They Hope You Fail

A tree goes through your roof at two in the morning. Water is coming down the hallway, your kids are awake, and you are standing in the dark with a bucket. The last thing on your mind is a list of contractual obligations buried on page 34 of a policy you have never read.

That is exactly what the carrier is counting on.

Here is what is happening. When a loss is clearly covered and there is no exclusion that fits, the insurance company still has one card left: your own conduct after the loss. Every homeowners policy in Florida contains a section called Duties After Loss, and those duties are what lawyers call conditions precedent. Plain English version: if you do not do them, the carrier gets to argue you never earned the right to be paid, no matter how obvious the damage is.

So let me walk you through the list, and let me tell you how they use each one against you.

Report it, and report it now

Under Fla. Stat. § 627.70132, you have one year from the date of loss to give notice of a claim, and 18 months for a supplemental claim. That is the outer wall. Do not treat it as a target. Your policy also requires prompt notice, and carriers love the gap between “prompt” and “one year.” Wait eight months and you will get a letter saying the delay prejudiced their ability to investigate. Report it in days, not seasons.

Protect the property from further damage

You have a duty to mitigate. Tarp the roof, dry the floors, shut off the water, board the window. Keep every receipt, every invoice, every photo of the tarp on the roof. What you should not do is start tearing out and rebuilding before they inspect, because then you have handed them a spoliation argument. Emergency repairs yes, permanent repairs no, at least not until the property has been documented and looked at.

Do not throw anything away

The soaked drywall, the ruined cabinets, the cracked tiles, the wet flooring. Bag it, box it, put it in the garage, take pictures of it. I have seen claims fight over whether a tile was even broken because the homeowner did the responsible thing and cleaned up. Cleaning up is not rewarded here. Documenting is.

Photograph and video everything before you touch it

Wide shots of every room, close shots of every damaged item, the exterior from all four sides, the attic, the ceiling stains, the date and time on your phone doing the work for you. If you only take one piece of advice from this article, take this one. Photographs taken before mitigation are the single most valuable thing a policyholder brings me.

Let them in, more than once if they ask

Your policy requires you to show the damaged property as often as reasonably required. That means the field adjuster, then their engineer, then their consultant, then sometimes another engineer because the first one wrote something they did not like. It is tedious and it feels like harassment. Let them in anyway. Refusing an inspection is the cleanest denial they will ever get.

The paperwork demands

Expect a Request for Information, usually called an RFI, asking for repair records, prior claims, permits, mortgage information, and receipts. Expect a recorded statement request. Expect a Sworn Proof of Loss, which is a notarized document stating the amount you are claiming, and your policy will usually give you 60 days from their request to return it. In bigger or older losses, expect an Examination Under Oath, which stands for a formal sworn question and answer session with the carrier’s lawyer, transcribed by a court reporter, before any lawsuit exists.

All of these are legitimate contractual rights the carrier has. All of them are also easy to fail. Miss a Proof of Loss deadline, skip a document, guess at an answer under oath and get it wrong, and the file stops being about your roof and starts being about you.

Keep records of your own claim

Write down every phone call, every adjuster name, every date, every promise. Keep every email. Save every letter. Under Fla. Stat. § 627.70131, the carrier has to acknowledge your communications within 7 calendar days, begin its investigation within 7 days of receiving your proof of loss, complete the physical inspection within 30 days of receiving it, and pay or deny within 60 days of notice of the claim. You cannot hold them to a clock you did not write down.

The part that actually matters

Do everything they ask, and prepare before you do it.

Comply with the recorded statement, but know what your claim is before you sit for it. Return the Proof of Loss, but have a real number supported by a real estimate before you swear to it. Sit for the Examination Under Oath, but do not walk into a lawyer’s questioning without a lawyer of your own. Cooperation is required. Cooperating blind is not.

None of this is fair. You paid premiums for years, a covered peril hit your home, and instead of a check you got a scavenger hunt. But the scavenger hunt is the system we have, and policyholders who run it carefully get paid far more often than policyholders who assume the truth speaks for itself.

About the Author

I am Louis P. Meyer, Esq., a Senior Attorney at Kanner & Pintaluga, P.A., where I represent Florida homeowners and business owners in first party property insurance claims and personal injury cases. My property practice covers hurricane damage, wind and windstorm damage, water damage, roof damage, fire and smoke damage, mold claims, denied and underpaid claims, and insurance bad faith throughout Florida, including Tampa, Boca Raton, Orlando, Miami, Fort Lauderdale, West Palm Beach, Jacksonville, Sarasota, Naples, and Fort Myers. My injury practice covers car accidents, motorcycle accidents, truck accidents, boating accidents, and slip and fall cases.

Legal Notices and Disclaimer

No legal advice. The content above is general information about Florida insurance and personal injury law. It is not legal advice, and it is not a substitute for the advice of a lawyer who has reviewed your policy, your claim file, and the specific facts of your situation. Insurance policies differ, deadlines differ, and small factual differences change outcomes. Do not act or refrain from acting on anything you read here without consulting a licensed attorney about your own circumstances.