Water Damage

Jennifer Pena

Offering Legal Help for Insurance Claims on Water Damages

Water Damage Claim Denied in Florida: What Now?

Given where it is located, and its geographical make up, Florida is highly prone to water invasion by hurricanes, heavy rains, and coastal flooding. These environmental factors are added perils for homeowners who also have to contend with everyday water damage from burst pipes, failed appliances, or faulty HVAC and fire suppression systems. Water damage is not easily reversed and can cause extensive harm to a home’s structure, floors, walls, ceilings, and personal property. The good news is that as a responsible Florida homeowner you purchased a homeowners’ policy and you have faithfully paid the premiums. Now you expect the insurance company to pay for water damage. But your water damage claim was denied. Why did that happen, and what can you do about it? Below we provide a guide to both questions.

Why Are Water Damage Claims Denied?

First, flood damage is not usually covered by a standard homeowners’ policy. A flood insurance policy is almost always required to cover water damage which is considered flood damage. That said, there are several other reasons for denied coverage.

  • Gradual Water Damage

    Water leaks occur over time from an old pipe, a faulty appliance, or an aged roof that then damages your home is usually considered gradual water damage. Homeowners' insurance policies do not cover this type of water damage. Implied in this denied coverage is the duty of the homeowner to maintain their property and to timely keep up with repairs. On the other hand, sudden and accidental occurrences are usually covered under your homeowners’ policy.

  • Sump Pump and Sewer Overflows

    Backups or overflows into a home because of a failed sump pump or a sewer is also not usually covered by a standard homeowners' insurance policy. Since these events originated from below ground and are not a sudden and accidental occurrence your claim will likely be denied.

  • Poor Training

    Believe it or not, poor insurance adjuster training can result in a denied claim. Adjusters are looking for events that are sudden and accidental, and if the water damage does not fall into this category, the claim is usually denied. However, the adjuster may mistake or misidentify the water damage source and thus think that it is not sudden or accidental. Also the adjuster could be misapplying the policy terms.

How to Get Insurance to Pay for Water Damage

The harsh reality is that insurance is a business, and insurance claims are a business negotiation. Understanding this reality will help you fight a denied water damage claim. After your claim is denied, ask for a written explanation, so you can see the reasons behind it. You should then appeal your claim within the insurance company and take the following steps, including as much as possible in your appeal:

  • 1 Get a list of all the people from the insurance company who were involved in your claim and try to pinpoint the person who actually issued the denial.
  • 2 Take lots of pictures of the water damage to your home and personal property. Pictures are often the most critical element of the claim, so the more the better. Make sure you not only take pictures of the actual water damage but also of the immediate surrounding area. Finally, any pictures from before the damage are helpful too.
  • 3 Make a detailed list of all damaged personal property with their cost. Also, save the personal property for the insurance company to inspect.
  • 4 Hire a water damage expert to do an independent analysis. What you are looking for here is the source of the leak, how it occurred, and when it happened. Determining this can significantly help in reversing your claim denial.
  • 5 Keep all your receipts, invoices, bills, estimates, and analysis about the water damage.
  • 6 Get copies of your water bills. These bills can help prove when the leak occurred.

This documentation can help you demonstrate that your damage fell into a category covered by your insurance policy.

Lady Law Group Can Help Get Your Claim Approved

Lady Law Group is composed of local south Florida property damage lawyers, and we experience and live in the weather that causes water damage to homes. Our years of legal knowledge of how to get insurance to pay for water damage enables us to understand the insurance company’s thinking and why they denied coverage. Contact us today so we can help you get the insurance benefits you deserve.