Frustration is starting to set in for many policyholders with Hurricane Matthew claims.
Here are few tips for those who are concerned that they are not being properly indemnified.
90 days have passed: Confirmation of Coverage is Due
We are now post 90 days from the storm, this matters in Florida because complete and through investigations should have been completed if you made your claim in the week following the loss. Even if your state does not have this rule, three months is a reasonable time to see some action in your case.
In Florida, Fla. Stat. 627.70131(5)(a) states that policyholders should be paid or their claim denied within 90 days after the insurance company receives notice, unless factors beyond the control of the insurance company for not making a decision exist.
Watch out for excuses that may not be legitimate “factors outside the control” of the insurance company. Carriers have a lot of control and may not be promptly responding, hoping to rely on an excuse.
Some will tell you this statute doesn’t have enough power, but if the insurance company thinks that you are unaware of this regulation it will try to sweep under the rug that the claim decision is untimely. If you work for a Florida insurance company, you will diary this 90-day deadline and watch the time line closely—it matters more than it might appear on the surface.
In addition, the Florida Homeowner Bill of Rights, F.S. § 627.3518(9), states:
3. Within 90 days, subject to any dual interest noted in the policy, receive full settlement payment for your claim or payment of the undisputed portion of your claim, or your insurance company’s denial of your claim.
Understaffed Insurance Companies = Low Estimates or Denied Cases
Some adjusters are reporting that their counterparts who work for the carriers have too many files to handle and some teams handling the catastrophe claims have been downsized. Carriers are stating that Matthew claims are “closed” but that doesn’t mean the claims were properly paid. A surface audit of some of the companies handling claims across the Southeast coast may appear to have things handled, but a deeper dive may reveal that the coverage and proper dollars were not afforded.
The existence of over-worked and undertrained representatives is evident in this storm. Companies not hiring enough staff has been reported. Carriers are in the business of making money and those profits decrease if they hire and train adjusters only to have those adjusters without a full workload in the future. To save money, the team that is hired-on does more work and relies on outside vendors, independent adjusters, and experts to get the job done. In theory, this process and plan could work, but not if those in the field are improperly trained. Moreover, the in-house adjuster can only handle so many files before things start getting lost in the cracks. This leads to multiple file transfers and problems galore.
CAUTION: Read the Check Language
If your carrier has issued you a payment, make sure you protect yourself from signing a full and final check or release. If you have questions about whether the damages are complete or if you feel that the insurance company is aggressively trying to get you to end the claim, you should seek assistance. Right after Hurricane Matthew, one large Florida insurance company was writing checks on site. From outward appearances this seemed like a wonderful thing, but the language on some checks read: Full and Final Payment. Such language could be a quick attempt to stop the insured from a full claim payment and might be overlooked by a distraught insured.
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