Bad faith is used to refer to the intentional or malicious refusal to perform a duty or contractual obligation or to cause fraud or deception.
Insurance bad faith practices can include:
Unfortunately, insurance claim adjusters often find their hands tied — limited by restrictive claims processing guidelines designed to cut costs and increase profits for the insurance company. In these cases, adjusters have neither the authority nor the support to timely and fairly process a claim.
It is extremely important that you find a qualified attorney that can help you put the insurance carrier on notice of the alleged bad faith activity in order to create a paper trial of the abuses and to preserve the policyholder’s rights to pursue a claim for bad faith. Florida law requires that you put the insurance carrier on notice of potential bad faith and give them an opportunity to “cure” the damages within sixty (60) days. This process is very detailed and should be completed by a professional that is familiar with law, statutes, and restrictions that govern this process.
The first thing you should do is locate your insurance policy. Remember that in many cases you may have more than one policy for a given property, such as a windstorm policy, flood policy and all-risk peril policy. If you are unable to locate the policy documents, you should reach out to the insurance agent or the issuing insurance company and have them provide you with a copy. You should then review the policies and get familiarized with your coverage.
You will then need to report the loss to the insurer and open a claim. It is important that you do this as soon as possible, regardless of whether you are certain that the policy covers the specific loss and even if it may exceed the deductible. The policy documents will provide you with the specific instructions for reporting.
When contacting the insurance company, make sure you are able to describe the cause and extent of the loss and the date of the loss. You should consider speaking with an attorney before making this call, in order to better understand your rights and responsibilities under the policy.
Most insurance policies require you to take reasonable efforts to minimize the loss once discovered. Most policies will reimburse you for those costs, such as fixing leaks and tarping the roof, to protect other portions of the home or contents from any further damage like mold, fungus, or wet rot. If significant, you should consider hiring a reputable emergency services mitigation company that can extract any standing water, remove water from behind your walls, and set up dehumidifiers and fans to circulate air and remove moisture.
A picture is worth a thousand words. Make sure you take pictures and video of the damage and loss. Ideally, you would have taken pictures of your property and its contents before the storm, so there can be a point of comparison. But even if you did not, the more you document, the better. You should also obtain estimates for repair and replacement and itemize the personal property damage. But most importantly, make sure to keep receipts of all out of pocket expenses associated with the remediation, repair, replacement and all other expenses you incur as a result of the damage.
Except for Flood Insurance, which always requires a “Proof of Loss” submission, most standard insurance policies also contain this requirement if requested by the insurance carrier. This term refers to a formal submission of your claim amount and each insurance company has its own form and requirements. You should obtain the specific instructions from your insurer to avoid delays. Once the Proof of Loss is properly submitted, the insurance company will have 30 days to respond. If your insurer does not require a Proof of Loss to be submitted, you should always double check with the insurance company’s adjuster to be sure.
Insurance policies have post loss obligations that require you to cooperate with their investigation into the claim which often includes making the home available for an inspection and may require that you submit to a recorded statement. A recorded statement is an opportunity for the insurance carrier to ask you a variety of questions about the loss, when you noticed the damages, where you noticed the damages, and what efforts you took after you noticed the damages. The insurance carrier gets to record your answers and more likely than not your statements may be used against you when adjusting the claim or in a court of law. We recommend you consult with an attorney before submitting to the recorded statement and better yet, have an attorney present when you make the statement.
Insurance carriers send out licensed adjusters to investigate your claim, inspect your property, and take your recorded statement. The insurance carriers usually refer to these adjusters as “independent.” The adjusters are referred to as “independent” because they are often not employees of the insurance carriers, but independent contractors that do work for the carriers on a project basis. However, they are rarely “independent” and often have long standing relationships with the insurance carriers and handle hundreds or thousands of claims. The adjuster will take pictures of your property, create an estimate of the items they believe are damaged as a result of the loss, and make a recommendation to the carrier if your claim should be covered and for how much. Be aware that these people do not generally bind the insurance carriers and what they say is covered at the inspection is very different from what the carrier ultimately pays.
After you, or we, report the claim to the insurance carrier they will open the claim and assign it a number. Most carriers will send you a letter telling you that the claim has been reported and you should expect a phone call from an “independent” or “field” adjuster within 48 hours to set up an inspection. Often, especially after a storm, homeowners are forced to wait days or maybe weeks for an adjuster to contact them and schedule the inspection. At the inspection you can expect the adjuster to walk around your house, measure rooms, ask you questions about where the damages are located, what caused them, how long you noticed them, what you have done to fix them, and take lots of pictures. At the inspection, adjuster may, or may not, give you their opinion about what is covered under the policy, but remember these comments are not the statements of the insurance carrier. Usually, within a couple weeks the carrier will send you a letter letting you know if they need more information to adjust the loss. This request could include a personal property inventory sheet, receipts for repairs, mortgage documents, or photographs. The carrier will then send you a letter letting you know their decision about whether your claim is covered and will likely reference provisions from your insurance policy that supports that decision. By law, the carrier has ninety (90) days to make a decision about whether to cover your loss under the policy. If you disagree with the carrier’s decision of the amount of money that the carrier is willing to pay then your policy may require that you take certain actions within a set period of time to challenge that decision. We recommend that you speak with an attorney if you disagree with the carrier’s decision so that you can understand exactly what the policy requires that you do, and also what is not required under the policy or the law.