Levi Lawrence Wilkes, Esq. / Your Resource for Property Insurance Claims

Levi Lawrence Wilkes, Esq. / Your Resource for Property Insurance Claims Helping owners of residential and commercial properties everyday get the most out of their property

Elephant goes down again in Palm Beach County to my colleagues Jeff Groover and John Edwards. They’re racking up the bad...
03/24/2023

Elephant goes down again in Palm Beach County to my colleagues Jeff Groover and John Edwards. They’re racking up the bad faith cases.

Preaching to the choir here.
03/19/2023

Preaching to the choir here.

Can I rely on my “Replacement Cost Policy” for replacing and repairing my home when disaster strikes? The state of affairs of homeowners insurance in Florida. By: Levi Lawrence Wilkes This article seeks to give its reader a synopsis what the predominant homeowner's insurance policy looks like af...

Tides are Rising, Don't Drift out to Sea.Photo  #1 - FEMA Flood Map which I've highlighted. You can obtain a flood map o...
06/11/2022

Tides are Rising, Don't Drift out to Sea.

Photo #1 - FEMA Flood Map which I've highlighted. You can obtain a flood map of your own property at https://www.fema.gov/flood-maps

Photo #2 - Picture taken during recent Tropical Storm Alex in same place where I highlighted on the FEMA map.

The FEMA map is effective 2014 and designated this section of the map as a .2% chance of Flood risk. Does the picture taken look like .2% to you? If you are in Florida, you see the year to year changes in flooding in and around your property. Simply put, don't rely on FEMA to rezone your property to buy flood insurance.

A list of private insurance companies who write for Flood Coverage can be found here:

https://www.floir.com/sections/pandc/floodinsurance/floodinsurancewritersfl.aspx

If you do not have a Flood Policy you could be left with a water soaked and soon mold infested property when the water comes rushing in and having to pay out of pocket for what will undoubtably be very expensive job dealing with flooring, drywall, painting, dry-out, with possibly electrical or structural issues as well.

Please contact me if you have questions on Flood coverage or have a claim that the insurance company has denied or underpaid.

When Appraisals Go AwryWhat is an Appraisal? If you are reading this article you likely just found out your insurance po...
02/24/2022

When Appraisals Go Awry

What is an Appraisal?

If you are reading this article you likely just found out your insurance policy has an appraisal provision and your carrier just invoked it and you’re wondering what to do. Appraisal is a type of dispute resolution. For the reasons below you might say it’s the wild wild west of alternative dispute resolution. Without deep diving the history books one could surmise it was implemented by carriers and allowed by insurance regulators in homeowner’s policies as an attempt to curb litigation and “bring down costs” as the industry often touts. The typical appraisal provision is utilized when the parties (the carrier and Insured) have determined there was a covered loss under the policy but however disagree as to value of that particular loss. When that happens and the carrier, or insured, invoke appraisal as specified in the insurance policy then each party is typically entitled to appoint their own appraiser. These two appraisers typically evaluate the property creating competing estimates and attempt to come to medium that is suitable to both. If those appraisers don’t come to terms then they appoint what is known as an umpire to “break the tie”. Two out of the three persons coming to an agreement and signing an appraisal award (i.e. setting value of loss) then becomes binding outside some very narrow exceptions.

Sound scary and uncertain? That is because it is. But it gets better. . .

What makes someone an Appraiser and/or Umpire?

As of the date of this publish there is no licensing requirements for an appraiser or an umpire in the State of Florida. Yes, you heard it right, the individuals tasked with creating a value for your most priced asset in life has no licensing requirements.

Is this uncertain appraisal process avoidable?

Unfortunately this process is not only being enforced by courts when invocation is made pre-lawsuit but also post-lawsuit and the judiciary is allowing carriers to invoke appraisal—for the first time—even after a lawsuit has been filed inhibiting Floridians constitution rights for access to the courts. Some insurance carriers appear to deliberately make an attempt to open coverage for nominal amounts—instead of denying coverage—as it leaves open the door for invoking appraisal should the homeowner seek out legal counsel. Florida’s new law Fla. Stat. 627.70152 (2021) in fact appears to potentially allow the insurance carrier to invoke mandatory appraisal when the carrier receives a “Notice of Intent letter to Sue” that homeowners are now required to give to the carrier and State when an insurance company has wronged that Insured and a lawsuit is needed to right that wrong.

Hypothetical #1

The Insurance Company originally undervalued my loss at $5,000 and I disputed the amount and they invoked appraisal. The appraisal process determined the loss amount was $12,000.00 does that mean they will pay the costs of the appraisal?

No (typically). The insurance carriers mess up actually requires you to come out of pocket for your appraiser and half the umpire (when an umpire is used). These costs can range from one thousand to a several thousand dollars on a typical residential home. And again, think of it as a tattoo artist, will you (should you) go with the cheapest appraiser you can find?

Although there may be ways for a law firm to recover these unnecessary costs for the homeowner it will typically require the firm to be very involved early on. Contacting a law firm dealing with these claims on a daily basis so you can be better equipped to know what the current law and the underlying policy allows is crucial.

Hypothetical #2

My appraiser and the insurance companies appraiser came to a value in the appraisal award I don’t agree with, what is my recourse?

This is where it gets tricky, fast, grey and legal. Florida doesn’t actually have rules specifically designed for the appraisal process and how an appraisal award may be challenged, modified and/or vacated. Instead the answer to the above question is better answered through an extrapolation of common law, the policy, and borrowing from law on a similar process known as arbitration. Case law makes it clear that appraisal is not arbitration but without any guiding principles on appraisal and vague policy language courts have looked to the arbitration rules and concepts. Using those Arbitration rules, specifically Fla Stat. 682.14 and 682.15, an attorney may find refuge or recourse for an otherwise unfortunate client. To what extent an Insured is confined to timelines or elements of these arbitration rules (or whether broader common law principles may apply) needs to be flushed out by the courts. Yes you may have to be the guinea pig. For the time being, you as the homeowner should know time is of the essence when dealing with appraisal awards and any delay to contact an experienced attorney may result in a loss of rights.

It’s this authors opinion that the appraisal process can be uncertain but is also unfair to Florida homeowners whom not only must come out of pocket for their deductible which may be thousands but are then subjected to unknown appraisal costs which some homeowners may find difficult or impossible to pay. I would encourage Florida citizens to contact your representatives to have this process changed. Until then, I would encourage you to lean on your legal representatives on how to best navigate the appraisal process and insurance recovery process in general.

When being a good homeowner backfires. Many cases come across my desk where a homeowner explains they didn't report a cl...
05/31/2021

When being a good homeowner backfires.

Many cases come across my desk where a homeowner explains they didn't report a claim to their insurance company when they knew of damage because they "took care of it" and had a contractor, after the storm, repair the damage but it fell below their deductible.

In theory, this sounds great as you would think insurance companies would commend their homeowners for taking initiative and mitigating their damages as soon as possible and not overburden the insurance company with open and shut claims. In practice, however, these very homeowners are often the ones left out in the cold when latent damages later reveal themselves.

Many insurance policies have a requirement that you provide "prompt" or "immediate" notice of a loss. The term "loss" is often undefined by many insurance policies. Therefore what is a "loss"? Is a loss an amount of damage that would exceed the applicable policy deductible? Or is a loss merely an identification of damage or potential damages of any kind?

Court's generally take a more expansive interpretation on a dispositive motion and look to whether notice was promptly provided after taking into account the reasonable facts and circumstances of the individual case.

What attorneys on both sides of the aisle are left with is "grey" which means to say it can go either way. With potentially monetary consequences on both your claim and possible obligation for paying defense attorney's fees and costs I can assure you that you don't want to be put into this metaphorical rock and a hard place. Accordingly, I've listed a few examples of when you should provide notice to your insurance company:

Example 1: Do I report a claim if I have a $6,000 hurricane deductible and upon return to my property all I observed were some downed trees in the yard which we had removed?

Answer: Yes

Explanation: Here we have a storm with sufficient intensity to knock down trees so what did it do to your roof? If you aren't going to have contractor(s) look at the roof atleast preserve your claim by reporting it if, and when, you later get an interior leak from the roof.

Example 2: Do I report a claim if my agent says I don't need too?

Answer: Yes, and get a new agent while you're at it.

Explanation: All too often I found that homeowners contacted their agent, or even their insurance company, after a hurricane and that person told them don't worry about opening a claim because the damage was below their deductible. DO NOT BELIEVE THEM and insist they open a claim number to preserve your rights.

Examples 3: Do I report a claim if the screens blew out of my screen enclosure during the storm but I had someone repair them for $500?

Answer: Yes

Explanation: Often after storms many repairmen are there to make the easy money and will "overlook" or fail to advise homeowners of the potential larger damages because its too much of a hassle to pull permits or there is materials or manpower shortages directly after the storm(this happens with roofing contractors as well).

Morale of the Story: Protect yourself and your family and report the claim. If you have reason to believe the insurance company failed to investigate your claim or failed to adjust your claim properly feel free to contact me and we can go over your options together.

Don't get caught with your pants down because of a new and/or unexperienced insurance broker or just being cheap. This s...
11/27/2020

Don't get caught with your pants down because of a new and/or unexperienced insurance broker or just being cheap. This segment deals with the "Law and Ordinance" coverage under your insurance policy. Depicted in the picture is a line item for "Law and Ordinance" and it states the limit is 25% (of Coverage A) which comes with an additional premium. So what is "Law and Ordinance" and why is it so important. The easiest way I can explain it is that Law and Ordinance coverage is insurance coverage to fix undamaged portions of your home. But why would I want to fix undamaged portions of my home? Good question and in most instances its not that you "want" but rather that you will "need" to do so as required by a law or ordinance. So lets take an example. In Florida, if more than 25% of your roof structure is said to be damaged then you must, by law, replace the entire roof and bring the roof up to current building codes. Otherwise you're not getting a permit. So lets say a hurricane hits your property and damages the north slope of your home which makes up 30% of the home. Your insurance company indeed pays you for 30% of the roof, minus deductible, at a price of $20,000. The insurance company refuses to pay you for the entire roof because you rejected law and ordinance coverage when you purchased the property. The roof replacement is going to cost you $60,000. Do you have $40,000 laying around to make up the difference?

Many brokers want to impress you by showing you how low they can get the premium and coax you into rejecting probably one of the most important portions of your policy. Florida requires insurance companies to advise insureds carefully on this matter and to sign certain documentation in order to reject the default 25% law and ordinance coverage.

Upon initiation of an insurance policy make sure you get every single document you signed and store it in a safe place as I've had instances where the insurance company (and declarations page) said the insured rejected or requested only 10% law and ordinance coverage for a premium reduction but upon further investigation the "rejection" was improperly done and therefore invalid.

The roof situation is just one out of many instance where you will need law and ordinance coverage. Feel free to reach out should you have any questions or concerns on law and ordinance coverage.

Hi Everyone,My little segment of homeowner beware (Screen Enclosure edition):Homeowners whom have a screen enclosure at ...
06/12/2020

Hi Everyone,

My little segment of homeowner beware (Screen Enclosure edition):

Homeowners whom have a screen enclosure at their home normally want to insure that enclosure. Here in South Florida, the most likely culprit of loss would be wind damage during a hurricane event.

Most Insurers are providing insurance on screened enclosures with a sublimit (meaning no matter the cost of the repair your capped at that amount). Generally these sub-limits range from $10k to $25k. That's not really the surprise but you should consider whether your sublimit is enough for a total loss.

The surprise is I'm seeing a few policies that have both a sublimit but also have an exclusion for "Hurricane Loss" embedded deep in the policy. The kicker is that some of these policies you can't identify from the declarations page that there is any such exclusion. No asterisk, no bolded language, nothing and so the unsuspecting homeowner won't know it till there is a Hurricane and your carrier tells you to kick rocks.

Obviously, such behavior by the carrier does present quite a few good public policy and other arguments for a litigator like myself. That said, don't leave it up to chance. Reach out to your carrier and/or broker (in writing) and ask "Is there a limit or sublimit on my screened enclosure" and "will my enclosure be covered for a Hurricane and/or Wind Loss."

Then make your choice. I'm all for homeowners having choices but those choices need to be made with informed consent.

Stay safe everyone.

Give back whenever, however you can.
01/24/2019

Give back whenever, however you can.

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