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Insurance policies are binding contracts. Each party to the contract bears the responsibility of following all of the contract terms. The failure by you, the insured, to follow all of your obligations under the contract will allow the insurance company to avoid having to pay your claim. Insurance companies make money by taking your premium and then finding ways to avoid covering you. Do not let this happen to you.  The Miami homeowners insurance lawyers at Greenberg, Stone, & Urbano want to make sure their clients understand that they must follow the rules set out in the insurance policy and will work diligently with them to make sure they receive the coverage due.

Our homeowners insurance lawyers have seen cases where the insurance company tries to deny payment to their insured by arguing that the insured did not do what they agreed to do under the insurance policy.  Take, for instance, the case of Goldman v. State Farm. The Goldmans were insured by State Farm against theft from their home. Unfortunately, someone burglarized the Goldman’s home. The Goldmans filed a claim with their insurer for the amount stolen. They even submitted sworn affidavits setting out what property was taken and the value of it.

State Farm began investigating the claim as part of their due diligence. Part of their investigation involved taking the Goldmans’ examinations under oath and produce certain documents.  The Goldmans’ attorney asked to postpone the examinations, and they never refused to submit to them. On the other hand, the Goldmans sued State Farm for refusing to pay their claim. State Farm declined to pay their claim on the basis that they did not follow the appropriate procedures spelled out by the insurance policy before they sued State Farm. State Farm did not outright deny the claim either. They objected to payment because the Goldmans did not allow State Farm to complete its investigation. Continue reading →

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Many people in Florida run businesses out of their homes. With the proliferation of Internet accessibility and e-commerce driving a significant portion of our economy, scores of at-home businesses come into being every day. Other work-from-home businesses such as childcare are also prominent. The home-based business owner must beware that your homeowner’s policy contain various exclusions, one of which is a clause excluding coverage for people who operate a business out of their home. The prohibition comes into effect when a third party suffers injuries while by the homeowner, or someone covered under their policy, during the business-based activities. The homeowners insurance attorneys at Greenberg, Stone, & Urbano want people to understand that their homeowner’s insurance policy might exclude coverage for injuries that occur during business conducted in the home.

As Miami’s preeminent homeowner’s insurance attorneys we have seen insurance companies try to deny extending coverage to incidents that happen in the home. Take the case of Landis v. Allstate Ins. Co. While this instance might be factually different than most we see, the principle of law announced in the court’s decision is an important one. Any person considering running a business from their home should consider this ruling in determining whether their homeowner’s policy provides sufficient insurance coverage. Continue reading →

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June 1 to November 30 is hurricane season in the Atlantic Ocean. While 2016 has been relatively quiet up to his point, there’s still plenty of time for things to change. One storm has the power to devastate entire communities. While Hurricane Matthew churns up the islands in the Atlantic, South Floridians anxiously wait for the storm to determine its path. The storm struck Haiti with fury. Matthew delivered a punch of 145 miles per hour winds and somewhere between 20 and 40 inches of rain. While landfall might take some of the steam out of Matthew, the storm can build up its strength as it crosses over Cuba, westward toward Florida and the eastern seaboard of the United States. Greenberg, Stone, & Urbano is one of Miami’s top law firms according to the Miami Herald. Their homeowners’ insurance claims attorneys will help you with problems involving your homeowner’s insurance policy.

Forecasters are calling Matthew a storm similar to 1999’s Hurricane Floyd. Floyd skirted Florida’s east coast, causing damage along the way before finally striking land in North Carolina.  As of the time of this writing, meteorologists have not determined Matthew’s path. Matthew could hit Florida head-on or skirt past like Floyd. Either way, Floridians might suffer hurricane-related property damage. What happens to homeowners’ policies if Matthew invades Florida? Continue reading →

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Florida law obligates a homeowner’s insurer to notify a claimant of the claimant’s various rights and the insurance company’s obligations in writing. The insurance company must send these rights to the insured within 14 days from the day the insured gives notice of a claim. The rights are not subject to change unless the legislature or court decides to alter them. They are very important. Homeowners should familiarize themselves with their rights. Knowing what they are entitled to will make sure the insurance companies deal with homeowners fairly and honestly. If you any questions about your homeowner’s insurance policy, contact the Miami homeowners insurance lawyers from Greenberg, Stone, & Urbano.

While the Homeowner Claim Bill of Rights is critically important, it is neither an exhaustive list of the homeowner’s rights nor obligations of the insurance company. The Bill of Rights does not set forth independent grounds on which to sue an insurance company.  Violations of these rights might give rise to a claim of bad faith on the part of the insurance company in rare circumstances. However, Florida’s insurance regulators need to know if insurance companies are violating homeowners’ rights granted by the Bill.

The rights listed in the statute, if followed, give the insured a timeline of events and related obligations of the insurance company. Remember, your insurance company has the duty to advise you in writing. The rights you have as a homeowner when you file a claim are: Continue reading →

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Nik Sackstein was a senior citizen and longtime homeowner who experienced significant damage to his home when monsoon intensity rains came flowing through his roof and damaged the interior walls of his home.  However, the senior who faithfully paid premiums for years was not concerned because he had homeowner’s insurance through Farmers Insurance.  When Mr. Sackstein submitted his claim, the insurer sent out an adjuster who predictably went up on the roof to investigate the damage.

Property Damage Claims Lawyers Discuss Relationship between Maintenance and Coverage of Claims

However, Mr. Sackstein told a CBS News affiliate that the situation went sideways as soon as the adjuster climbed down from the roof of the house.  The adjuster informed the befuddled homeowner that the roof tiles were all intact, so the damage to the interior of the home must have been caused by leaks resulting from lack of maintenance.  According to the adjuster, pine needles and leaves that had dropped from trees onto the roof worked like a dam causing water to pool on the roof.  Although Mr. Sackstein was able to go up on the roof and easily sweep away the debris, the damage had been done.  His claim was denied because of his alleged failure to perform five minutes of virtually effortless maintenance. Continue reading →

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Most insurance policies include conditions precedent that must be performed for an insured to receive benefits under the policy.  Many policies contain these conditions, including homeowner’s policies. The term “condition precedent” refers to required acts or omissions to be performed by the insured before the insurance carrier has a duty to pay benefits under the policy.  Common examples include the duty to notify the carrier of a loss in a timely fashion and to provide a sworn proof of loss.  Our Florida insurance damage attorneys recently noted a decision by the Florida 2nd District Court of Appeals, Tower Hill Select Insurance Company v. McKee.  Our Miami homeowner’s claims lawyers offer this decision as an example of the importance of understanding these conditions and fulfilling their terms.

South Florida Insurance Claims Lawyers Note Performance of Conditions Impacts Deadlines to Perform

The insured filed a claim with his homeowner’s carrier related to property damage allegedly caused by sinkhole activity.  The insurer retained an engineer who (predictably) concluded that sinkhole activity did not cause the damage to the property.  Based on the engineer’s opinion, the carrier denied coverage for the claim under the policy.  The insured also retained an engineer who determined that sinkhole activity caused the damage to the home.  After the insured’s expert’s submitted his report to the insurance company, the carrier denied coverage.  The insured filed a lawsuit for breach of contract.  The trial court granted summary judgment to the homeowner for $181,317, which included $22,429 in prejudgment interest. Continue reading →

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Homeowners benefit greatly from the right to summon a water mitigation company to remove water from their home after a severe storm without waiting for their insurance company to adjust and pay the claim.  However, the right of an insured to assign post-loss benefits to a loss mitigation contractor is being hotly contested by Florida insurance companies.  Insurers presume that taking on an individual homeowner in an insurance claims dispute presents less of a challenge than taking on a water mitigation company.

Fortunately, a fair number of decisions have favored the right of policyholders to assign their right to proceeds under their policy to obtain services to remedy water damage.  A recent decision from the Florida 2nd District Court of Appeals (2nd DCA) continues this trend, affirming the ability of homeowners to use this effective approach for prompt remediation of water damage.  While our property damage attorneys discuss a single case in this blog post, many other Florida appellate court decisions also have affirmed the right of policyholders to assign post-loss benefits without the consent of the policyholder’s insurance company.

In Bioscience West, Inc. v. Gulfstream Property and Casualty Insurance Co., the insured experienced water damage to her home and hired a water mitigation contractor to perform “emergency water removal and construction services.”  The insured executed a document with the heading “Assignment of Insurance Benefits.”  The document provided as follows: “I hereby assign any and all insurance rights, benefits, and proceeds, pertaining to services …. I hereby authorize direct payment of any benefits or proceeds to my property… as consideration for any repairs ….” Continue reading →

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Many homeowners pursue insurance claims for damage to their home on their own but the technical requirements of pursuing a claim and taking advantage of legal remedies can make this a costly decision.  Florida insurance law involves many hypertechnical procedural and administrative requirements that can derail a valid claim.  These procedural hurdles frequently are compounded by technical minutia inserted into insurance policies that homeowners do not notice as their eyes glaze over while reading page after page of complex legal terminology.  These complex procedural requirements might even be subject to their own timing requirements, which mean that a claim might be denied because the insured’s attempts to satisfy technical requirements are considered untimely.

Miami Homeowner’s Insurance Disputes Attorneys Analyze Timing and Notice Issues

The Florida Fourth District Court of Appeals decision, State Farm Florida Insurance v. Lime Bay Condominium, Inc., provides an example of the importance of timely compliance with the notice requirement associated with the appraisal process.  The insured submitted a claim for replacement of the roof of a condominium complex after damage caused by a hurricane.  The insured submitted an estimate for repair of about $1.5 million.  State Farm conducted several inspections and concluded that the roof needed repair rather than replacement.  The insurer tendered $6,940 to the insured to cover the repairs in September 2006. Continue reading →

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Our Florida homeowner’s insurance attorneys know that there are many procedural and evidentiary issues that make the process of pursuing a legal claim complicated when an insurance carrier denies your claim.  While the law provides remedies and legal venues to pursue your rights, the path to obtaining benefits under a homeowner’s policy can be convoluted and complicated.  One issue that homeowners will have to understand and navigate effectively if they pursue a lawsuit for breach of contract against their insurer is the nature of the shifting burden of proof in a lawsuit involving an insurance claims dispute.  A recent case decided by the Florida Second District Court of Appeals provides an overview of this shifting burden under an “all-risk” homeowner’s policy.

Miami Homeowner’s Property Damage Lawyers Explain the Relative Roles of the Homeowner and Insurance Company in Proving Their Claim Under the Policy

In Citizens Property Insurance Corporation v. Salkey, policyholders filed a sinkhole claim with Citizens.  Under the insureds’ all-risk policy, the property was covered for all perils unless they were expressly excluded.  While the policy specifically excluded sinkhole damage, it also contained an endorsement for “direct physical loss” resulting from sinkhole activity.  The policyholders filed a lawsuit for breach of contract after their sinkhole claim was denied.  The jury reached a verdict for the policyholders of $542,883, and the insurance carrier appealed the judgment. Continue reading →

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Our homeowner’s insurance lawyers understand that the language in a policy often can be difficult to interpret especially in the context of other provisions of the policy.  Ambiguity in a policy generally will be construed to provide coverage when the language is susceptible to conflicting interpretations both authorizing and negating coverage.  However, this rule must be understood in terms of the distinction between latent and patent ambiguity.  Patent ambiguity refers to provisions or terms that are conflicting or unclear in the policy itself.  Because the insurance company drafts the policy, such ambiguities will be construed against the carrier.  Latent ambiguities involve situations where the policy is clear when considered on the policy’s face, but unanticipated facts emerge that render the policy unclear under the specific circumstances.

Experienced Florida Insurance Attorneys Can Exploit Policy Ambiguities

The Florida Second District Court of Appeals in Price v. Castle Key Indemnity Company considered this distinction in reversing summary judgment against an insured.  The court considered whether a loss caused by 195,000 gallons of water over a prolonged period would be considered “seepage.”  The parties to a homeowner’s policy agreed that the massive water loss was caused by a leaking pipe in an upstairs bathroom during an extended absence of the policyholder.  The policy covered “sudden and accidental physical loss to property” subject to the following exclusion: Continue reading →

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