Why Wind Damage Insurance Claims Get Denied in Florida

Most Florida Policyholders Need to Hire a Lawyer for Wind Damage Claims

In Florida, wind damage from hurricanes, tropical storms, and severe weather is a common threat to homeowners. While most homeowners insurance policies include coverage for wind damage, many policyholders are surprised when their wind damage insurance claims are denied. Unfortunately, insurance companies often use tactics to reduce or deny valid claims, leaving homeowners with the financial burden of repairs.

Wear and Tear vs. Storm-Related Damage

One of the most frequent reasons for denying a wind damage claim is the argument that the damage was caused by wear and tear or poor maintenance rather than the storm itself. Insurance companies may claim that your roof, windows, or siding were already in poor condition before the wind event, which means the damage falls under the policy’s normal wear and tear exclusions.

Why Claims Are Denied:

• Pre-existing Damage: Insurers may argue that the damage was due to the natural aging of the property rather than the windstorm.
• Lack of Maintenance: If your roof or other parts of your home were not well-maintained before the storm, the insurer might deny the claim, suggesting that the damage was preventable with proper upkeep.

How to Avoid Denial:

• Document Maintenance: Keep detailed records of regular maintenance, repairs, and inspections to demonstrate that your home was in good condition before the storm.
• Get a Pre-Storm Inspection: If you’re concerned about the condition of your home, consider getting a professional inspection before hurricane season to have proof that your home is in proper condition

Disputes Over the Cause of Damage

Another common reason for wind damage claim denials is the dispute over the cause of damage. In many cases, insurance companies argue that the damage was caused by something other than wind, such as flooding or poor construction, and therefore deny the claim based on these exclusions.

Common Disputes:

• Flood Damage vs. Wind Damage: If your home sustains water damage after a hurricane, the insurance company may argue that the damage was caused by flooding (not covered under standard homeowners insurance) rather than wind-driven rain. In this case, you would need separate flood insurance to cover the damage.
• Concurrent Causes: Insurance companies may deny claims if there are multiple causes of damage, such as wind and poor construction, and only one cause is covered under your policy.

How to Protect Yourself:

• Hire an Insurance Claim Lawyer: Consider hiring an insurance claim lawyer to assess the damage independently and provide an unbiased claim review.
• Document the Damage: Take detailed photos and videos of the damage immediately after the storm to show how the wind directly caused the destruction.

Policy Exclusions and Limitations

Insurance policies often include specific exclusions and limitations regarding wind damage coverage, which can lead to claim denials. Many homeowners don’t realize that certain types of damage—especially cosmetic or minor damage—may not be covered by their policy.

Common Exclusions:

• Cosmetic Damage: Some policies exclude or limit coverage for cosmetic damage, such as dents or scratches on siding, roofs, or other surfaces that don’t affect the functionality of your home.
• Wind-Driven Rain: Some policies exclude wind-driven rain damage unless the wind causes a physical opening in the roof or walls, such as a broken window or damaged roof shingles.

How to Avoid Issues:

• Review Your Policy: Before hurricane season, review your homeowner’s insurance policy carefully to understand what is and isn’t covered for wind damage.
• Upgrade Coverage: If your policy excludes wind-driven rain or cosmetic damage, consider upgrading your coverage to better protect your home from wind damage.

Failure to Meet Reporting Deadlines

Insurance companies require policyholders to report damage promptly after an event. Failing to meet these reporting deadlines can result in denying your wind damage claim. Some Florida policies have specific time limits for filing claims after a hurricane or windstorm.

Why Claims Are Denied:

• Late Filing: If you wait too long to file a claim, the insurance company may argue that the delay allowed the damage to worsen or that the cause of the damage is unclear due to the passage of time.
• Failure to Mitigate Damage: Homeowners must take reasonable steps to prevent further damage after a storm. If you don’t make temporary repairs, such as covering a hole in the roof or boarding up broken windows, the insurer may deny your claim.

How to Avoid Denial:

• File Your Claim Quickly: Report the damage to your insurance company as soon as possible, ideally within a few days of the storm.
• Make Temporary Repairs: Take immediate action to prevent further damage, and keep receipts for any materials used in the process, as these costs may be reimbursed.

Undervalued Claims

Even when a wind damage claim isn’t outright denied, insurance companies often undervalue the claim, offering a settlement that doesn’t cover the full cost of repairs. This is a common issue with wind damage claims, where the insurance adjuster may downplay the severity of the damage or estimate repair costs too low.

Why Claims Are Undervalued:

• Low Repair Estimates: Insurance adjusters hired by the insurance company may provide a lower estimate for repairs than needed.
• Depreciation of Property: Insurers may reduce the payout by applying depreciation to the damaged property, especially if the roof or other parts of the home are older.

How to Fight Back:

• Get Independent Estimates: Hire an independent contractor to estimate the full cost of repairs. This can help you challenge the insurance company’s low settlement offer.
• Consult an Attorney: If the insurance company is undervaluing your claim or refusing to pay the full amount, consulting with a wind damage insurance lawyer can help you negotiate a fair settlement.

Florida Bad Faith Insurance Practices

Insurance companies sometimes engage in bad faith practices, where they intentionally delay, deny, or undervalue valid claims without a legitimate reason. This can include failing to investigate your claim properly, offering a lowball settlement, or providing vague reasons for the denial.

Signs of Bad Faith:

• Unreasonable Delays: The insurance company delays responding to your claim or takes too long to investigate and process the claim.
• Inadequate Explanation: The insurance company denies your claim without providing a clear or valid reason for the denial.
• Lowball Settlement Offers: The insurer offers a settlement far below the actual cost of repairs or refuses to negotiate in good faith.

Hiring an Insurance Claim Lawyer Levels the Playing Field

Navigating the insurance claims process can be overwhelming, especially when dealing with the aftermath of a storm and trying to repair your home. Insurance companies have teams of adjusters, experts, and lawyers working to protect their interests. Without legal representation, homeowners often find themselves at a disadvantage.

Here’s how hiring a lawyer helps level the playing field:

• Understanding Your Policy: Lawyers can interpret the complex language of your insurance policy and ensure that you understand what’s covered and what isn’t.
• Negotiating a Fair Settlement: Attorneys are skilled negotiators who can challenge lowball offers and present evidence to secure a fair payout.
• Dealing with Bad Faith Practices: If the insurance company is acting in bad faith—delaying your claim, denying it without cause, or underpaying—an attorney can hold them accountable through legal action.
• Providing Expert Testimony: Lawyers can work with independent experts, such as contractors or engineers, to assess the damage and provide testimony that supports your claim.