Filing A Claim On Your Homeowner’s Policy
By Jane L. Lyon
Many Floridians experience a great deal of
stress when thinking about and dealing with their homeowner’s
insurance. This article is an overview of
what may happen when a claim is filed.
Smooth Claims Process on the dwelling:
Take
photos or a video of the damage, if possible, have two copies: one
for you and the second for the insurance company.
When a claim is filed, the insurance company
will assign an Adjustor. The Adjustor may work exclusively
for your insurance company, or, may contract with several companies,
or may be self-employed. All Adjustors must be licensed in the
state of Florida. Check to see if an adjustor is licensed by
calling the Department of Financial Services Consumer Helpline,
1-800-342-2762.
Policyholders can also hire a Public
Adjustor to review and negotiate claims with the insurance
company on behalf of the policyholder. Public Adjustors charge
the policyholder a percentage of the claim settlement amount
the policyholder will receive. Public Adjusters must also be
licensed. They cannot charge more than the amount stated on the
contract and cannot charge up front for their services.
The Adjustor has the authority to inspect the
damage and write an estimate of the cost of the claim. Some
adjustors have the authority to issue checks. If they do not have
check-writing authority, then they send the estimate to the
insurance company who will issue the check.
Most checks will state that acceptance or
cashing of the check is considered payment in full. However, if the
damage is greater than initially estimated, supplemental claims can
be filed. To file a supplemental claim, the policyholder must have
estimates from licensed contractors to verify the additional costs.
REPAIR WORK:
Many types of
repairmen/contractors may approach seniors. If you are approached
by someone claiming to be from a public utility company (electric
company, gas company), ask for their identification and look for
their repair truck. If you are still note sure, call the utility
company using the number in your local phone book to verify that
crews are working in your area.
If other types of
repairs are necessary, it is important to keep the following things
in mind. Contractors work for YOU. You need to interview them and
ask questions like: How long have you been in business? Are you
licensed and registered with the state? Do you have workers
compensation insurance (ask for proof). How many projects like mine
have you completed in the last 12 months? Will my project require a
permit? Will you be using subcontractors? Can I contact one of your
previous customers?
Check on the
contractor’s address, license and complaint history by calling your
city or county building department, or by checking with the
Department of Business and Professional Regulation, 850-487-1395 or
www.state.fl.us/dbpr.
Ask for their
business card and license number as well as proof of worker’s
compensation and liability insurance for the contractor and
subcontractor. This is an important protection for you, so that
attempts to file for any injuries are not filed under your property
insurance.
Obtain at least
three bids/estimates or quotes. When comparing these, keep in mind
the type and quality of materials each bid lists. Remember that the
lowest bid may not always be the best bid. Also make sure that the
repairs being made will be up to the current city or county codes.
Find out what type
of mitigation discounts your homeowner policy offers. A mitigation
discount is a discount insurance companies offer policyholders to
include wind-resistant building materials in the structure. These
may provide you with a discount on your homeowner’s policy premium.
More importantly, they will protect your home from extensive damage
and provide a secure place for you in the event of a storm.
NEVER agree to
file or “pull” the work permit yourself. The repair company should
be able to do this, it is their responsibility and if you file for
it, you may become responsible for any code violations, fines and/or
penalties.
Make sure that
inspections are done and that a final inspection is passed on the
job. The contract should be clear on the responsibility of these
inspections.
Look out for any
other necessary expenses not specified in the contract, like
permits, inspections, electricians, architects, or changes to plan
designs. Be very clear on what is included in the contract and what
you are expected to pay.
Read and keep a
copy of the contract that should be signed by you and the
contractor. NEVER SIGN A BLANK CONTRACT. Make sure that everything
you have agreed upon is listed in the signed copy of the contract as
well as the warranty and the beginning and end date and any
penalties or discounts for delays.
Make sure that
there are no liens placed on your property regarding this work, if
there are, get the final release when you make the final payment.
PAYMENTS: AVOID
PAYING UP FRONT. DO NOT PROVIDE ANY PAYMENT WITHOUT A SIGNED
CONTRACT IN HAND. A company might request a down payment; this
should be no more than one –third of the total estimated cost, but
no one should pay any money without a signed contract. It is
extremely important that licensed, reputable businesses and/or
individuals are hired for repairs; preferably those who are local
and can provide you with references. DO NOT PAY CASH, AND OBTAIN
RECEIPTS. Low interest loans are available to storm victims through
the Small Business Administration, visit their web site at
www.sba.gov.
Contractors should
provide a pay schedule as work progresses and itemized prices for
the work.
Do not make the
final payment until the final county/city/state inspections AND
until you are satisfied with the work, this includes all clean-up.
Be wary of any
contractor who refers you to someone they know who can help you get
the money. This could be part of a home improvement loan scam and
could result in your losing your home.
Possible
issues with claim processing:
The 2004 Hurricane Season was unprecedented and as
such several problems arose for homeowners filing claims. It is
important to note that at any time in this process consumers are
encouraged to contact the Florida Department of Financial Services.
This Department can be reached through the toll free statewide helpline
at 1-800-342-2762, or through our web site: myfloridacfo.com.
Adjustors: If the adjustor does not contact the
consumer, the consumer can contact the insurance company.
Estimate Disputes:
(1)
If the adjustor provides a lower estimate than the contractor,
try to obtain three estimates, submit them to the insurance company to
validate the dispute. Maintain copies and records of contact made with
the insurance company.
(2)
If the insurance company does not respond, or does not honor the
request for the higher bid, contact the Florida Department of Financial
Services. Your options may include a mediation hearing at no cost to
you.
Delayed Payment: If the consumer and the
insurance company comes to an agreement, but the insurance company is
delaying payment, the consumer should contact the insurance company, and
if possible, document the details of the call. If this does not result
in any action, contact the Florida Department of Financial Services.
Lost Files: Many consumers reported that
the insurance company and/or the adjustors lost their files. If
possible, the consumer should keep their own records regarding meetings
with adjustors and/or other insurance representatives. If copies can be
obtained of any related documents, this should be done as well.
Property Disputes:
Inventory Disputes: Consumers frequently complained
that their insurance would not cover certain items, or disputed their value.
Options to prevent this include documenting contents with photo’s or a video.
(It’s important to have the video stored somewhere other than the consumer’s
home). If there are unique or hard to replace items, consumers should obtain
written estimates on their value. Note that some policies may require
additional coverage, or endorsements on items such as antiques, jewelry, furs
and electronics.
Additional Structures: It is important to
confirm whether the policy covers any additional structures on the
property. These include tool sheds, detached garages, small boats,
fences and pool cages. There have been numerous disputes over these as
a result of the 2004 hurricanes.
Condominium Disputes: It is to the
policyholder’s benefit to make sure that their Condominium Documents
have been updated in accordance to Florida state laws. It is equally
important to understand the responsibility of the unit owner and the
responsibility of the association in the event of a disaster. If there
is a dispute, contact the Consumer Services Helpline.
Consumer Options:
Consumer Services Helpline: This Helpline is
staffed by Consumer Services Specialists who can answer questions and provide
resources for additional assistance. The number is 1-800-342-2762.
Florida Department of Financial Services web
site:
myfloridacfo.com has useful information for consumers.
Mediation: Mediation is a process where a
court certified mediator meets with the consumer and a representative
from the insurance company. The purpose is to reach an agreement both
parties can accept. The mediator helps the parties focus on the issues
and understand each other’s point of view, but does not dictate the
outcome of the discussion. Certain factors must be present to qualify
for mediation. To determine if mediation is an alternative, consumers
are encouraged to call the Consumer Services Helpline.
The Department of Financial Services stands ready
to help consumers who have questions or, are having problems with their
insurance company. The department urges all consumers to check and
update their coverage at least annually and to call the Consumer
Services Helpline with any questions.
Please
call the Florida Department of Financial Services’ toll-free helpline or
visit our web site with insurance or financial inquiries, (800)
342-2762 or
myfloridacfo.com
Note: Jane Lyon is
the Regional Manager of the Consumer Services, Florida DFS. For additional
information or to request a speaker for your organization, please contact the
local office at (727) 587-7260.
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