The following is an insurance claim question we answered for a policyholder through the United Policyholders Ask an Expert Forum.
Q. What are the insurance company’s responsibilities to their policyholders with regard to providing any adjuster’s reports, ALE expenses and any timeline they are ruled by? Insurance company says I am not eligible for ALE because I have a second home. Any guidance you could give would be appreciated.
A. So sorry to hear that you are having these problems with your insurance company. Your insurance company owes you a duty to respond to your needs (ALE – Additional Living Expenses) based on the terms and conditions of your insurance policy. Since there are numerous variations of homeowners property insurance policies in force in Florida, I would need to see what form you have and read the terms and conditions outlined in the policy.
Having said that, if you do have ALE and your home is not livable, your company owes for additional living expenses to maintain your normal and customary lifestyle. In my opinion, your second home has nothing to do with your insurance company failing to pay for your loss. If your second home will afford you the same life style as the damaged home then you need to have a realtor provide you with a statement as to the fair market value of the second home and submit this as part of your additional living expense claim.
As to your other questions about other responsibilities your insurance company has, they need to provide to you in detail any issues they have with your claim such as coverage questions, disagreements if they differ with you on the cost of repairs and replacements of the covered property. If you have not been given any information regarding the status etc, I would forget trying to deal with the field adjusters. They simply are not doing their job. You need to find out where your insurance company is located and write a detailed letter to the president of the company with the facts of the claim and the problems getting info you are experiencing. Send the letter certified mail with a copy to the Florida Department of Financial Services or Office of Insurance Regulation in Tallahassee where you can file a complaint. This agency oversees the Department of Insurance.
If your claim does not get turned around quickly, consider looking into retaining a public adjuster. My firm and others are actively helping folks like you with insurance claims disputes. In my opinion there is no excuse for your claim dragging on this long. You most likely will need professional help. Always check references, as well as experience levels. If you are going the public adjuster route, be mindful of fee caps imposed due to a state of emergency issued by Florida’s Governor for storm events such as Hurricane Matthew.
As always, the professional public insurance adjusters at Tutwiler and Associates are here to help with any property insurance related questions you may have. Please call 800.321.4488 or contact a public adjuster to submit a question to one of our insurance claim experts.