Contrary to what the insurance companies want you to believe, in Florida, the insurance carrier has the burden to prove that your damages are excluded under the insurance policy.
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Squirrels Damage Your Home—Coverage or Not?
A number of media outlets, including a news broadcast, reported on Mercury Insurance Company denying its Atlanta customers’ claims caused by squirrel damage because the policy it sells excludes damage caused by “rodents.” Mercury Insurance reasoned that since “squirrels” are “rodents” and damage caused by “rodents” are excluded from coverage, the squirrel damage is not covered.
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Does the Presence of Furniture In My House Satisfy My Insurance Policy’s Occupancy Requirement?
Homeowner insurance policies often contain exclusions disclaiming coverage for certain losses if an insured residence is unoccupied. These exclusions are designed to prevent extensive damage from accidents that might otherwise be avoided with early detection or simple preventative measures, as an unoccupied house presents a risk that damage will go unnoticed for some time.
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Although Many Policies Exclude Sewer Line Backups from Coverage, What Is A Government Entity’s Liability Under Inverse Condemnation?
Most homeowners are surprised to learn that almost all homeowners’ policies include exclusions for damage caused by sewage water originating outside their home. For example, if your city or county’s sewer main line backs up because of tree roots or debris and the sewage water backs up into your home, the resulting damage will not be covered, or if it is, may be subject to significant limits—often covering only $5,000 or $10,000 of damage. Given the scope of cleaning required in these events, this amount will likely not cover even the costs to clean up the sewage. What’s more, some policies even exclude backups on the homeowner’s own lateral lines. Insurers may offer policy endorsements for coverage at an additional cost, but as many homeowners shop based on price alone, they may not realize they lack the coverage until it is too late.
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Arson of Vacant House: Covered Fire Loss or Excluded Vandalism?
In a recent case,1 a federal appeals court addressed the issue of whether fire damage to a vacant dwelling from an arsonist was considered distinct from vandalism, so as to not implicate an exclusion within a homeowners insurance policy. In that case, Wells Fargo Bank owned an insurance policy on an abandoned house that an arsonist set ablaze. The insured sued its insurer after the insurer refused to indemnify the insured for the loss, relying on a policy provision exclusion for damage caused by “vandalism or malicious mischief” after the property had been vacant for more than thirty consecutive days.
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Feral Felines Are Focus of Appellate Court’s Findings on Fracas Over Domestic Animal Exclusion
A few days ago, a family member called to ask me if I was interested in adopting a stray kitten. Hmmm… I had to think about this offer. I have “owned” cats over the years. But cats are quirky. Perhaps that is why memes and videos of domestic cats make up some of the most viewed content on the internet.
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The New Water Damage Limitation and Other Non-Traditional Coverage Gaps
Public adjuster Guy Cohen and I discussed various issues of property insurance and adjustment at a recent lunch. He raised a very serious topic of coverage gaps being created in the small print of property insurance policies which Florida insurance regulators are allowing to be sold. He thinks that these coverage gaps are the most serious issues facing insurance consumers. He is not alone.
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Gator Coverage?
Chomp, Chomp!
Insurance Policies are designed to cover sudden and accidental loss and damage. Mary Wischusen, 77, believed that she had a suffered a sudden and accidental act of nature and that coverage would be afforded when a gator came crashing into her kitchen. This 11-foot alligator was not her domestic pet or a planned guest, but her insurance company has denied the claim.
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When Can My Property Insurance Claim Be Denied Due to War or Other Undefined Terms?
I often receive calls from policyholders asking how an insurance company can deny their claim based on an exclusion that isn’t defined in the policy. One of these terms is “surface water,” a common exclusion found in most policies. Recently, I had a client whose home’s gutter system malfunctioned during a rainstorm. Rather than channeling water to run from his roof, through the gutter system and out to the street, water was redirected at the side of the home. The water filled up a planter built in to the side of the house and eventually made its way into the home, damaging his flooring.
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Why is the Carrier so Quick to Argue the Wear and Tear Exclusion?
Chip Merlin posted about the Wear and Tear Exclusion just last month in Wear and Tear Exclusions Versus Depreciation For Resulting Damage To Worn and Torn Older Parts of a Structure. Explaining about wear and tear, Chip gave this example:
The judge made up his own example of ten old bolts giving way and then the rest of what the bolts failed to hold up, crashed and broke the rest of the old structure. The worn-out bolts may not be covered, but if you have the right ensuing loss provisions after the “wear and tear” clause, the rest of the loss is covered—even if the rest is old.
The older parts of the structure are the ensuing loss. They did not suffer a loss because they were worn out and broke. They suffered a loss because other parts of the structure broke from “wear and tear.” Those ensuing parts of the loss are depreciated on an actual cash value basis. If replaced, they are then valued at Replacement Cost.