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Insured Losses

Fire

When a building burns, the fire itself is not the only cause of damage to consider when assessing the damage. Smoke permeates the structure as well as the personal property inside the building. In order to extinguish the fire, the fire department often needs to break openings in the roof, ceilings, and walls or break down doors in order to access the fire. Water may be poured into the building cavities, soaking the owner’s furnishings, personal effects, electronics, documents and equipment. Mold may develop as a sequel to the fire.

It takes a comprehensive investigation to determine the full extent of the damage after a fire. Not just the cosmetic result of a fire loss needs to be dealt with but the full effect of the fire must be assessed in order that the insurance claim will result in a proper settlement.

 

Sinkhole

• Large or small step-cracks in walls
• Foundation cracks
• Out-of-square window and door openings
• Cracked or wrinkled dry wall

Do you know what is causing these problems? The truth of the matter is that an untrained property owner cannot determine if these changes are the result of settlement, other causes, or if they are the result of sinkhole activity.

It is easy to overlook the beginning signs of a sinkhole. The problem might appear in subtle ways at first; however, if a sinkhole is present, the situation only gets worse.

 

Theft / Vandalism

 

When vandals or thieves willfully damage your property and steal your possessions, putting your life back in order can be a large undertaking. It can be a tremendous burden for a person who has just experienced such a trauma to prepare and document all of the details necessary to pursue the subsequent insurance claim. We at Keys Claims Consultants, Inc. stand ready to assist you with the process.

Notification: Before the scene is disturbed, file a police report. Without delay,  notify your insurance agent or carrier of the loss.

Documentation: As police collect evidence, numerous photographs of all aspects of the damage should be taken and copies retained by the property owner.  This photo record needs to include damage to the structure, personal or business property, and any damage resulting from the police investigation itself.   Begin making a list of any missing items.

Loss mitigation:  Temporary repairs should be done that are sufficient to prevent further damage.  The property must be secured and all damage preserved so that the insurance company may make a full inspection of the loss.  It is important that damaged items not be thrown away until the claim is settled..  

Policy Compliance:  It is imperative that policyholders become fully informed as to both the requirements and the benefits that are outlined in their policy.  For example:

    • A Sworn Statement in Proof of Loss may need to be filed within a stated timeframe.
    • The insurance company may have the right to replace missing items rather than issue a settlement check to the insured. 
    • Receipts or verification of ownership for missing property may need to be produced if available.

Valuation and Negotiation: It is quite a chore to determine and document the value for missing and damaged items following a theft with vandalism.  It stands to reason your insurance company will be able to respond best to a detailed, well-documented and professionally presented outline of  your damages.

 

Water

 

For a water leak to be covered under the terms of most insurance policies, the event must be fortuitous or sudden and accidental in nature. Insurance coverage for damage resulting from a water leak is often denied when the insurance carrier takes the position that the water damage resulted from an ongoing problem that the property owner did not properly Address.

Lack of maintenance may, in fact, not be the cause of the event. Important details may have been overlooked by the insurance company’s field adjuster in his initial inspection of the loss. At Keys Claims Consultants, Inc., we are frequently able to help clients who have had their water claims initially denied by their insurance carrier.

If you enter your business or residence to find that a water leak has occurred, it is imperative that you begin the mitigation process as soon as the leak is discovered. The source of the water must be identified and remedied. Dry out and temporary repairs should be performed by a licensed professional experienced in preventing further damage to the building and any affected personal property.

Many policyholders do not realize that they are required to preserve the damage so that all insurance company representatives may make a full inspection. It is important to note that more than one inspection is often necessary to finalize the claim. It may seem unreasonable to a property owner to be asked to keep what appears to be garbage, however, keeping damaged items is important to the final outcome of the claim. Accordingly, keep wet drywall sections, baseboards, cabinetry, flooring and any wet furniture or other personal items. A storage facility may be utilized if it is not possible to keep these items at the affected property.

 

Flood

 

Flood is a term used in the insurance industry to refer to rising water which covers two or more adjacent properties. Most standard commercial and homeowner policies do not cover flood damage. If your building is located in an area where flood is a possibility, it is prudent to purchase flood insurance.

The majority of flood insurance is written through The National Flood Insurance Program (NFIP) administered by the Federal Emergency Management Agency (FEMA) and the Department of Homeland Security of the United States government.

Homeowners:

Under the Federal flood insurance program, insurance is available to any homeowner who lives in an NFIP-participating community. The maximum coverage available is $250,000 replacement cost coverage for property and $100,000 replacement cost coverage for contents. Homeowners may purchase additional flood insurance from private flood insurers.

Condominium Associations:

Residential Condominium Building Association Policy (RCBAP) is a replacement cost policy obtained through NFIP with maximum limits of coverage of up to $250,000 per unit.

Commercial properties:
The Federal NFIP program also provides flood insurance for businesses. The building and its contents are insured separately and are not insured on a replacement cost basis. All commercial flood claims are settled using Actual Cash Value or depreciated value.

Special regulations and requirements apply under all federal flood insurance programs. Claims under flood policies are handled differently than claims under standard private insurance policies. It is imperative that the insured understands and complies with all duties under the policy so as not to waive their right to recovery.

When a hurricane strikes, causing damage from both flood and wind, it becomes critical to separate the damages caused by flood from those caused by wind. This is a complex and highly detailed process that requires a thorough understanding of both the governing wind and flood policies. To allow for the best outcome, a licensed, accredited claims professional should be employed to assist in this process.

 

Wind / Tornados

 

Following a significant windstorm, it is important to have your building professionally inspected for damage. The integrity of your building’s envelope or outer shell may have been significantly compromised in a manner which may not be readily apparent to an untrained eye.

For example: The roof may initially appear undamaged until closer inspection has taken place. Portions of the roof may have separated and lifted during the storm allowing water to penetrate into building cavities. The roof may appear untouched after the wind dies down and the roof covering has settled. However, the roof membrane is often damaged, tiles are frequently loosened and the life expectancy of the roof may be severely shortened.

The window and door systems can also be damaged by wind. Even though glass is not shattered, it may be significantly scratched, window and door frames may be deflected, and seals broken. This may call for the repair or replacement of these systems.

If undetected, this type of damage may later cause problems when it is no longer possible to make a claim for recovery.

 

Chinese Drywall

 

Chinese Drywall was imported into the United States and used extensively in construction and reconstruction between the years 2004 and 2008.  Unfortunately this drywall is causing damage to the properties in which it was installed.

 

Are you experiencing:

    • A strong sulfur odor?
    • Frequent problems with your Air-Conditioning Unit?
    • Black or Corroded pipes or wiring?
    • Problems with electronics and appliances?

If you are affected, your property insurance policy needs to be assessed to determine whether it may provide you with coverage.   If you have an “All Risk” policy we can assist you to put together an action plan which will allow for an appropriate claim presentation to your carrier.   There may be opportunities for recovery under your insurance policy that do not fall under policy exclusions for “wear and tear” or “pollution”.