Insurance Claims

It can be devastating when an insurance company denies your claim without a valid reason or without investigating properly.  When you are in the midst of responding to damage caused by mold, water intrusions, or contamination of your home, it is doubly unfair when an insurance company that should provide coverage refuses improperly to do so.  Our firm is experienced in reading and analyzing insurance policies.

If you have suffered a loss resulting in property damage to your house, condominium, or apartment, it can be difficult to read an insurance policy that may provide coverage for your loss.  It is rarely advisable to accept the insurance company’s assertion that there is no coverage without thoroughly examining the entire policy, including endorsements, exclusions, and exceptions that may provide coverage.

First Party Claims.  A Homeowners’ (HO) insurance policy provides first-party coverage for damages caused by non-excluded losses.  Insurance companies have a duty of good faith and fair dealing with homeowners.  When an insurance company fails to evaluate a claim fairly and in good faith, it may be in violation of statutes that prohibits unfair and deceptive insurance practices.  Insurance companies have an obligation to respond within a reasonable time to a claim, and must not deny a claim without conducting a proper investigation.  Most HO policies now provide limited coverage for mold-related claims.  It can often be difficult to determine what coverage is, or is not, provided by mold endorsement language in a policy.  We have experience in interpreting these mold coverage provisions.

Third party claims.  An insurance claim based on the negligence of a third party such as a contractor or remediation company will be the subject of a claim against the contractor or remediation company’s insurance company.  These policies are third-party contracts, generally referred to as a Commercial General Liability (CGL) policy.

Condominiums.  If you own a condominium unit, issues may arise regarding both your unit owner’s policy and the condominium association’s master policy.  Where one leaves off and the other begins can be confusing, and will often depend on the description of your unit and of the common areas which are generally found in either your unit deed or the condominium master deed.

HO, CGL and condominium policies are complicated and difficult to fully understand.  We have experience in reviewing insurance policies to determine when and to what extent a policy may provide coverage.  We can advise on whether it is necessary to hire a “public adjuster” to appraise property damage on your behalf.

It is important to review your policy carefully soon after a loss.  The policy will contain provisions regarding time limits and other requirements for making a claim.  It is important that these claims provisions be carefully followed and complied with.

When an insurer fails to investigate properly or denies a claim without a valid reason, such ‘bad faith’ conduct can permit you to sue for additional money damages, including attorney’s fees and multiple damages.  We are experienced in interpreting insurance policies, and holding insurance companies accountable for their prompt and fair investigation and payment on claims that are not excluded by the policy.