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How to Navigate Insurance Claims Post-Disaster?

FORT LAUDERDALE, Fla. – When the shock that your house has been damaged in a hurricane wears off, it’s time to think about how quickly you can get your insurer to cover the cost of your repairs and make you “whole” again.

These days, in Florida, that can be a daunting task.

But you’ve been paying your premiums and now you have major damage. Questions swirl: What’s the best way to file a claim? Who do you call first? Your insurer? A public adjuster? An attorney? And what do you do if the storm created a hole in your roof and left it vulnerable to further rain damage before permanent repairs can be made?

The South Florida Sun Sentinel asked several people who perform varying insurance-related roles for their best advice on how to manage the claim process. Responses from officials in the insurance business, of course, were more trusting of insurers’ motives compared to recommendations from attorneys and public adjusters.

Each claim is different. A simple claim might require a different approach than a complex one. If your entire house is destroyed, you’ll likely have more difficulty dealing with your insurer and want to seek outside help.

And different insurers might approach claims handling in different ways that make it difficult to recommend a one-size-fits-all strategy. Some, for example, have their own repair contractors. Others require you to hire your own.

Ultimately, each homeowner will have to decide which approach works for their situation.

Here’s what experts say about best ways to file a claim:

What should a homeowner do first after a hurricane or tornado breaches their roof and leaves a hole that can cause water to come into their home?

Travis Miller, spokesman, Universal Property & Casualty: In any catastrophe scenario, the first step insureds should take is to protect their personal safety and the safety of their families. Insureds should follow guidance as to evacuating locations and safely returning to those locations.

Next, insureds should consider whether they can safely mitigate further damage to the property. This will help reduce further damage to the home and its contents. Note that many Florida policies specify that an insurer will pay up to $3,000 for measures to protect the property from further damage. For costs expected to be beyond $3,000, the insured should contact the insurance company with information about the damage and the request to exceed the emergency repairs limit.

Amy Rosen chief marketing officer, People’s Trust: Document your damages with photographs. If your contents were damaged, begin to make an inventory with photos and do not dispose of anything until your home has been inspected. If your home is unlivable, keep receipts of all expenses associated with your relocation for review by your adjuster.

Jonathan Wilson, public adjuster, Intellaclaim Public Adjusters, Palmetto Bay: Most importantly, photograph any holes caused by the wind event, as many policies like Citizens exclude water damage unless there is a “wind created opening.”

When do I report the damage to my insurer?

Travis Miller: As soon as practicable. One advantage is to help ensure that emergency measures are covered. In addition, insurers typically have adjusters in the field as soon as possible after storms pass.

Stacey Giulianti, chief legal officer, Florida Peninsula: The carrier typically has preferred mitigation vendors ready to go, and they can tarp your roof, dry out the water, or board up broken windows. Be wary of hiring “door knockers” that may not even be licensed.

Louis Gonzalez, property insurance chair, Florida Justice Association: As soon as possible. Insurance companies will deny claims that are not reported “promptly,” and since “prompt” is not defined in the policy, they will take liberties with what to consider “prompt.” Many claims are denied when homeowners don’t realize the extent of the damage, and then when they report it, the carrier says it’s “too late.” The carrier will claim they are “prejudiced” in their ability to investigate the loss. I have seen carriers deny a claim reported as short as four days after the event.

How long should I anticipate it taking for my insurer’s adjuster to show up?

Lisa Miller, insurance consultant: In non-catastrophe situations, within 48 to 72 hours. In a catastrophe situation, one to two weeks. Please be mindful that insurance companies “triage” claims so that in many cases, policyholders who are elderly or have extenuating circumstances will be first in line.

Should I hire a company to make emergency repairs while waiting for my insurer’s adjuster to show up?

Wilson: Failure to mitigate damages could get your claim denied. So installing a tarp or a temporary roof repair is required by your insurance policy.

Gonzalez: However, this is a double-edged sword, because if you make repairs before the insurance company can inspect, they will deny your claim because of the “prejudice” of their ability to inspect. It’s important to make temporary repairs, but also document the damage, take videos and photographs, and keep all your invoices and receipts.

Lisa Miller: Do not sign any document/contract without reading it.

When should I call repair contractors and start getting estimates for permanent repairs?

Giulianti: You can call repair contractors immediately, and have estimates done – those are very helpful to the field adjusters in terms of potential scope of damages. However, make sure that only temporary repairs are done until the adjuster can view, inspect, and photograph your home.

What else should I do while waiting for the adjuster to show up?

Lisa Miller: Keep a daily log of any changes to the damage. In fact, take pictures immediately after the damage occurs. Word of caution: If the loss is a water loss, do your best to prevent mold. Run your air conditioner if you have electricity, and if a water extraction service company is handling the water loss, inquire about the daily costs of their equipment.

Wilson: Keep following up with your insurance company every couple of days until they assign an adjuster to your file. Document the date, time, and who you spoke to every time you call.

How long should I expect before the adjuster files a report estimating damage repair costs?

Lisa Miller: In most cases, within 10 days. In the aftermath of a catastrophe, it varies and could be as long as three to four weeks.

Travis Miller: In the early weeks following a significant event, it might take a week or two for the adjuster to submit the report.

Michael Peltier, media relations manager, Citizens Property Insurance Corp.: The adjuster handing the claim has up to seven days to send the report estimating the loss to the policyholder after it is finalized. Citizens has up to 60 days to pay or deny a claim.

How long should I expect to wait before finding out what the insurer is willing to pay for repairs?

Lisa Miller: Some claims are not complex and can be settled in just a matter of days. On the other hand, complex claims such as heavy damage from a hurricane and losses that involve flood damage can take several weeks.

Travis Miller: In general, the insured should be informed of a decision within 60 days after the loss is reported. In many instances, an insurer will respond sooner. It is important to keep in mind that a storm claim often involves more than just a single review with a single payment. For example, if a payment for additional living expenses is warranted, an insurer often will issue an initial payment within days and will continue to issue additional payments as expenses are incurred.

Under what circumstances should I contact a public adjuster?

Lisa Miller: It is not recommended that a public adjuster be engaged at the outset of a claim. It is in the best interest of the policyholder to first let the insurance company’s adjuster provide feedback and a report. If the customer is not satisfied, they can seek the assistance of the Department of Financial Services, which is a free service.

Paul Handerhan, president, Federal Association for Insurance Reform: There are two typical reasons for hiring a public adjuster. One is if you are very busy, say a professional, and you’re willing to pay a percentage of your claim to let someone handle it for you. A second reason is if you’re having a difficult time getting the claim sorted out, or your insurer has already denied it and you want to hire someone to convince the insurer to reassess your claim.

Wilson: Most South Florida consumers recognize the importance of engaging an experienced and professional public adjuster. We possess the expertise to identify hidden damages that are only detectable with specialized tools. Additionally, we handle all communication and inspections, meticulously prepare claim documents, and thoroughly review your policy coverages. Our objective is to guarantee that you receive appropriate and timely compensation for all covered damages.

What are the potential pitfalls of hiring a public adjuster to handle my claim?

Lisa Miller: According to the Office of Public Policy and Government Accountability, a claim takes nine months longer when a public adjuster is involved. A public adjuster’s compensation is paid out of the claim, so if a claim is $1,000 and the public adjuster’s fee is 10%, the policyholder only receives $900.

If I and/or my public adjuster disagree with my insurer’s repair cost estimate, should I consider hiring an attorney?

Lisa Miller: It is recommended that the policyholder exhaust all avenues to resolve the claim before considering an attorney. For example, the State of Florida offers a free mediation service through the Florida Department of Financial Services. In other words, consult your policy for alternative dispute resolution processes versus immediately launching litigation.

Travis Miller: Before hiring an attorney, an insured first should try to understand the basis for any difference between the insurer’s estimate and the amount the insured believes is appropriate. The reason might be as simple as the insured becoming aware of additional damage or new information since the inspection that the insurer has not taken into account, or perhaps the insurer has a different view of the scope and pricing of the needed repairs.

Handerhan: If after the policyholder has filed a legitimate claim and they’re still not satisfied with the response from their insurer, that’s when they would consider hiring an attorney. They would sign an “intent to litigate,” and the insurer could file a reverse determination, or tell the policyholder to go through mediation or appraisal. Or they could say, ‘We’re very comfortable with our determination’ and we’re not going to change it.

Will hiring an attorney expedite or slow the process of getting a larger settlement proposal from my insurer?

Peltier: The process will take longer to complete. In some cases, it will take much longer.

Gonzalez: In most instances, you cannot get a settlement at all without the assistance of an attorney. Once the carrier denies a claim, they will not overturn that decision without the assistance of an attorney.

If I disagree with my insurer’s settlement offer but don’t want to hire a public adjuster or an attorney, how can I get my insurer to take another look at my damage?

Giulianti: Every customer has the ability to request their carrier to re-open the file and have it reviewed, especially if the customer has additional documentation or information to submit. Insurance companies are always willing to discuss the field estimates and coverages that impact the payment amount. If you hire a contractor, have them send their estimate and report to the carrier as well; this often provides additional information to the carrier on current pricing in the impacted zone. Finally, the State of Florida has a mediation program. Contact the mediation coordinator and request that one be set up. Having both parties review the same documents and photographs can often lead to an amicable outcome for everyone involved.

What other considerations am I omitting?

Lisa Miller: Be patient, particularly in times of disaster. Hurricane Ian resulted in almost 800,000 claims. There are only so many adjusters in the country! And Florida isn’t the only place having summer disasters!

© 2023 South Florida Sun-Sentinel. Distributed by Tribune Content Agency, LLC.

https://www.floridarealtors.org/news-media/news-articles/2023/07/how-navigate-insurance-claims-post-disaster