Why Do Universal Property and Casualty Insurance Claims Get Denied?
Navigating the complexities of insurance claims can be challenging, especially when dealing with claim denials. Universal Property and Casualty Insurance Company (UPCIC) is a significant player in the Florida insurance market, providing coverage to thousands of homeowners. However, many policyholders have reported issues with claim denials.
The average homeowners’ insurance policy from Universal Property and Casualty Insurance covers many different types of events and property losses. If your home gets damaged in a storm or another covered event, you can file a claim to pursue financial compensation under the terms of your policy. It may surprise you to find, however, that the insurance company denies your claim for one or more reasons. The insurance company lawfully must explain the reason for the rejection, which could be:
- Fault or liability dispute
- Not the correct type of coverage on your policy
- Failure to mitigate your losses
- Policy limits
- Missed deadline
- Missing information
- Lack of supporting documents
- Further proof of losses is needed
Policy Exclusions
One of the most common reasons for claim denials is that the damage falls under policy exclusions. UPCIC policies, like those of other insurers, have specific exclusions for certain types of damage, such as:
- Flood Damage: Standard home insurance policies typically do not cover flood damage, requiring separate flood insurance.
- Wear and Tear: Damage resulting from regular wear and tear or lack of maintenance is excluded.
- Mold or Rot: Unless directly caused by a covered peril, mold or rot damage is often excluded.
Disputed Cause of Damage
UPCIC may deny claims by disputing the cause of the damage. For example, after a hurricane, they might argue that the damage was due to pre-existing issues or lack of maintenance rather than the storm itself.
What You Can Do:
- Document the damage immediately after it occurs, including photos, videos, and repair estimates.
- Obtain a professional inspection report to substantiate your claim.
Failure to Report Damage Promptly
UPCIC often requires policyholders to report claims within a specific timeframe. Delayed reporting can result in a denial, as the insurer may argue that the delay prevented them from verifying the cause and extent of the damage.
What You Can Do: Report damage to UPCIC as soon as possible. Prompt action strengthens your case and avoids complications from delayed reporting.
Insufficient Documentation
Insurance claims require thorough documentation, including evidence of the damage, repair estimates, and receipts. UPCIC may deny a claim if they believe the provided documentation is incomplete or inconsistent.
What You Can Do:
- Keep all records related to your home, including maintenance logs, receipts for repairs, and photos of the property’s condition before and after damage.
- Working with an insurance attorney can help ensure your documentation meets insurance standards and expedite the claim process.
Underpayment Disguised as Denials
In some cases, a denial may come in the form of an underpayment. UPCIC may claim that only part of the damage is covered or that the repair costs are lower than estimated. While not a full denial, this tactic effectively prevents policyholders from receiving the full benefits of their coverage.
What You Can Do:
- Challenge underpayments by obtaining independent repair estimates.
- If negotiations fail, consider hiring an insurance claim lawyer experienced in handling property insurance claims.
Alleged Policy Violations
UPCIC may deny claims if they believe the policyholder violated the terms of the policy, such as:
- Failing to mitigate further damage after the incident.
- Misrepresenting facts when applying for coverage or filing the claim.
What You Can Do:
- Take steps to prevent additional damage, such as tarping a roof or removing water after a flood.
- Having an experienced insurance claim attorney can protect your rights during the claim process.
Claims for Pre-Existing Damage
UPCIC may deny claims by alleging that the damage existed before the policy’s effective date or was not caused by a covered event.
What You Can Do:
- Maintain records of your property’s condition, including inspection reports and photos, before purchasing insurance.
- Challenge pre-existing damage claims with evidence of recent inspections or repairs.
What to Do if Your Universal Property and Casualty Insurance Claim Gets Denied
If you feel that Universal Property and Casualty Insurance wrongly denied your insurance claim or that you are not being offered a fair settlement based on the extent of your property loss. In that case, you have a few different options. In general, the process for disputing a Florida insurance claim follows these steps:
If your claim with Universal Property and Casualty Insurance is denied, it’s important not to panic. Instead, follow these steps:
- Review the Denial Letter: UPCIC will send a denial letter outlining the reasons for the denial. Carefully review this letter to understand why your claim was denied.
- Gather Documentation: Collect all documentation related to your claim, including photographs, repair estimates, receipts, and correspondence with UPCIC. This information will be essential if you choose to dispute the denial.
- Contact UPCIC: Contact Universal Property and Casualty Insurance to discuss the denial. In some cases, there may have been a misunderstanding or missing information that can be resolved through communication.
- Consult an Insurance Claim Lawyer If your claim is wrongfully denied, consulting a Florida insurance claim lawyer can significantly improve your chances of a favorable resolution. Lawyers experienced with Universal Property and Casualty Insurance claims can identify bad faith practices and help you take legal action if necessary.
Your Rights as a Florida Property Owner
After filing a property damage claim, your insurer must acknowledge it within 14 days, respond within 30 days after receiving your proof-of-loss statement, and pay or deny the claim within 90 days. Florida homeowners have rights to free mediation, neutral evaluation for sinkhole claims, and assistance with insurance claims through the Florida Department of Financial Services.
The Florida Homeowner Bill of Rights reassures homeowners by outlining the steps the insurance carrier takes after a claim. However, complexities, the random assignment of adjusters, and insurers’ tendencies to underpay or deny claims complicate the process.
Signs of Bad Faith Practices
In some cases, claim denials are not justifiable but may stem from bad faith practices by the insurer. Watch for these red flags:
- Delays in processing your claim without valid reasons.
- Denial of claims without a thorough investigation.
- Misrepresentation of policy terms to avoid paying a claim.
- Offering an unreasonably low settlement.
If you suspect bad faith, consult one of our insurance claim attorneys immediately to protect your rights.
How Williams Law, P.A. Insurance Claim Lawyers Can Help You:
If your appeal is unsuccessful or you believe that UPCIC is acting in bad faith, it’s time to consult an experienced insurance claim lawyer.
Expert Interpretation of Insurance Policies: Insurance policies are complex legal documents with technical jargon and fine print. Williams Law, P.A. can help you understand your policy’s specific terms and conditions, identify the coverage that may apply to your situation, and explain any exclusions or limitations the insurer might use to justify a denial.
Effective Communication and Negotiation: We have extensive experience dealing with insurance companies and understand the tactics insurers often use to deny or underpay claims. This is particularly important when dealing with disputed claims or complex policy interpretations.
Comprehensive Evidence Collection: Our lawyers will assist in gathering and presenting the necessary evidence to support your claim. This includes obtaining expert reports, damage assessments, repair estimates, and other documentation to substantiate your case. We will also advise on how to document your damages and losses.
Representation in Litigation: In cases where negotiations and appeals do not resolve the dispute, litigation may be necessary. We will represent your claim in court, advocating for your rights and seeking the compensation you are entitled to. Legal representation is particularly crucial in cases involving allegations of bad faith, where the insurer may have acted dishonestly or unreasonably in handling your claim.
Protection Against Bad Faith Practices: Insurance companies must act in good faith and deal fairly with policyholders. Suppose UPCIC is found to have engaged in bad faith practices, such as unjustly denying a valid claim, delaying payment without reason, or offering an unreasonably low settlement. In that case, we can take legal action against the company. In such cases, you may be entitled to additional compensation.
Peace of Mind: Dealing with a denied insurance claim can be stressful and time-consuming. Hiring a lawyer allows you to offload the burden of dealing with the insurer, giving you peace of mind and focusing on recovering from the damage and restoring your home.
Conclusion
Dealing with an insurance claim denial from Universal Property and Casualty Insurance can be a stressful and frustrating experience, especially when you’re already dealing with the aftermath of property damage. However, understanding the reasons behind claim denials and knowing how to respond can help you navigate the process more effectively. If you’re facing a denial, don’t hesitate to seek professional advice to ensure that your rights are protected and that you receive the coverage you’re entitled to under your policy. Call us at 1-800-451-6786 or fill out our online contact form.