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Types Of Claims We Can Help You With
A hurricane, tornado or thunderstorm may destroy or damage your home or business. A storm can damage the roof, walls, windows or doors and allow destructive winds and water into the interior.
If your home or commercial building has suffered wind damage, you should take immediate steps to secure the property to prevent injuries. You also should mitigate the damage, such as putting a tarp on the roof or plywood over a broken window.
Next, you should document the extent of the damage. Take photographs and videos and prepare a written list of everything that has been damaged by the storm. If there has been significant damage to the roof or exterior, you may need to call in a contractor who can inspect the structural damage and provide an estimate for repairs. Also, if the building has suffered previous damage, try to locate any information related to those repairs. You want to be able to establish the “pre-loss” condition before filing your claim.
With wind damage, it’s usually best to report a loss within one or two weeks of its occurrence. That gives you time to gather the evidence. Garcia Adjustment Corp can help you assess the damage and document your claim in order to maximize your eventual settlement. Otherwise, your claim may be denied, delayed or minimized by the insurer.
In any case, it’s important to talk with the insurance company before you begin repairing the property. The insurer will want to inspect the damage “as is,” and any premature repairs could result in a smaller settlement.
Because repairing storm damage can be expensive, particularly if the property is a total loss, it’s important to have Garcia Adjustment Corp on your side – right from the start!
Residential and commercial property can fall victim to fire, a small spark can set ablaze a massive structure. In Florida, fire departments, on average, respond to a fire every 30 seconds, and a structure fire every 60 seconds.
The major causes of home fires are:
- Cooking equipment
- Heating equipment
- Electrical problems
- Clothes dryer or washing machines
- Exposure to other fire such as candles
- Children playing with electrical or heat sources.
…and kitchens are the leading area of origin for home structure fires.
Smoke damage resulting from a fire is a cause for serious concern. Most often, smoke damage is covered peril under your homeowner’s insurance policy, but disputes are likely to arise. Smoke can cause damage to your property in a mere matter of moments.
Smoke is a cause for concern in terms of your health. The greatest danger is from the fine particles that make up smoke as a result of a fire. These complex particles can lodge themselves into your skin, eyes or respiratory system and create a multitude of health issues. If you have any pre-existing conditions, particularly heart or lung, you may be more susceptible. Children and older adults are generally at a higher risk.
Of course preventing fires in the first place should be everyone’s priority. One of the best ways to prevent a home fire injury or death is to invest in smoke detectors and fire extinguishers. Nonetheless, fires are some of the most stressful and life altering events that can cause hazard to life and property. When a fire occurs, most people find themselves in unfamiliar territory, often losing not only their home or business, but all of their personal property.
Sadly, going through this catastrophic event can be only the beginning of a nightmare when you throw in the mix -on top of potentially having to find a new home for your family, or a new location for your business, dealing with contractors, and repairmen, and recovery personnel, getting rid of smoke odors, the rebuilding and restoration of your home and business- the added complexities of filing an insurance claim.
This is where we come in. Here at Garcia Adjustment Corp we will guide and assist you through this tragic life event. Reduce your stress by putting our expertise to work for you! As fire insurance claim experts, we understand what is required by your insurance company to properly and quickly help you get your life back together.
Don’t allow the insurance company to re-victimize you. Let us help you!
A large number of South Floridians experience a water damage or a flood in their home, condominium, or business each year. A high percentage of water damage claims are not properly diagnosed and mitigated by the third party insurance provider’s contractors that are sent to your property by your insurance company. If water damage isn’t handled correctly, it can cause greater damage inside walls and underneath floors resulting in mold growth.
In addition, water damage losses result in many items that are overlooked by the insurance company. Leaving you with an under paid claim with not enough money to cover the clean up and damage restoration!
By hiring Garcia Adjustment Corp immediately after a water damage event, you will have an experienced insurance claim specialist, licensed by the state of Florida, to advise and represent you throughout the insurance claims process.
Floods have the potential to be quite dangerous, as well as damaging. This overflow of water can be due to a discharge from a surrounding body of water or from an excess of rainwater. Floods range from very small to very large; floods can develop slowly or suddenly as flash floods.
The National Flood Insurance Program (NFIP) defines flooding as “a general and temporary condition of partial or complete inundation of two or more acres of normally dry land area or two or more properties (at least one of which is your property) from: Overflow of inland waters, unusual and rapid accumulation or runoff of surface waters from any source, and mudflows.”
Flooding typically occurs in low-lying flatland where water cannot easily damn. Flooding can also develop in areas where there are impenetrable surfaces such as concrete, where the precipitation cannot be easily absorbed into the ground. When there are instances of extensive heavy rains, this can create an opportunity for flash flooding.
After wildfires, floods are the most widespread of all natural disasters. Approximately 90% of all U.S. natural disasters that have been officially declared by the President of the United States include a degree of flooding. Coastal areas are at particular risk, all areas are at some level of risk of flood and flood damage. Within the last five years, all 50 states have experienced some form of flooding or flash flooding.
Know the difference between a flood warning and a flood watch. A flood warning indicates that flooding is possible. A flood watch informs that flooding is currently or about to occur. Faced with the dangerous situation of a flood, it is advised that individuals get to the highest level of ground possible. When a flood is imminent, be prepared. If possible, bring outdoor furniture inside and remove any important contents from the basement, if applicable, to higher ground. Turn off main utility lines and disconnect any electronic appliances.
For health reasons, make sure to sanitize anything that comes into contact with flood water, as the extent of its contents is unknown. After a flood, your community’s water supply might not be safe for drinking purposes. In the midst of a flood, do not walk through moving water. Do not drive through any flooded areas. If you find yourself in a vehicle when a flood occurs, abandon the vehicle and make your way to higher ground if safely possible. Do not make contact with any electrical equipment if you are wet or in standing water. Avoid downed power lines and moving water at all costs.
Most home or property owners purchase a flood protection policy separate from their standard property or homeowner’s insurance policy. Property owners need to purchase flood insurance through the National Flood Insurance Program. With the National Flood Insurance Program, all rates are set and do not differ from company to company or from agent to agent.
Flood insurance covers both the building and its contents. Remember that it is absolutely crucial to know exactly what your insurance policy covers and what it does not cover. In the majority of cases, it takes 30 days for a flood insurance policy to become active. Garcia Adjustment Corp can help you navigate the complexities of the claims process.
Roof leaks are known to be one of the major causes of water damage in a home. A roof leak usually goes undetected until the resulting water damage is observed inside the dwelling. Water intrusion from a roof leak can cause major damage to a home, costing homeowners thousands in repairs. The aftermath of a residential roof leak water loss can leave homeowners and other property owners with the burden of facing extremely difficult and complex decisions. Issues related to property damage of items such as: ceilings, walls, drywall, flooring, insulation, cabinets, and other interior finishes are just some of the many concerns one should have when dealing with roof leak claims.
Properly identifying and investigation other potential issues such as: repairing or tarping a roof, water extraction, dehumidification for mold prevention, structural drying and restoration & repairs may create larger obstacles to the simple apparent cosmetic damage to finishes that an insurance company’s adjuster may just consider. Property owners are also faced with the delicate and emotional toll that damage to personal property such as cloths, furniture, electronics, and items of sentimental value can take on one whose house just got heavily water damaged. Displacement of one’s home in many cases is the biggest loss to someone dealing with a roof leak damage claim. Navigating and understanding the process of a roof leak claim will be overwhelming, the assistance of an experienced and qualified public adjuster can prove to be essential to the policyholder.
Pipe or Plumbing leaks are among the top 10 home and business hazards. These leaks can include:
- Frozen Pipe Burst & Ice Dams
- Drain Pipe Leaks
- Water Pipe Leaks, pipe breaks, burst pipes
- Toilet Overflows
- Tub Overflows
- Water Heater Leaks
- Leaky Appliances
Remember that even the smallest leak can cause mold and other significant personal property damage. Hiring a professional to handle this claim can make the difference between a minimal or adequate settlement to repair your damage due to coverage complications and the public adjuster’s ability to help manage costly dry-out charges.
Water damage from plumbing leaks seldom makes the headlines, but the damages can and often are catastrophic. Garcia Adjustment Corp has been involved in many claims over the years where the entire inside of buildings and homes have been destroyed due to water leaks, many of which are sudden, with others that may occur over time due to absent property owners.
Often compounding a water loss is what is called a “black water loss,” which is one where the water discharged is sewage from the sewer system. Special care needs to be taken in the remediation process if the property is impacted with black water. Cost can and often will be many times more than a normal water remediation job. This type of loss will involve certified hygienists to set the necessary scope protocol as well as do clearance testing once the work is completed.
In both types of water losses the correct drying process is critical to a successful clean up. Carpets need to be pulled and the padding should be replaced. In most water losses it is necessary to remove baseboards and make the necessary cuts to air out wall cavities. In a black water loss it will probably be necessary to remove at least 4 feet of drywall as well as wall insulation so that adequate space is availabile to clean and sanitize the structure.
A disturbing trend is developing in some states with some insurance companies successfully lobbying the insurance regulators to reduce or completely eliminate coverage for water losses. The new trend is for policy language to be written so that if a water loss is over 14 days old the whole loss is not covered. Approval of these forms will have a devastating effect on property owners who own second homes or who travel and are not there to make regular inspections of their property. We now are hearing of a new tests that can detect how long a water loss has occurred by the breakdown of wood products and other materials. Sadly for property owners nothing is being offered for the first 13 days of a water loss. Property owners should pay close attention to any endorsements sent to them regarding water damage coverage.
What Is Mold?
Mold and fungi exist everywhere. The spores they release as part of their reproductive process are claimed to cause illness and injury to humans and destroy property containing cellulose. Wood, paper, and the paper coverings of drywall are all vulnerable to mold. Mold growth can destroy, by slow rot, buildings designed to withstand major earthquakes. As a result, litigation claiming injury due to fungal or mold contamination is a growing industry.
The term “mold” is a layman’s term for microscopic filamentous fungi. Mold is the microscopic version of the mushroom. Mold is everywhere. It is a living thing that is neither animal nor what is usually considered a plant. It grows naturally outdoors. The spores, which molds create to reproduce, are present in the air. When mold moves indoors, it grows rapidly in environments that contain an excessive amount of moisture.
Many molds are benign. Some are wonderful and tasty, like mushrooms and the fungi that convert milk to cheese. Other molds, called mycotoxins, produce toxins that can be harmful to human health. Mycotoxins can be absorbed into the human body through the intestinal lining, airway paths, and skin. Human exposure to mold can be dangerous.
Mycologists have estimated that there are hundreds of thousands of species of mold, each having its own preference for moisture, temperature, and food source. Mold grows on all plants, animal matter, and in soil. Spores are blown about by the wind and are almost always found in indoor and outdoor air. They are a normal component of house dust.
Mold spores are hardened containers sufficient to create new mold creatures. When the spores bump into dry walls, they simply rebound and continue floating. When they bump into wet walls, however, they stick.
The main body of the mold can’t handle everything it absorbs. Much of the nourishment absorbed by the mold is poisonous. To solve this problem, they spray out the excess, releasing it as a gas. At any moment during the day, there will be freshly landed molds on the walls of every home in the country excreting carbon dioxide, hydrogen cyanide, ethanol fumes, various alcohols, and much else.
Concentrations are generally too low to detect (except with special equipment). When the mold levels are high enough to produce this odor, they are likely visible. Enormous colonies of mold will appear as an unpleasant fur-like growth on walls, floors, or ceilings. Even when the density is too low to see, many thousands of separately plugged-in mold individuals exist on a home’s inner walls.
Mold typically grows on organic materials that remain moist for more than 24 hours. Materials exposed to high humidity can become moist enough to support mold growth. Good housekeeping requires, therefore, a reduction in humidity and the drying out of any moisture that might exist in organic compounds that could support mold growth. If proper maintenance is not followed, the volatile organic compounds released by some molds that are toxic and associated with Sick Building Syndrome (SBS) may grow and cause injury.
Molds are extremely hearty living things. They can be anywhere and they are difficult to kill until they grow into colonies large enough to be seen by the human eye.
The Ubiquitous Problem
When mold grows in moist organic materials, building occupants may begin to notice odors and suffer from a variety of health problems associated with mold exposure. Molds produce allergens, irritants, and in some cases, toxins that endanger humans and animals. Some toxic molds such as aspergillus, cladosporium, penicillium, stachybotrys, and trichoderma produce mycotoxins capable of causing severe health problems. Mold spores and fragments can produce allergic reactions in sensitive individuals regardless of whether the mold is dead or alive. Repeated exposure to mold or mold spores may cause previously nonsensitive individuals to become sensitive.
Mold has been documented to weaken people’s immune systems, leading to a variety of infections and problems. People with weak immune systems (i.e., immune-compromised or immune-suppressed individuals) are more vulnerable to infections by molds (as well as more vulnerable than healthy persons to mold toxins). Healthy individuals are usually not vulnerable to opportunistic infections from airborne mold exposure. However, molds can cause common skin diseases, such as athlete’s foot as well as other infections, such as yeast infections.
The National Institute for Occupational Safety and Health (NIOSH) prefers the term “Indoor Air Quality” (IAQ) rather than SBS. If 20 percent of the workforce has symptoms—including watering eyes, hoarseness, headaches, dry itchy skin, dizziness, nausea, heart palpitations, miscarriages, shortness of breath, nosebleeds, chronic fatigue, mental fogginess, tremors, swelling of legs or ankles, and cancer—the building may be labeled a “sick building.” The telling factor is if the symptoms ease when workers are at home or on vacation.
Testing for Mold
Often, the largest expense incurred by insurers faced with mold claims are the fees of experts to test for mold and provide opinions on what is needed to remediate the situation. It is imperative that every claims person faced with a mold claim understand how the sampling is done, and the weight that should be given to the findings.
An expert testing for mold will collect samples for laboratory analysis. These may include: air samples, bulk/surface sampling, dust collection samples, tape lift sample, and wipe or “swab” samples. OSHA recommends that, in most cases, if visible mold growth is present, sampling is unnecessary. Air sampling for mold may not be part of a routine assessment because decisions about appropriate remediation strategies often can be made on the basis of a visual inspection.
The first step in any mold investigation is to inspect for any evidence of water damage and visible mold growth. In many cases, it is not economically practical or useful to test for mold growth on surfaces or for airborne spores in the building. OSHA does not recommend testing because:
There are no standards for acceptable levels of mold in buildings, and the lack of a definitive correlation between exposure levels and health effects makes interpreting the data difficult, if not impossible. [“A Brief Guide to Mold in the Workplace, Safety and Health Information Bulletin,” U.S. Department of Labor, document SHIB 03-10-10 www.osha.gov/dts/shib/shib101003.html].
Consultation with an industrial hygienist or other environmental health or safety professional with experience in microbial investigations should be performed before a decision is made that sampling for mold is necessary or useful, and to identify persons who can conduct any necessary sampling. Sampling results can be used as a guide to determine the extent of an infestation and the effectiveness of the cleanup. Interpretation is best left to the industrial hygienist or other environmental health or safety professional.
In all situations, the underlying cause of water accumulation must be rectified or fungal growth will recur. Any initial water infiltration should be stopped and cleaned immediately. An immediate response (within 24 to 48 hours) and thorough cleanup, drying, and/or removal of water damaged materials will prevent or limit mold growth. If the source of water is elevated humidity, relative humidity should be maintained at levels below 60 percent to inhibit mold growth.
Emphasis should be on ensuring proper repairs of the building infrastructure, so that water damage and moisture buildup does not recur. The work area and areas used by remediation workers for egress should be cleaned with a damp cloth or mop and a detergent solution. OSHA provides detailed instructions on what is necessary for mold remediation.
Every insured, insurer, or their respective adjusters involved in claims regarding injury or damage due to mold or fungal infestations, must thoroughly understand every aspect of the mold claim. Knowledge about mold and mold claims is the only means by which insurers can successfully control covered mold claims or defeat those that are not covered. Knowledge in possession of an insured, a public insurance adjuster, or a plaintiff’s lawyer will allow them to recover of insurance benefits owed to their clients and protect them from adverse decisions of inadequately trained claims personnel. Mold: A Comprehensive Claims Guide is the only available source that covers every aspect of mold claims from governmental regulation to insurance policy interpretation, from claims investigation to litigation. It can be used as the basis for a training program for claims personnel or a resource for litigators pursuing or defending a mold claim. Here at Garcia Adjustment Corp, our expert adjusters can guide you through the claims process and help you recover the maximum amount of money you deserve. Contact us today!
Although the majority of strategies and methodologies in adjusting theft and vandalism damage claim is similar to that of other losses, there are unique aspects of this peril that require special attention and expertise.
Typical questions posed by insurance companies after receiving notice of a theft/vandalism claim are: Did a theft/vandalism actually occur? Did the policyholder actually own or possess the items being claimed stolen, and if so, can proof be provided? What is the value of the item or items being claimed? Was there any related property damage such as broken windows, doors, locks, or equipment related to the theft or vandalism?
With respect to the theft/vandalism event, most are substantiated and supported by official police reports which document the actual event. These reports are used by insurance companies to verify an event happened and also to assist them in future subrogation avenues it may pursue. It is absolutely critical that a police report be filed in claims involving theft and/or vandalism. You should make sure the police report and the report of items being claimed is accurate as to the list of items stolen. Should you discover additional items later be sure to update the police report and tell the insurance company you have filed a supplemental police report.
With respect to ownership and value, insurance companies rely heavily on documentation provided by the policyholder to prove ownership and substantiate value. This documentation could take the form of video, pictures, receipts, credit card statements, appraisals, insurance policy endorsements, etc. Try to provide as much documentation as possible to help substantiate the claim for theft with your insurance company.
In the event no title or ownership documentation can be provided; in the case of larger losses, most insurance companies will invoke their right to an examination of the insured under oath also called EUO. In addition to EUOs, the company may also request financial documentation from the insured to establish a basis of ownership and in some cases, tax returns and support showing a person had the income and lifestyle for the items they claimed were stolen.
In addition to ownership and measurement of loss issues, a very detailed review and evaluation of the insurance policy must be completed. Most policies contain limits or exclusions for certain scope items related to theft/vandalism claims and in many cases, certain items must be scheduled in a policy in order for coverage or higher limits to apply. Often this can be accomplished by what is called an inland marine floater insurance policy. Third party appraisals will be required to schedule items and a limit will be set as to the maximum amount you will be paid in the event of a theft.
A problem we have seen over the years following a loss for an item on a schedule is that the insured will assume they will be paid the dollar limit on the schedule as it was based on an appraisal. This is always true, as an insurance company will often go out in the market and seek a price from companies that have buying power to reduce the estimated replacement price, particularly on jewelry. They will then offer you the money based on lower price or offer to buy it for you. This is true despite the appraisal you had that they accepted and charged you a premium on. Also, appraisals can vary greatly in opinion of a value. So you may want to ask the insurance carrier to give you the name of the company they use or will use if a loss occurs and go to that firm to get your appraisal for the scheduled items.
Although theft/vandalism claims are very common, they can be some of the most complicated and time consuming matters to resolve. Let Garcia Adjustment Corp guide you through the process.
In the event that a building you own collapses unexpectedly, it can feel both literally and figuratively like your world is falling apart. The last thing property owners need during these stressful times is an insurance claim nightmare. Collapse claims unfortunately require extensive expertise and diligence to navigate the ever-changing collapse coverage policies and assess the valuation of total damage.
Call us at (305) 901-2242 today or contact us online for help filing your collapse insurance claim. At Garcia Adjustment Corp, we employ only the most experienced team of public adjusters, property damage appraisers, construction specialists and engineers. Our trusted professionals have years of experience settling even the most complex building collapse insurance claims and will work diligently on your behalf to get you the settlement you deserve so you can focus on getting your life back in order.
Collapse Insurance Coverage Tips
Follow these tips to help keep your building collapse claim on the right track:
- Request a certified copy of your insurance policy immediately
- Understand how your policy defines the term “collapse,” if at all
- Wait to start any rebuilding, restoring or demolition until you have a solid claim strategy in place
- Determine agreed upon facts about the collapse of your building and have your insurance adjuster put them in writing
- Decide if a partial collapse has occurred and if there is any hidden structural damage
- Request that the insurance company provide you with written documentation of their collapse insurance coverage or written denial of the claim if applicable
- Contact a trusted and experienced public insurance adjuster immediately if your insurance company has denied collapse coverage or you suspect that your damage was undervalued
The Complexities of Collapse Insurance Coverage
Building collapses can be caused by a number of factors, including (but not limited to) snow and ice on roofs, shockwaves from explosions, structural problems, soil subsidence, earth movements, improper construction, blasts, gas leaks and more.
Property insurance policies typically cover some types of building collapses, but not all. Insurance companies today frequently restrict collapse coverage by redefining the term “collapse” and limiting their exposure. Furthermore, because building and structure repairs after collapse tend to be costly, insurance companies commonly deny coverage for these collapse claims. That’s why it’s in your best interest to be proactive and contact a trusted and experienced public adjuster for a consultation about any claim involving a structure or building collapse of any kind.
When to Get Help with a Building Collapse Insurance Claim
Almost any insurance claim process can be difficult to navigate on your own, especially when you’re bogged down with the concerns of how to get your life back in order. While most people could benefit from the services of a claim professional, it’s imperative you at least consult with an experienced public adjuster if any of the following situations apply:
- Your insurance claim has been delayed by more than 30 days
- Your insurance claim has been denied altogether
- You have received a Reservation of Rights letter from your insurance company
- You’ve been required to submit a Proof of Loss form
Our Claim Adjusters Are Here to Help
As a policyholder, you have rights and options you should be aware of, even in the event of your insurance company denying your claim.
Our claim adjusters, property loss appraisers and construction experts are experienced when it comes to cutting through the red tape of insurance companies to find you answers and settlements you deserve. In fact, we boast a 100 percent success rate when it comes to winning larger settlements for people just like you. It’s that simple. Contact us today to get started.
According to the Florida Department of Environmental Protection, the state of Florida is experiencing more sinkholes than any other state in the nation. However, sinkholes are not a new phenomenon and can certainly occur at any time, in many different locations.
Some geological experts attribute the increase to urban expansion, including developers pumping more water out of the ground for new projects or for agricultural use. States are responding by enacting statutes requiring every insurer authorized to sell property insurance in the state to also provide coverage for catastrophic ground cover collapse. See Florida Statute 627.706. Additionally, all insurers licensed to do business in Florida must offer sinkhole coverage, usually as an endorsement to an existing policy, often for an additional premium charge.
Scope of Sinkhole Losses and Coverage
In the event of a sinkhole, it is critical that policyholders assess as quickly as possible the extent of their losses and the scope of coverage available to cover those losses. Insurers will request detailed proof of the loss claimed under the policy and documented evidence of the expenses incurred in responding to that loss. Policyholders must fully understand the scope of coverage afforded by their policies to maximize the potential for recovering all covered losses.
Businesses and home owners may consider purchasing sinkhole coverage because Florida law, for example, defines sinkhole damage differently from catastrophic ground cover collapse. Florida law defines a sinkhole as “a landform created by subsidence of soil, sediment, or rock as underlying strata are dissolved by groundwater. A sinkhole may form by collapse into subterranean voids created by dissolution of limestone or dolostone or by subsidence as these strata are dissolved.” See Florida Statute 627.706. Florida law defines “catastrophic ground cover collapse” as geological activity that results in all the following:
- The abrupt collapse of the ground cover;
- A depression in the ground cover clearly visible to the naked eye;
- Structural damage to the building, including the foundation; and
- The insured structure being condemned and ordered to be vacated by the governmental agency authorized by law to issue such an order for that structure.
See Florida Statute 627.706. Chapter 627 of the Florida Statutes also states: “Contents coverage applies if there is a loss resulting from a catastrophic ground cover collapse. Structural damage consisting merely of the settling or cracking of a foundation, structure, or building does not constitute a loss resulting from a catastrophic ground cover collapse.” See Florida Statute 627.706.
Businesses are well advised to carefully review their property policy to determine if, and to what extent, insurance will protect against sinkhole losses. Property policies frequently contain sublimits and deductibles that apply differently depending on the covered peril causing the policyholder’s losses. Just last month, the Florida First District Court of Appeal upheld a decision by state insurance regulators rejecting Farm Bureau Financial Services’ attempt to amend its sinkhole coverage endorsement that would limit sinkhole loss coverage to 25 percent of the overall coverage amount.
Policy Conditions and Requirements
Policyholders should be wary of their policies’ potential time traps. For example, a policy may obligate the policyholder to provide the insurer with notice of a loss “as soon as possible” or “as soon as practicable” after a loss or other insured event. Some policies require that notice be given in as little as 30 or 60 days. Failure to give prompt notice has different consequences for the policyholder, depending on the type of policy and the jurisdiction, and may even completely bar a policyholder’s claim.
Additional Coverages, Including Business Interruption and Extra Expense
In addition to covering property damage, many property policies also provide some or all of the following coverages designed to recover non-property sinkhole-related losses. These are discussed below.
This coverage frequently reimburses the policyholder for the loss in profits that the policyholder would have earned but for the interruption to its business. Business interruption coverage sometimes, but not always, requires that “interruption” result from damage to covered real or personal property. Policyholders, for example, have obtained reimbursement under such coverage when widespread disasters such as Hurricane Katrina and the September 11 terrorist attacks caused business interruption. Business interruption coverage provisions typically apply even when a policyholder is forced to relocate in order to maintain business operations or to minimize its overall loss. Most business interruption policies limit business interruption losses to the time required to complete repairs with “due diligence and dispatch.” Determining the time to complete repairs after a significant sinkhole loss could be challenging.
This provides coverage for losses that the policyholder incurs from interruption of utility services that result from physical damage to the property that supplies the utility. Property policies frequently provide this coverage, although they may require that the interruption of service last a minimum amount of time. The coverage may be subject to separate and lower limits of insurance than other business interruption coverages. Service interruption coverage can vary widely with regard to what types of utilities are covered. Depending on the specific service interruption coverage purchased, it may apply to several services, including water, communications, and power supply. With no electricity, for example, there may be—like many in New York, New Jersey, and Connecticut experienced after Superstorm Sandy—a massive gas shortage (even if stations had gas, with no power they could not pump it), meaning that goods and services cannot get delivered and employees cannot get to work.
This coverage protects the policyholder from losses caused by the inability to access its premises when a civil authority denies such access because of covered damage to, or destruction of, property belonging to third parties. Some civil authority coverages require physical damage to the policyholder’s own premises; others do not. A “civil authority” for purposes of this coverage may extend beyond federal and state governments. For example, after the September 11 terrorist attacks, some policyholders successfully argued that the baseball commissioner’s cancellation of games constituted an order of a civil authority.
Similar to civil authority coverage, ingress/egress coverage may be available when access to (“ingress”) or from (“egress”) an insured’s premises has been prevented or made more difficult because of sinkholes. Unlike civil authority coverage, no governmental act is required to trigger this coverage. Many policies cover losses when “ingress” to or “egress” from insured premises is “prevented” because of a covered peril. In the aftermath of sinkholes, many businesses may be unable to operate because employees cannot get to work if roads are closed or otherwise blocked. The availability of ingress/egress coverage varies greatly from policy to policy. Frequently, a policy will cover the loss sustained by an insured “due to the necessary interruption of the Insured’s business due to prevention of ingress to or egress from the Insured’s property, whether or not the premises or property of the Insured shall have been damaged” if the interruption resulted from damage of a type insured against by the policy.
Contingent Business Interruption
Typically, this covers two types of business interruption. First, it protects against economic losses caused by a “direct” supplier’s inability to get its goods to the insured due to damage to, or destruction of, the supplier’s property by an insured peril. Second, it protects against economic losses caused by damage to or destruction of a customer’s property that prevents the customer from accepting the insured’s products. Accordingly, businesses located nowhere near a sinkhole may still suffer insured losses.
This coverage indemnifies the insured for reasonable and necessary extra or increased costs of business operations above the norm because of a peril insured against. It may include coverage for, among other things, costs incurred for the insured to temporarily continue business operations “as normal as practicable,” such as the temporary use of the property or facilities of others.
Maximizing Insurance Recovery
Pursuing an insurance claim following a sinkhole loss may be a complex and challenging process. Even sophisticated businesses unknowingly commit errors in assessing, documenting, and quantifying their losses or interpreting their insurance policies that later limit or even bar potential insurance recovery. Policyholders should carefully review their coverages, comply with all policy conditions, and strategically approach their insurance claims to maximize coverage and avoid pitfalls. At Garcia Adjustment Corp , our experts can help you every step of the way. Contact us today!
Summer is the time of the year when lightning can cause severe damage or even destroy your property. No surprises to folks in Florida, as they know we are widely regarded as the lightning capital of the U.S. The raising heat over the Florida peninsula pulling in the cooler sea breeze later in the day often creates spectacular lightning shows followed by out of this world thunder claps.
The results of these storms can be manifested in two ways, both bad. The first is life, health, and safety issues (See Lightning Season in Florida Proving Deadly) and the other is property damage resulting from lighting strikes that cause fires to buildings and destroy personal and business property. The insurance claims that follow can get quite complicated.
Now turning to some insurance claims tips following a lightning strike, the manifestation can take two forms. The first is a fire, which is fairly straightforward as to the cause and the damage. If a fire burns the home or commercial building, it does not matter that lightning caused the fire. The loss will be treated as a fire loss with the adjusting protocols that come into play with that peril. However, if some part of the home or business is saved and not impacted by the fire, smoke or water, there may well be issues of damages to personal property albeit commercial or residential that needs to be looked at and experts consulted. As an example, lightning may have traveled throughout the building via the wiring system, damaging or destroying electronic items like computers, entertainment centers, and other electronics and appliances.
With no visible smoke, fire or water damage, the insurance company adjuster may try to pass on paying you for the replacement of these items by offering a cheap cleaning. Our advice is beware, once a high charge of current passes through an electronic item, it most likely will have either fried the circuit board or weakened the system. Complete failure is likely to occur in a short period of time. And remember, if an item is under warranty and the manufacture or service provider finds out about a lighting loss that will be the end of the warranty.
Another type of lightning loss that may not be as dramatic as a fire is a loss that results due to a lightning strike close by a home or building that results in electrical current passing through the property’s electrical wiring. In fact, property owners may not even know about the damage until they discover something doesn’t work or it works in an intermittent way. If this occurs, immediately disconnect whatever is not working and call an electrical expert to inspect the property. These types of losses can be very problematic as there may not be visible signs of the lightning strike and many uninformed adjusters may try and pass this off as a power surge or a defective product or appliance. Even if accepted as damaged by a surge caused by lightning, often the carrier will offer to pay for some minor repair but with no guarantee. If the insurance company or its preferred repair vendor will not stand behind the work they are offering, then you know what the likely outcome will be a few months later after the insurance company has closed their file. If you get no guarantee or warranties to repair lightning damaged items, demand a replacement.
Finally, if your insurance company has questions about lightning hitting your property causing the damages you are claiming, ask a third party expert to inspect the items and ask them to sign an affidavit attesting that lighting caused the damage. You might also ask them to give their opinion on the likely success of a repair and if they would instead recommend replacement. Lighting affidavits have been around for years and a good insurance company will accept them, as they are a sworn notarized statement by a service provider attesting to his or her findings.
Remember, if your insurance company says the items are repairable and still have some value or life expectancy, tell them to take the item as salvage. You will be surprised what a professional salvage company will say about that. No insurance company adjuster I know of is an expert on assessing lightning damage repairs to complex electrical components. This is an expert driven function. So be prepared to have your own team in place to make sure you are fully paid for your lighting loss. Contact us so we can help you through the process and get you the money you deserve.
A/C leaks and damages
Water damage originating from an ac leak or other HVAC systems is a far too common occurrence for homeowners. In southern regions of the US, 67% of homes have their air conditioning running all summer long. Air conditioner leaks can arise from many sources such as: cracked or rusted drain pans, broken condensation pumps, disconnected drain lines, frozen evaporator coils and in most cases clogged drain line. Identifying the source or cause of the ac leak is not always simple and can mean that contacting an A/C technician is the next step to take.
Unfortunately, water damage arising from an ac leak may not only stay contained to the boundaries of where the air handler is located. Many adjacent areas may become affected. We find that water travels in the path of least resistance, as a result water leaks will channel and travel into: dining rooms, living rooms, closets, bedrooms, hallways and even bathrooms that may be “back to back” sharing the same wall.
Identifying & investigating potential issues
The effects of a residential air conditioning water loss can leave homeowners and other property owners with the burden of facing extremely difficult and complex decisions. Issues related to property damage to materials such as: baseboards, ceilings, walls & drywall, flooring, insulation, and other interior finishes are just some of the many concerns one should have when dealing with air conditioner leak insurance claims.
Properly identifying and investigation other potential issues such as ac leak detection, replacement of HVAC components & systems, water extraction, dehumidification, structural drying and restoration & repairs may create larger obstacles to the simple apparent cosmetic damage to finishes that an insurance company’s adjuster may just consider. Property owners are also faced with the delicate and emotional toll that damage to personal property such as cloths, furniture, electronics, and items of sentimental value can take on one whose house just got heavily water damaged.
Initial documentation of your A/C leak damage claim
The initial documentation of your A/C water damaged property is imperative in providing the evidence needed to create an initial presentation to your insurance company. Contacting an A/C tech or other qualified contractor to diagnose, document and provide you with a written opinion is imperative. Taking photos and videos with your smartphone or any other device will help solidify your claim and show important documentation of damaged property that may not be obtainable at a later time. Contacting an insurance claim professional such as a public adjuster is beneficial in the documentation of damaged property at the early stages of an insurance claim.
We find that homeowners and other policyholders at times fail to understand and identify the nature and extent of their damage. Our adjusters have the experience and trained eye that allows us to immediately understand the scope of repairs with clarity. Garcia Adjustment Corp will advise that the property be tested for levels of category water and possible mold growth that may be present yet unseen to the naked eye. It is imperative that such issues be immediately addressed and identified at the early stages of presenting an A/C leak water damage insurance claim.
Heater leaks and damages
When a heater leaks, it occurs 69% of the time through a slow leakage or a sudden burst. If your water heater is nearing the 20 year old mark, there is actually a 95% chance that it will eventually leak or burst. Studies have found that placement of the water heater in the home can have a significant increase or decrease in the risk of costly water damage repairs. For example, a water heater that is placed in a garage or basement, will have less of a water damage impact to the home rather than being placed in the first floor or other livable floors of the home. When a water heater eventually corrodes and begins leak or burst, gallons and gallons of water are being discharged throughout.
Issues related to property damage of items such as baseboards, drywall, flooring, insulation, cabinets, and other interior finishes are just some of the many concerns one should have when dealing with water heater leak claims. Properly identifying and investigation other potential issues such as immediately removing the water heater, water extraction, dehumidification, structural drying and restoration & repairs may create larger obstacles. Property owners are also faced with the delicate and emotional toll that damage to personal property such as cloths, furniture, electronics, and items of sentimental value can take on one whose house just got heavily water damaged. Displacement of one’s home in many cases is the biggest loss to someone dealing with a major water heater leak damage claim. Navigating and understanding the process of a water heater leak claim will be overwhelming, the assistance of an experienced and qualified public adjuster can prove to be essential to the policyholder.
Tips for residential policyholders after water heater damage
- Ensure that your home is safe for entry
- Shut the water supply off as soon as possible
- Attempt to drain the water heater or call a plumber immediately
- Take initial photos and a list of damaged property (Interior & Exterior of building)
- Locate your property insurance policy (hardcopy & PDF if possible)
- Immediately take steps to prevent further damage
- Contact Garcia Adjustment Corp for a FREE CONSULTATION!
- Provide prompt notice of loss to your insurance company
- Develop a plan and claim management strategy with your public adjuster
You assume and expect your insurance company to fully protect you when a loss occurs. Whether it’s your home or business, you are exposed to loss from flood, storms, fire, wind, lightning, sinkholes and other natural disasters as well as theft or vandalism. Disputes over an insurance claim are very common and insurance companies routinely deny, underpay and delay claims but it’s still shocking to receive a denial letter or find out the insurance company has undervalued your claim.
Find Out Why Your Insurance Claim Was Denied
The formal letter from the adjuster should specify exactly why the claim was denied. It should state the results of their investigation, what section of the policy backs up the denial, and how to contact them if you have any additional facts you would like considered. It could be that the policy language was misinterpreted or misapplied, the adjuster did not have access to enough evidence, or that there was a filing error. When in doubt, ask for clarification from the adjuster. If there was no formal notification, reach out to the adjuster and request it. The insurance company is required to provide the reason for the denial within 90 days of the date of loss.
Know Your Insurance Policy and Rights
Read your homeowners insurance policy carefully, as it’s important that you understand your coverage. There are many common reasons for insurance claim denials, including failure to pay your premiums, delay in reporting, exclusions in your insurance policy, or insufficient documentation to verify the damage.
Gather Information and Details About Your Claim
It is important to keep documentation of all conversations, information provided, copies of paperwork, as well as copies of any photos or video evidence. This may include:
- Documentation about the facts of the original incident, including dates, times, parties involved, and steps you may have used to prevent the incident or protect your property
- Document all phone calls to your insurance company and keep all letters received and sent
- Photos or videos of the damage, the incident, or the aftermath
- Statements from witnesses
Being prepared will help you improve your chances to be provided with coverage for your loss.
Our experienced and knowledgeable Public Adjusters are prepared to help you get to the bottom of why your claim was underpaid, unpaid or denied and fight the insurance company to get you the money you deserve.
Garcia Adjustment Corp covers a wide range of insurance claim types. If you do not see your insurance claim type listed on this page, we most likely can still provide you with the help you need. Please contact us and let us help you get paid the money you deserve. Keep in mind, we get paid when YOU get paid!