Fire

Potential problems with coverage:

• • Brush exposure, failure to remove an adequate distance from structures
• • Neighbors or cities or counties who don’t comply with necessary standards
• • Not meeting demands of mortgage clauses
• • Insufficient supply of fire extinguishers
• • Breaches of compliance by tenants or third parties

Hail

Potential problems with coverage:

• • Hail damage is covered by standard home insurance in most states, but how that coverage is applied can vary or be excluded altogether; they can also have percent-based deductibles (based on the home’s insured value)
• • Damage can come in the immediate and long-term; for this and other reasons, what is and isn’t covered can be a source of dispute
• • No matter the weather or climate conditions in your area, carriers can hike your rates if more than one claim is made within a time period
• • Your carrier may have an option to exclude payments for cosmetic damages such as exterior surfaces, walls, roofs, doors, and windows if the storm impacts the appearance but not the function of these elements; what is and isn’t coverable can be very gray—often, if something is damaged but functional, it’s not covered

Wind

Potential problems with coverage:

• • Depending on where you live, wind damage can be subject to percentage-based deductibles—which is based on your home’s insured value—or deductibles for wind damage, rain, tornados, hurricanes, or more; these costs are another reason it’s imperative you get your best compensation
• • For disasters qualifying for FEMA relief—presidentially-declared disasters—help tends to be short on compensation and long in time coming 
• • High winds can also bring other related damages—storm damage, inland flooding, falling trees, etc.; the more complicated the damages, the more cover you carrier has for denying your claim

Flood

Potential problems with coverage:

• • Your insurance policy may require you to mitigate damage once it’s discovered; such costs may be reimbursable—fixing leaks, tarping the roof, installing dehumidifiers, etc.; initial water damage can worsen with mold, fungus, wet rot, and more—these are all consequences most insurance won’t cover
• • It may be necessary to bring in an emergency services mitigation company to limit damages 
• • As flood damage can be complicated, so is its coverage—e.g. sinkholes and earth movement, even as a result of flooding, may not be covered or there may be limitations given to living in a “high-risk” area
• • The particular source of water damage can be critical too as carriers may have exclusions for discharge, sewage or other water backups or overflow

Appraisers not only help determine the amount of loss, but may also help determine the cause of loss. In Auto-Owners Insurance Company v. Summit Park Townhome Association, 100 F. Supp 3d 1099 (D. Colo. 2015) the court held that the cause of loss is an essential part of determining the amount of loss. Furtdao Law PC is litigating Certain Underwriters of Lloyd’s of London v. Southwind and Eastpointe Homeowners Association, Inc. (Case No. 1:16cv01288-MJW) where this ruling has been applied.

It is important that qualified professionals assist policyholders with the appraisal process. Insurance companies often attempt to influence the process by choosing biased appraisers to assist them. Some companies undermine the process by claiming an appraiser cannot determine the scope or cause of loss, and otherwise attempt to delay the process by interfering with the appraisal.

Furtado Law PC has sucessfully navigated the appraisal process for its clients.

Indemnity and defense provisions are so common, yet can be easily misinterpreted and misapplied. The terms defense and indemnify can often appear in the same clause, but each is understood to impose different obligations. These can be further compounded due to variations in statutes as well as case law that exists state to state.

The experienced attorneys at Furtado Law PC know the difference between the duty to indemnify and the duty to defend. We also know that there are some jurisdictions in which an indemnity obligation automatically carries with it the duty to defend regardless of whether the duty to defend is expressly stated.  We understand what is at stake, which is why we are committed to doing a thorough evaluation of your case to identify any ambiguities in the contract and determine how the governing law can be applied to your individual case.

Disputes between a policyholder and their insurance company about the “amount of loss” can be stressful and confusing. Furtado Law PC is committed to holding insurance companies accountable for a fair and cost-effective appraisal process.

This includes a “Proof of Loss” declaration under penalty of perjury. It is wise to consult with a qualified professional when submitting this document. If the “Proof of Loss” is found to be inaccurate, coverage under the policy may be voided.

Appraisers not only help determine the amount of loss, but may also help determine the cause of loss. In Auto-Owners Insurance Company v. Summit Park Townhome Association, 100 F. Supp 3d 1099 (D. Colo. 2015) the court held that the cause of loss is an essential part of determining the amount of loss. Furtdao Law PC is litigating Certain Underwriters of Lloyd’s of London v. Southwind and Eastpointe Homeowners Association, Inc. (Case No. 1:16cv01288-MJW) where this ruling has been applied.

It is important that qualified professionals assist policyholders with the appraisal process. Insurance companies often attempt to influence the process by choosing biased appraisers to assist them. Some companies undermine the process by claiming an appraiser cannot determine the scope or cause of loss, and otherwise attempt to delay the process by interfering with the appraisal.

Furtado Law PC has sucessfully navigated the appraisal process for its clients.

Too often, life insurance companies deny claims without justifiable reasons. Not all life insurance companies are created equal, and not all life insurance claims are treated fairly. There are a number of reasons that an insurance may deny a claim, such as no beneficiary named on the policy, policy lapse due to non-payment, divorce, “incontestability clauses”, or an assortment of tactics the company believes to be misrepresentation by the insured. In some cases, the insurance company pays the claim to the wrong beneficiary, leaving the intended beneficiary from collecting payments rightfully intended for them. Life insurance companies gain a financial benefit by collecting insurance payments and then either denying or paying substantially less when the claim is filed.  This conflict of interest can often result in a broken promise by the insurance company, denying loved ones the benefits to which they are entitled.