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Common Claim Questions POST Harvey

After Harvey many of our clients, family members and friends had many questions. Questions about their damages, hypothetical questions about what could have happened, and questions to get better prepared for the next hurricane.

  1. What is considered Flood Damage? — Flooding is defined as a temporary condition where two or more properties are inundated by rising water or mud flow.
  2. Is flooding covered by my Home Insurance? — No, flooding is only covered by Flood Insurance. This is a separate policy from your Homeowners insurance.
  3. Should I get my roof checked? — You do not lose anything by getting your roof inspected. Many roofing contractors offer a free roof inspection to help you determine if you have damage or not. If your roof in fact has damage due to the winds make sure to consult with your insurance agent to determine if the cost of damages will be much more than your deductible.
  4. Will Flood Insurance cover damage to the foundation? — If the adjuster determines that the damage to the foundation was caused by the flooding he will have an engineer also inspect the damage. If the engineer also determines the flooding caused damage to the foundation, then the flood policy will cover the damage.
  5. Is my car covered if it is flooded? — If you have Comprehensive coverage on your auto policy then it is covered. Comprehensive is also referred to as Other than Collision on some policies.
  6. Does the deductible apply even though this is a Catastrophic event? — Yes, your claim is still subject to your deductible. The coverage is written in preparation of these events.
  7. My friend said his/her claim was denied?! Why would that happen? — A claim is handled as a case by case basis. Yes there is a standard of care in every claim process, and that standard of care includes an inspection. Adjusters have the tough task of inspecting the damage and applying their expertise to determine when the damage occurred and what caused the damage. Common causes for denials are damages caused by wear and tear, wind-driven rain (if your policy isn’t endorsed to cover this), a previous weather system (a date in the past), or negligence. We can dive in to the definition and examples of each of these soon.
  8. Should I file for FEMA disaster assistance? — When you register for FEMA assistance, you must tell FEMA about all insurance coverage that you have available to meet your disaster-caused needs. You may not be eligible for certain types of FEMA disaster assistance if your insurance provides coverage. Many homeowners insurance policies include Additional Living Expenses or other coverage that may provide insurance benefits for housing assistance for the period you are unable to live in your residence, and FEMA will be able to determine your eligibility for disaster housing assistance based on information about your insurance claims. FEMA may require you to provide evidence that your insurance company denied your claim for the disaster-caused loss as part of the eligibility determination process.
  9. I have business insurance, could I claim Business Income for the amount of time we were closed? — Business Income is covered by your business property coverage only if you suffered covered damages to your business. Keep in mind it does hold a deductible as well, usually of 72 hours. There is a separate coverage that you might have on your policy referred to as Utility Time Element which pays Business Income loss caused by an interruption of covered utility services to the described premises.
  10. Why is my payment taking so long?! — We understand your frustration and can understand that the funds are needed right away. Unfortunately in a major catastrophe claim event there are many many claims opened all at once. Claim adjusters and processors are inundated with claims and many families to help. Patience can make the claims process a bit smoother. But the claims process will usually look something like this:
  • After you file a claim, you should hear from the insurance company within a day or two. The company will tell you about its claims process and any responsibilities you have. They will also give you the name of the person or unit handling your claim along with a contact number.
  • The insurance company must start investigating your claim within 15 days after receiving written notice and may ask you for more information. Once you send the information, the insurance company has 15 business days to accept or reject your claim.
  • As part of the process, the insurance company will send an adjuster to your house to look at the damage. It might be awhile if there was a disaster and the area isn’t deemed safe. Try to be home when the adjuster comes so you can discuss the damage and answer any questions.
  • The insurance company will tell you in writing if your policy covers the damage and will give you an initial damage estimate. Keep in mind that the estimate may change. The insurance company might provide you with a list of contractors, but you don’t have to use someone from the list.
  • Your insurance company has five business days to send you a check after it says it will pay your claim. If you have a replacement cost policy, most insurance companies pay claims with two checks. The insurance company will give you the first check after the adjuster has reviewed your damage. This check will be for the estimated cost of repairs, minus depreciation and your deductible. The insurance company will then give you a second check for the balance of your claim after it gets the contractor’s bill for the finished job. You must complete repairs or replace your property within a certain number of days from the date of loss.

Review your policy or ask your agent any questions or concerns. Remember, communication is key and your insurance company will help any way they can.