-Dade, Broward and Palm Beach Counties, the rise in claims has been most pronounced in those counties.

Insurance fraud is defined as giving false information to gain benefits one is not entitled to. If the information provided is, in fact, found to be false, it is easy to identify who provided the information and who stands to benefit. However, the problem really lies in the sheer volume of fraud complaints that the Florida Department of Financial Services’ Division of Insurance Fraud receives on a yearly basis. That number is over 16,000! A number that is far greater than what the Division of Insurance Fraud can realistically handle. Furthermore, priority right now goes to the two most common types of insurance fraud, personal injury protection (PIP) and workman’s compensation.

Insurance Companies Say they are Being Strangled by Assignment of Benefits Lawsuits

Even with no major hurricanes, 2015 was still a tough year for insurance companies that cover homeowners in South Florida. The problem from their perspective is the proliferation of “frivolous” Assignment of Benefits (AOB) lawsuits and the high cost of fighting or settling them.

Here is what is happening in a nutshell. A homeowner’s property suffers water damage, and the homeowner calls in a water mitigation company to deal with the damage. The water mitigation company presents the homeowner with the bill as well as an Assignment of Benefits. The AOB transfers to the water mitigation company the homeowner’s rights to recover payment for damages from the insurance company. When the water mitigation company sends the claim to the insurance company, the insurance company denies the claim, or it is learned that the damage was not covered in the first place. The final step occurs when the water mitigation company decides to sue the big insurance company instead of the homeowner to collect payment.

The property insurance industry has lobbied for legislation that would limit the ability of a company to sue the insurance companies when they have no direct relationship with them. Until now, the Florida Legislature has not acted on the issue. Florida homeowners would be wise to stay abreast of developments as it could have a serious impact on their coverage and its cost.

Roof Leaks and Water Damage

Rick Tapanes - Tuesday, October 27, 2015

Does Your Policy Cover Roof Leaks?

When it comes to water damage, homeowners’ insurance policies become a bit complicated and specific. Damage from flood waters, which insurance companies define as being caused by rising water from an existing body of water entering a property, requires a seperate flood policy to cover it. Conversely, if your living room becomes “flooded” by rain water coming in through a leaky roof, a flood insurance policy won’t help. The majority of property insurance claims are for water related events, yet most policyholders do not have a clear understanding of what water damage they are covered for.

The first thing to do is review your property insurance coverage to understand exactly what is and is not covered. Talk to your insurance agent or a public adjuster at Guardian Adjusting. Your public adjuster can identify any holes in your coverage and make sure that you are ready for any eventuality.

Perform Regular Maintenance

The typical homeowner’s insurance policy will cover water damage caused by accidental events. The most common reason for a denial of a water claim is neglect and failure to perform regular maintenance. So, imagine that a storm brings a large amount of rain with it and suddenly your roof starts leaking in several places. Some furniture and drywall is damaged and a large portion of the carpet and floor becomes soaked. The next morning your insurance company’s adjuster gets up on your roof where she finds no visible damage. There are no roof tiles blown off by the wind or damage from a tree branch that hit the roof. The insurance company’s stance will be that the damage is due to negligence and failure to properly maintain the roof, which is the homeowner' responsibility. Similarly, any water coming in to the property through a leaky pipe or crack in the wall falls to the homeowner to prevent through routine maintenance.

Other things you may have trouble securing a claim for are improperly installed plumbing fixtures that leak, and malfunctioning appliances like refrigerators, ice makers and air conditioners. All of these items require maintenance and sometimes replacement and will not be covered by the majority of homeowners’ insurance policies.

On the other hand, you may be surprised to learn that damage resulting from these leaky roofs, walls and appliances is often covered. So, although your insurance company is not going to fix your roof, it is likely that your policy covers damage to floors, and furniture due to those leaks.

The best advice is to know what your property is covered for before the damage hits. Maintain a relationship with a public adjuster from Guardian Adjusting to stay on top of your insurance coverage and for the peace of mind of knowing that they will be there in an emergency to protect your interests.

Hurricane Preparedness

Rick Tapanes - Saturday, July 11, 2015

Prepare For Hurricanes Before They are Even Approaching

Any time a hurricane approaches the coast you're likely to see scenes of people wasting their time and energy "preparing" for the storm. In fact, you might have seen these images so often that you think the folks shown are doing the correct thing. If a hurricane is approaching, forget about:

  • Rushing to a building supply store to buy plywood for your windows.
  • Taping up your windows.

If your house is in danger of being hit by a hurricane, protecting windows and sliding glass doors is almost always the number one thing you can do to ensure you'll have a livable house if the worst happens. But, if you wait until a hurricane watch is posted, you are almost surely too late. Taping up windows is a waste of time because tape isn't going to keep your neighbor's garbage can - which he should have stashed in a place where the wind can't grab it - from breaking your window when a 100 mph wind flings it at your house. True, the tape just might keep the glass from flying around the room when the garbage can hits it.

An important rule for any wind storm is to not be in a room with windows that can be broken. If your house doesn't have a windowless room, you should at least hide behind an overturned table or a heavy sofa in case glass starts flying. If you waste time taping your windows, about the best you can hope for is that the storm will miss your house, and the tape won't be too hard to remove.

While tape doesn't do much, heavy plywood or metal shutters are vital. But you can't wait until a storm is bearing down to go buy the plywood because by then it's almost surely too late. This is because the plywood has to fit the windows and it has to be firmly attached to them. Experts recommend using 3/4 inch plywood and drilling screw holes 18 inches apart all around it. Are you going to have time to do this after a watch is posted? This is the kind of thing that should be done well ahead of time so the window covers will be stored with the screws started, and everything you'll need to install them,such as a ladder and the correct size screwdriver handy. The big question you have to answer ahead of time is: Who's going to install the plywood covers, maybe with a 20 mph wind gusting to 30 mph as a storm approaches? It's probably a sure bet it's not going to be your 70-year-old mother, by herself.

Why is protecting windows so important? Once a window is broken, the wind blows inside to not only wreck the interior, but also to apply upward pressure on the roof, which might be enough to sent if flying. If this happens, the walls collapse and your house is done for. Protection can include impact-resistant glass, sturdy shutters, pieces of marine plywood marked and cut to fit each window and glass door, or other permanent materials that have passed the state of Florida or Miami-Dade County impact standards tests.

Here are some other things you should do before a tropical storm or hurricane watch or warning is posted:

  • Remove weak and dead trees or tree limbs on your property.
  • Know whether your home is in a zone that could be flooded by storm surge, meaning you'd have to evacuate.
  • Have plans for where you will go if you evacuate, when you will leave (maybe early to avoid traffic jams), and how family members will contact each other.
  • Make sure you have contact information for Guardian Public Adjusting Services to help you evaluate any damages after the storm.
  • If you might have to evacuate, have a "grab and run" bag ready with important papers, such as your home owners insurance policy, and prescription drugs.
  • If you live outside possible storm surge zones, and your house is sturdy, you should plan on riding out the storm in a "safe room" inside the house.
  • Have an evacuation or survival kit ready with nonperishable food, water, a first aid kit and other things you'll need.
  • Have a battery-powered radio, maybe a battery-powered television set for keeping up with the latest advisories.

Before a watch is posted, you should have done all of the things listed above. Then, you should stay tuned to forecasts and possible warnings from radio or television stations. If you are in an area that could be flooded, you should be ready to evacuate. Of course, if you are living in a mobile home, or a house that isn't sturdy enough to stand up to the wind, you should evacuate early and avoid the rush.

Mold your mold damage claim to your advantage

Rick Tapanes - Friday, May 22, 2015

Learn the Facts Before Filing a Mold Damage Claim in Miami

Mold contamination is not to be taken lightly. Left unchecked it can cause serious illness and property damage.

The introduction of mass-produced building products and tract home construction techniques in recent years has only exacerbated the problem, making buildings more susceptible to developing mold infestation. If active mold growth is extensive and persistent it has the potential to cause irreparable structural damage.

The monetary ramifications of a mold contamination in your home can be dire. Thankfully, it’s possible that your homeowners insurance policy may cover the costs. But first you must identify the nature and cause of the mold damage.

What are the most common areas where mold damage may be found in your home?

Although most people associate shower stalls, bath tubs, and basements as the main culprits for harboring mold, the unfortunate truth is that any area that collects moisture in the home can be a breeding ground for mold.

Mold damage may be found in these other common areas:

  • drywall
  • roofing
  • paneling
  • ceiling tiles
  • improperly maintained air conditioners
  • carpets
  • furniture
  • duct work
  • wallpaper
  • near areas surrounding plumbing pipes
  • below sinks
  • underneath carpeting or rugs

Mold is insidious—it will gradually seep into your home through open doors , windows, and air vents. It will even attach itself to clothing, shoes, or pets in order to make its way inside from outdoors.

If You Need to File a Mold Damage Claim in Miami it is Crucial You Consult an Expert Public Adjuster

In terms of insurance coverage, mold damage is a complicated matter. Be aware that most property damage insurance policies include a mold exclusion or limitation. This means that mold damage may be covered only under a very specific set of circumstances. In most cases this involves linking the mold contamination to water damage that has been suffered by the property.

So how can you be sure that you are eligible to file a property damage claim for mold contamination? This is where a consultation with a knowledgeable public adjuster comes into play.

If you believe there is a mold contamination in your home your best course of action is to get a trained public adjuster to inspect your property and ascertain the nature of the mold damage. A thorough inspection will determine if the mold was caused by a past water damage incident such as a broken pipe or leaking roof. A link between the two must be established in order to build a strong case against any mold exclusion clause present in your insurance policy. It is the only way to ensure that your insurance company awards a settlement.

At Guardian Adjusting we have more than thirty years experience providing comprehensive, quality service to Florida residents. Our public adjusters will always defend your best interests and fight aggressively to ensure that you are properly compensated for your property damage claim. Please contact us today for a free evaluation.


         
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