Suppose some shingles on a roof are damaged, but not all. Does a policyholder get a hideous looking checkerboard roof which affects the value of the structure and possibly the neighborhood? If part of a carpet is damaged, is it patched leaving a new part slightly different looking in the middle of a room? Many of these issues never arise because many insurance companies pay to match, trying to maintain a happy customer. Some pay for only the damaged amount, and end up fighting with their customers.

Florida has a statutory answer to many of these issues:

"§ 626.9744. Claim settlement practices relating to property insurance

Unless otherwise provided by the policy, when a homeowner’s insurance policy provides for the adjustment and settlement of first-party losses based on repair or replacement cost, the following requirements apply:

(1) When a loss requires repair or replacement of an item or part, any physical damage incurred in making such repair or replacement which is covered and not otherwise excluded by the policy shall be included in the loss to the extent of any applicable limits. The insured may not be required to pay for betterment required by ordinance or code except for the applicable deductible, unless specifically excluded or limited by the policy.

(2) When a loss requires replacement of items and the replaced items do not match in quality, color, or size, the insurer shall make reasonable repairs or replacement of items in adjoining areas. In determining the extent of the repairs or replacement of items in adjoining areas, the insurer may consider the cost of repairing or replacing the undamaged portions of the property, the degree of uniformity that can be achieved without such cost, the remaining useful life of the undamaged portion, and other relevant factors.

(3) This section shall not be construed to make the insurer a warrantor of the repairs made pursuant to this section.

(4) Nothing in this section shall be construed to authorize or preclude enforcement of policy provisions relating to settlement disputes." 

For Florida policyholders, if the policy calls for replacement cost and the loss occurred after October 1, 2005, it is important to know that Fla. Stat. § 627.7011 prevents an insurer from attempting to depreciate the undamaged portion of the structure that needs to be replaced due to matching:

 "(3) In the event of a loss for which a dwelling or personal property is insured on the basis of replacement costs, the insurer shall pay the replacement cost without reservation or holdback of any depreciation in value, whether or not the insured replaces or repairs the dwelling or property."

Very few states spell it out as clearly as Florida, where, because of these laws, disputes over matching rarely occur.

  • catadjuster911

    Disputes in Texas over matching items is occurring with Ike Claims.

    I have one case in which State Farm is replacing only 2 sheets (8×4) of paneling in a bedroom of home where the paneling has been there for over 20 years. I have another case in which TWIA is replacing ceramic tile in the family room but not the breakfast area or the foyer even though the floor is continuous to both areas, this tile is over 30 years old. In each of these cases neither party can find these items available.

  • Cat Adjuster,

    Unfortunately, we have heard more adjustment complaints regarding matching from policyholders and public adjusters in Texas than anywhere.

    I am not certain exactly why. Indeed, some companies are not consistent with this issue.

    My initial impression is some in the insurance industry teach some adjusters to rely on Texas case law I cited in last week’s post concerning Texas causation issues rather than following what most in the industry do when confronted with matching situations.

    And, some insurance companies with some very good claims departments will go out of their way on this matching issue to make certain the policyholder is fully indemnified. Generally, those companies are Chubb, Firemans Fund, and Amica with respect to residential losses.

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  • Mike Rump

    Hey Chip

    Back on 5/17/09, Cat adjuster posted a comment regarding matching of aged paneling and tile floors. You advised that maybe the adjusters were relying on Texas Case Law regarding causation. In my experience, the adjusters and appraisers I am dealing with in Texas simply don’t feel they owe for match. For instance, I am dealing with an adjuster who agrees that the siding on this Galveston Home was discontinued in the 1930’s and is obviously unavailable and can not be matched. He agrees to replacement of the two damaged sides, but insists the carrier does not owe for match of the two remaining sides.

    I have argued that failure to replace all 4 sides will not completely indemnify the Insured. He is not moving at all. I have not found any case law or statutes dealing directly with this issue.

    Any thoughts??

  • REJackson
  • Chip Merlin

    REJackson,

    Off the top of my head, I do not know if there is or if there is not.

    If you have a specific case, I suggest you get a legal opinion because there is probably some value to the issue.

    There will be quite a few experts at the first party claims conference in October which I suggest you may want to attend as well if you are a professional adjuster.

  • Tere Strickland

    My roof was damaged by hail but only on the front half. The insurance co. agreed to pay for 60% of the roof replacement. Is this legal?

    The entire roof had to be replaced, of course.

    Thanks for any info concerning this.

    I am in Chattahoochee, Florida.

  • kim Snay

    My mother died in February 2015. Me and my siblings live out of state. We hired some people to remove furniture, others to replace carpet and windows replaced. The condo association said that sometime after the move they noticed a drain pipe had been damaged and said that we were responsible. Is that true?

  • Bob

    Are excess & surplus lines insurance companies required to follow “matching” statues in FL?

  • Jody

    Due to hurricane Irma two trees fell on the rear portion of our home. We are just under 25% damage. The home was built in 1999 so the present tiles are obsolete . The insurance company says they will only repair the roof not replace. But we can not match the tile. What are our options ?

    • as noted above, you can request a mediation of the claim. no cost to you, except your time, and it is not binding. you may be able to convince the carrier to do the right thing (the 25% statute or rule has to do with REPAIRS, not DAMAGE – and repairs are typically required to areas larger than just the damage itself, especially if MATCHING is an issue), but in my experience, it is more likely that you will need to hire a professional to represent you.

  • Jody

    due to hurricane Irma two trees fell on the rear portion of our roof. The home was built in 1999 leaving the tile obsolete. We are just shy of 25% damages.
    Is there a statue for Florida requiring insurance companies to replace the roof?

  • Ericka

    What if im renting a unit and the ceilings fall in my living room and the landlord blames me but the roof never got anything done to it since 1993