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Florida Court Affirms: Insurance Company Estimates Do Not Dictate Your Cost to Repair

Posted by Annie Dike | Oct 10, 2017 | 0 Comments

getting insurance proceeds to repair home after damage from a storm

“That is the amount you are owed,” says the insurance company. “I don't believe it's enough,” the policyholder replies. “Oh, it is,” the insurance company fires back, “because we said it is.”

That's not how it works. An important lesson in insurance: Who is entitled to determine the actual cash value to replace your damaged or lost property? It's not the insurance company unilaterally. Walk through this hypothetical with us: Assume you have suffered damage to your home from a storm, flood or fire, and you have filed an insurance claim to recover replacement costs. The insurance company sends one of its adjusters out to inspect your property and determine the actual cash value of your loss. Remember this adjuster works for, and is paid by, the insurance company, unlike a public adjuster who earns a percentage of his or her estimate. The insurance company then offers to pay you the amount its adjuster determined was sufficient cash value to cover your loss. Is this the unequivocal amount you must accept?

NO.

Often the insurance company's adjuster's initial assessment is inaccurate and not enough to cover the actual cash value of your loss. In a recent opinion from Florida's Third District Court of Appeal, the court re-affirmed Florida law that the insurance company is not allowed to unilaterally determine, as a matter of law, actual cash value or replacement cost value of your loss by simply “paying its own independent adjuster's estimate of the insured loss, less the deductible.” See Escobar v. Tower Hill Signature Insurance Company, Case No. 3D16-1844 (Oct. 4, 2017). Meaning, the insurance company does not get to indisputably set the price for your loss. If the policyholder presents a competing estimate that conflicts with the insurance company's estimate, this creates a genuine issue of material fact that must be decided by a jury.

At Taylor, Warren & Weidner, we have the resources to obtain an accurate assessment of your damages, from qualified professionals without incentive to reduce the amount of the estimate so the insurance company doesn't have to pay as much on your claim. Too often we hear about policyholders simply accepting an insurance company's estimate that was not sufficient to repair the damages, which leaves them stuck later with large out-of-pocket costs that should have been paid by the insurance company. You are not obligated to accept the offer the insurance company makes you without conducting your own assessment of your actual damages. If you have questions about your insurance claim and are unsure the actual cash value of your loss, feel free to contact us. We never charge an initial fee or cost to sit down with you and explain the insurance claim process and your legal rights. We only represent policyholders, never insurance companies. View the Escobar opinion here: http://3dca.flcourts.org/Opinions/3D16-1844.pdf

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