Question 1

What is first-party property insurance?

Accepted Answer

First-party property insurance is coverage you purchase to protect your own property. When you file a claim with your own insurance company (such as a homeowner's or commercial property claim), that's a first-party claim. This differs from third-party claims where you seek compensation from someone else's insurance.

Question 2

What does 'bad faith' mean in insurance terms?

Accepted Answer

Bad faith occurs when an insurance company fails to uphold its duty to fairly handle your claim. This includes unreasonably denying valid claims, delaying payment without justification, failing to properly investigate, or misrepresenting policy terms. In Florida, policyholders can sue insurers for bad faith practices.

Question 3

What is the difference between actual cash value (ACV) and replacement cost value (RCV)?

Accepted Answer

Actual Cash Value (ACV) is the cost to replace damaged property minus depreciation, essentially what your item is worth today. Replacement Cost Value (RCV) covers the full cost to replace or repair your property without deducting for depreciation. RCV policies typically provide better coverage but may have higher premiums.

Question 4

What is a proof of loss and when is it required?

Accepted Answer

A proof of loss is a sworn statement you submit to your insurance company documenting the items damaged or destroyed and their value. Many policies require you to submit this document within a specific timeframe (often 60 days). Failing to submit it properly can jeopardize your claim.

Question 5

What does 'subrogation' mean?

Accepted Answer

Subrogation is the process where your insurance company, after paying your claim, seeks reimbursement from the party responsible for the damage. For example, if another driver causes an accident and your insurer pays for repairs, they may pursue that driver's insurance for reimbursement.

Question 6

Do I really need an attorney for an insurance claim?

Accepted Answer

While not every claim requires an attorney, having legal representation often results in significantly higher settlements. Insurance companies have teams of adjusters and lawyers working to minimize payouts. An experienced attorney levels the playing field and ensures you receive fair compensation.

Question 7

What types of damage are typically covered under homeowner's insurance?

Accepted Answer

Most homeowner's policies cover damage from fire, lightning, windstorms, hail, explosions, theft, vandalism, and water damage from sudden events (like burst pipes). However, flood damage typically requires separate coverage, and maintenance-related issues are generally excluded.

Question 8

My roof was damaged in a storm. Will my insurance cover it?

Accepted Answer

Storm damage to roofs is generally covered under homeowner's insurance. However, insurers often dispute the cause or extent of damage, claiming it's due to wear and tear rather than the storm. Document the damage thoroughly with photos and get an independent inspection before the insurance adjuster arrives.

Question 9

What should I do immediately after discovering property damage?

Accepted Answer

First, ensure safety and prevent further damage if possible (cover holes, turn off water, etc.). Document everything with photos and videos before cleanup. Contact your insurance company to report the claim. Keep all receipts for emergency repairs. Don't discard damaged items until the adjuster has inspected them.

Question 10

Can my insurance company cancel my policy after I file a claim?

Accepted Answer

In Florida, insurers cannot cancel your policy mid-term simply because you filed a claim. However, they can choose not to renew your policy at the end of the term. If you receive a non-renewal notice, you have time to find alternative coverage.

Question 11

What if my insurance company's estimate is much lower than the contractor's estimate?

Accepted Answer

This is extremely common. Insurance adjusters often underestimate repair costs. You have the right to dispute their estimate. Get multiple contractor estimates, document everything, and consider hiring a public adjuster or attorney to negotiate on your behalf.

Question 12

Does my homeowner's policy cover water damage from flooding?

Accepted Answer

Standard homeowner's policies do NOT cover flood damage. Flood insurance is a separate policy, typically obtained through the National Flood Insurance Program (NFIP) or private insurers. However, water damage from internal sources (burst pipes, appliance leaks) is usually covered.

Question 13

How long does the insurance company have to respond to my claim?

Accepted Answer

In Florida, insurance companies must acknowledge your claim within 14 days and make a coverage decision within 90 days. If they fail to meet these deadlines without justification, it may constitute bad faith. Keep records of all communications and note any delays.

Question 14

What is business interruption insurance and what does it cover?

Accepted Answer

Business interruption insurance covers lost income and operating expenses when your business cannot operate due to a covered event (like fire or storm damage). It typically covers lost profits, rent, payroll, loan payments, and relocation costs during the restoration period.

Question 15

How is a commercial property claim different from a residential claim?

Accepted Answer

Commercial claims are typically more complex due to larger policy limits, multiple coverage types (building, contents, business interruption, liability), and the need to document business losses. The claims process often involves forensic accountants and business valuation experts.

Question 16

My business was damaged by a hurricane. What types of losses can I claim?

Accepted Answer

You may be able to claim: physical damage to the building and contents, business interruption losses, extra expenses incurred to continue operations, spoiled inventory, and sometimes contingent business interruption if suppliers or key customers were also affected.

Question 17

What is a commercial property appraisal and when should I request one?

Accepted Answer

When you and your insurance company cannot agree on the value of your loss, most policies include an appraisal clause. Each party selects an appraiser, and the two appraisers select an umpire. The decision of any two of these three is binding. This can be faster and less expensive than litigation.

Question 18

How do I prove my business income losses to the insurance company?

Accepted Answer

You'll need detailed financial records including tax returns, profit and loss statements, accounts receivable, sales records, and projections showing what you would have earned. Having a forensic accountant prepare this analysis significantly strengthens your claim.

Question 19

Can I continue operating my business while pursuing an insurance claim?

Accepted Answer

Yes, and you should. Taking reasonable steps to mitigate your losses is actually required by most policies. Keep detailed records of all expenses incurred to maintain operations since many of these 'extra expenses' may be reimbursable under your policy.

Question 20

What should I do if my insurance claim is denied?

Accepted Answer

Don't accept the denial as final. Request a written explanation citing specific policy language. Review your policy carefully because denials are often based on incorrect interpretations. Gather evidence supporting your claim, and consult with an attorney who can evaluate whether the denial was improper.

Question 21

What is the difference between mediation and appraisal?

Accepted Answer

Mediation is a voluntary negotiation process with a neutral third party helping both sides reach agreement. Appraisal is specifically for disputes about the amount of loss (not coverage) and results in a binding decision. Appraisal is typically required by your policy; mediation may be offered as an option.

Question 22

Can I sue my insurance company if they deny my claim?

Accepted Answer

Yes. If your insurer wrongfully denies your claim or acts in bad faith, you can file a lawsuit. In Florida, successful policyholders may recover the full claim amount, attorney's fees, and potentially additional damages for bad faith. Time limits apply, so consult an attorney promptly.

Question 23

What evidence do I need to dispute my insurance company's decision?

Accepted Answer

Gather all policy documents, your complete claim file, correspondence with the insurer, photos and videos of damage, repair estimates from licensed contractors, expert opinions, and any other documentation supporting your claim. The more thorough your evidence, the stronger your case.

Question 24

How long do I have to file a lawsuit against my insurance company?

Accepted Answer

In Florida, you generally have five years from the date of loss to file a breach of contract lawsuit against your insurer. However, some policies contain shorter limitation periods, so check your policy language. Don't wait because evidence becomes harder to gather and witnesses' memories fade over time.

Question 25

What is an Examination Under Oath (EUO)?

Accepted Answer

An EUO is a formal recorded interview conducted by the insurance company's attorney where you answer questions under oath about your claim. Your policy requires you to participate if requested. Having your own attorney present is strongly recommended to protect your rights.

Question 26

Will disputing my claim affect my future insurance rates or ability to get coverage?

Accepted Answer

Filing a claim or dispute becomes part of your claims history, which insurers can access. However, you shouldn't let this fear prevent you from pursuing legitimate claims. The financial recovery from a successful claim typically far outweighs any potential premium increase.

Question 27

How much does it cost to hire Ruiz Legal?

Accepted Answer

We work on a contingency fee basis for insurance and personal injury cases. This means you pay nothing upfront and we only get paid if we win your case. Our fee is a percentage of the recovery we obtain for you. Initial consultations are always free.

Question 28

What happens during the initial consultation?

Accepted Answer

During your free consultation, we'll discuss the details of your situation, review relevant documents (policies, denial letters, medical records), explain your legal options, answer your questions, and provide an honest assessment of your case. There's no obligation to hire us.

Question 29

How long does a typical insurance dispute case take?

Accepted Answer

Timelines vary significantly. Simple disputes may resolve in 2-4 months through negotiation. Complex cases requiring litigation can take 12-24 months or longer. We'll give you a realistic timeline based on your specific situation and keep you updated throughout the process.

Question 30

Will my case go to trial?

Accepted Answer

Most cases settle before trial, typically 90 to 95 percent of insurance disputes reach a settlement. However, we prepare every case as if it's going to trial. This thorough preparation often leads to better settlement offers because insurers know we're willing to fight in court if necessary.

Question 31

What does 'contingency fee' mean exactly?

Accepted Answer

A contingency fee means our payment is 'contingent' on winning your case. If we don't recover money for you, you owe us nothing for attorney's fees. If we do recover, our fee is typically a percentage (usually 33-40%) of the amount recovered. This arrangement allows everyone access to quality legal representation.

Question 32

Will I have to go to court or testify?

Accepted Answer

If your case settles (as most do), you likely won't need to appear in court. If litigation is necessary, you may need to participate in depositions (recorded interviews) and potentially testify at trial. We thoroughly prepare our clients for any testimony required.

Question 33

How do I communicate with my attorney during my case?

Accepted Answer

At Ruiz Legal, you have direct access to your attorney, not just paralegals or assistants. We communicate via phone, email, and in-person meetings as needed. We believe in keeping clients informed and are always available to answer questions and address concerns.

Question 34

What should I do immediately after a car accident?

Accepted Answer

Ensure safety first, then call 911 to report the accident. Document everything: take photos of all vehicles, the scene, and any injuries. Exchange information with other drivers. Get witness contact information. Seek medical attention even if you feel fine because some injuries appear later. Don't admit fault or give recorded statements to insurers before consulting an attorney.

Question 35

How long do I have to file a personal injury claim after an accident in Florida?

Accepted Answer

In Florida, you generally have four years from the date of the accident to file a personal injury lawsuit. However, you should report the accident to your insurance company promptly (most policies require 'timely' notice). Evidence becomes harder to gather over time, so consult an attorney as soon as possible.

Question 36

What is PIP insurance and how does it work in Florida?

Accepted Answer

PIP (Personal Injury Protection) is required no-fault insurance in Florida. It covers 80% of medical expenses and 60% of lost wages up to $10,000, regardless of who caused the accident. You must seek medical treatment within 14 days of the accident for PIP to apply.

Question 37

Can I still recover damages if I was partially at fault for the accident?

Accepted Answer

Yes. Florida follows a modified comparative negligence system. You can recover damages as long as you are not more than 50% at fault. However, your recovery is reduced by your percentage of fault. For example, if you're 20% at fault and damages are $100,000, you could recover $80,000.

Question 38

What damages can I recover in an auto accident case?

Accepted Answer

You may recover: medical expenses (past and future), lost wages and loss of earning capacity, property damage, pain and suffering, emotional distress, loss of enjoyment of life, and in some cases, punitive damages if the at-fault driver's conduct was particularly egregious.

Question 39

The insurance company is pressuring me to give a recorded statement. Should I?

Accepted Answer

Be very cautious. While your own insurer may have a right to a statement under your policy, the other driver's insurance company does not. Insurance adjusters are trained to get statements that can be used against you. We strongly recommend consulting an attorney before giving any recorded statement.

Question 40

What if the other driver doesn't have insurance or flees the scene?

Accepted Answer

If you have uninsured/underinsured motorist (UM/UIM) coverage on your own policy, it can cover your damages when the at-fault driver has no insurance or insufficient coverage. This is why we strongly recommend carrying adequate UM/UIM coverage. We can also investigate to help identify hit-and-run drivers.

FAQ & Resources

Categories

Stay Informed

General & Definitions

Still Have Questions?

Frequently Asked Questions