Storm Damage Insurance Claims: Having and Knowing the Contract


Southern Connecticut has surely seen its share of bad weather since August 2011.  There have been at least three weather events that have brought high winds, significant precipitation and coastal and river flooding.  There have been some unfortunate property owners who have experienced a triple whammy in that they have sustained damage from Irene, the 2011 Halloween snowstorm, and Super-storm Sandy!  Thankfully, most of these property owners have insurance to cover their losses.  Of course, just owning an insurance policy doesn’t automatically equal immediate payment from your insurance carrier when you file a claim for your losses.  This post will provide a thumbnail sketch, a primer if you will, of some simple yet vital steps to follow if you need to review your insurance needs, or experience a loss and need to make a claim. This post is not meant to take the place of legal advice and should not be construed as legal advice.  Most insurance policy disputes have their unique set of facts and must be analyzed on a case-by-case basis. This blog or any other information you might find on the Internet CANNOT replace professional legal analysis and advice from a licensed attorney.

At the outset, it is important to ensure that you have the proper coverages for your possessions and dwelling.  Some insurance policies will only reimburse you for replacement costs of your personal property, and others might not cover your jewelry or sports equipment. In fact, there are many homeowner insurance policies that will not replace or pay the actual cash value of lost/damaged/destroyed items like computers, antiques, collectibles or musical instruments. These items could require a rider, which is an amendment or appendix to your primary insurance policy. Usually, riders are available for virtually anything as long as the homeowner is willing to pay the premium to the insurance company.The same is true for the amount of dwelling replacement cost insurance you purchase. There are many different types of coverages and the manner in which an insurer will pay claims vary almost as much as the different companies that sell these policies.

Another issue of note is that most flood insurance policies have a waiting period of 30-days before coverage is effective.  This essentially cuts off the property owner who waits until a storm is forecast to strike close to home  from purchasing a policy at literally the last moment. Ultimately, you should speak with your insurance agent (preferably someone locally who understands that choosing the proper insurance requires a relationship with the buyer in order to determine what property needs to be insured, and you can’t do that over the telephone with a “800 Number” representative) about your needs and budget in order to purchase the correct coverage with the appropriate financial amounts.

So, you have ensured that you have the proper coverages. The next step is to document your “stuff.” In other words, take pictures of all your stuff. Get appraisals for your jewelry and other expensive collectibles.  Save your receipts from that new gas range or hot water heater. Keep these documents and pictures in a safe place. This is one of the steps that gets missed by virtually every homeowner.  Taking pictures of what your property and possessions look like when the sun is shining will go a long way in assisting you with replacing these things when a storm (or other loss like a fire) destroys everything you own. Preparation is a vital step and should not be overlooked no matter how time consuming the task might be. You will congratulate yourself for investing the time after you suffer a loss and need to make an insurance claim.

Insurance policies are interpreted by the courts as contracts.  This means that you have obligations and the insurance company that issued you your policy has obligations pursuant to the terms and provisions contained in the insurance policy. This reason alone dictates that you should keep your entire policy somewhere safe where you can access it immediately in the event you need to make a claim. You should notify your insurance company of any loss or damage you sustain as soon as reasonably possible after such loss. Most insurance policies or contracts contain provisions that place the burden of reporting a loss upon the policy owner as soon as practicable after a loss, or an occurrence. Fortunately, most courts will liberally interpret insurance contracts in favor of the homeowner when there are ambiguous or other unclear provisions in a policy. In other words, courts attempt to construe insurance policies in a way that coverage will be found under a policy, but this rule alone is not a substitute for reporting a loss as soon as possible after it happens.

Next, you need to document your loss. Most policies require a sworn statement indicating what property has been lost or damaged. This is also called a “proof of loss” or “proof of claim.” Generally, proofs of loss required by insurance policies are due within 60-days of a loss, but different policies have different terms and your policy will dictate when and how documentation should be submitted. When you are making a claim, you will be put in contact with a claim adjuster or claim representative. It is vital to write down your claim number and include this on all of your correspondence. Further, you should buy a notebook and document who you talked to, when you talked and what the substance of the conversation was. Finally, you should not sign anything without having your lawyer review it first. Remember that claims representatives or insurance agents do not work for you, these professionals are the representatives and employees of the insurance company.

At this point virtually every insurance claim is adjusted, compromised and paid without incident.  Sometimes an insurance company will calculate your payment in a way that you do not necessarily understand. If this happens you should document your concerns by sending a letter to the insurance company.  Document everything. If you still can’t reach a mutually agreeable compromise with your insurance company then it is time to retain legal counsel and explore the option of seeking damages for any consequential losses you sustain while waiting for the insurance company to perform its obligations under the insurance contract.

The attorneys at Sullivan Heiser, LLC can assist you with negotiating with insurance companies or hold your insurance company accountable for its actions or lack of actions. Contact our office for a consultation if you think you have reached an impasse with your company. Sullivan Heiser, LLC solves problems with excellence and integrity.

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