Sandy, Irene, Katrina, Harvey, Irma. It seems like every year a major storm hits the U.S., causing devastation, tragedy and an influx of insurance claims. Even worse: A staggering number of people are left uninsured and undercompensated afterward. With that in mind, it’s a good idea to be aware of insurance coverage tips in case the next windstorm, flood or other natural disaster hits near home.
“The insureds are human beings whose lives have been turned upside-down, and the stress of it can be immeasurable,” says Donna DeVaney Stockham, an insurance litigator with Stockham Law Group in Tampa. “These are people’s lives and homes we’re dealing with. They don’t have the money to fix everything, which is why they bought insurance, and it all takes a toll.”
Too many Floridians have learned this the hard way, from past storms like Wilma, but now they know what to do: “I had people hire me before the storm,” DeVaney Stockham says of Irma. “They said, ‘I know I’m going to be hit; please let me be first in line when you take cases.’ People are reaching out immediately, which is good. If you don’t deal with all these nuances day in and day out, you need to hire someone who knows it.”
Make Your Claim Immediately
After Hurricane Wilma, Florida passed a statute about insureds’ duty to report claims in a timely fashion.
“If you believe you’ve suffered damage, report the claim right away. You can’t just wait to see if it gets worse,” DeVaney Stockham says. “So many people after those ’04-’05 storms thought, ‘I have some damage, but it’ll probably fall under my deductible; we’ll just wait and see.’ Then over time there’s a lot of damage. With wind, you can’t always see damage with the naked eye.”
Insureds have three years from the windstorm or hurricane to make a claim; they can file a lawsuit against the insurer within five years of that filing date. The homeowner, or insured, is responsible for proving a loss and damage during the policy period. When that is satisfied, the burden then shifts to the insurer to prove an exclusion under its policy, should it choose to deny it.
Insurance Can Be Confusing
Your homeowners’ insurance is established based on the history, topography, weather changes, averages and types of events that have happened in your area. From these, probabilities are calculated and predictions are made—what insurance companies call your level of risk, which in turn sets your rates and eligibility for coverage. The language that comes out of this process can lead to confusion.
For example, the phrase “100-year flood.” Most people interpret this to mean a rare flood that happens only once every 100 years or so (once in a lifetime). The moniker actually refers to the statistical chance of one in 100 in any year for that level of flood, in that location. This designation is also not fixed. Your home can be assessed as being within a 100-year floodplain that is later reassessed as being in a 50-year floodplain, based on changing topography, development and/or weather patterns in your area. You may even be considered not in a floodplain at all and come to be smack in the middle of one over time. Flood insurance is typically not required for homeowners who don’t live in a floodplain, and is not part of regular homeowners’ insurance coverage. Rapid development, coupled with lagging updates to floodplain mapping, can lead to devastatingly inadequate insurance coverage, as well as homeowners who have no idea they’re at risk.
“Most policies written down here are HO3, which are all risk and include wind,” DeVaney Stockham says. “Flood is its own beast and policy.” Flood is defined as water rising, then entering the home. It is not a pipe break or water coming in from wind or rain. The deadline for flood claim is 60 days from the event, unless the government gives an extension, and the deadline for filing a lawsuit is one year.
If you file a claim with a National Flood Insurance Program (NFIP) insurer, if you’re denied or provided less than you believe you’re entitled to, you can appeal the decision to the Federal Emergency Management Agency (FEMA). You must file an appeal within 60 days of the written final claim decision, or you lose your right to do so.
If Your Claim is Denied
“You need to reach out to counsel in the event of a denial,” she says. “Policies don’t cover everything, and there can be legitimate denials, but many times a denial can be challenged and an inappropriate denial is a breach of contract.” This means you can file a lawsuit against the insurance carrier, which is a fairly common occurrence after major storm events.
“Let’s say people have an older roof,” Devaney Stockham says. “There becomes a dispute: ‘Did wind cause damage, or was it just an old roof?’ It’s a common theme we deal with.” Another common dispute is about wind-driven rain, since many policies exclude it unless an opening was first created by wind. If such debates reach court, it becomes a battle of experts.
However, that’s rarely the case. DeVaney Stockham estimates about 5 percent of cases go to trial. “Only in situations where no reasonable offer is made are the cases tried.”
The typical first step in a denied claim is to file a civil remedy notice with the state—a formal complaint against the carrier to which they must respond in 60 days or be at risk of a subsequent bad faith lawsuit. If the carrier pays the demanded amount from the notice, “they are forgiven all sins,” DeVaney Stockham says. People who can’t afford to wait 60 days often file suit right away, she adds.
This is typically when cases are resolved, via a settlement—“where the litigants have control of the outcome, and the money is generally paid 20 to 30 days later. They know what they’re getting; they can hire contractors; and they can get things going to move on with their life.”
Insurance attorneys are paid by contingency, meaning a fraction of what is recovered. Having a knowledgeable lawyer represent you can make a significant difference to your outcome.
Be likewise mindful of potential fraud that accompanies disaster situations. Common schemes include fraudulent inspectors, contractors, representatives of disaster aid, or requests for donations. Always ask for proof of credentials, and do not provide personal information unless you have verified the legitimacy of the source. There is no fee to apply for disaster assistance.