Understanding Wilmington Insurance Claims
The volume of homeowner’s insurance claims having to do with weather is steadily increasing. Homeowner’s insurance typically covers the home for damages such as fire, flood, wind, hail, and wind-driven rain.
Several years ago, many insurance companies in North Carolina begin requiring people to purchase different insurance policies for varying damages. For instance, floods are now rarely covered by homeowner’s insurance policies. Different policies have to be purchased separately from the homeowner’s insurance.
Insurance companies often try to deny coverage for wind-driven rain by saying that the damage to the roof was pre-existing, or that the roof was not kept in quality shape. As a result, policyholders may need assistance with understanding Wilmington insurance claims and what their policy covers. They should also make sure to get any denials from an insurance company in writing to help an experienced insurance claim denial attorney build a case if it must go to court.
Insurance Coverage Eligibility
Anyone over the age of 18 can purchase insurance in Wilmington. It is imperative to remember that an insurance policy is a contract and ultimately goes both ways. There are certain things that a policyholder must do after an incident to be eligible for coverage.
In most homeowner’s insurance contracts, the homeowner must give prompt notice of their claim to the insurance company — usually in a very specific way. They also have to cooperate with the insurance company’s investigation of the damage, fill out a proof of loss form, and have it notarized. A claimant must also fill out a personal-content inventory sheet that details personal property damage to things like furniture and clothing.
Things a policyholder must do to get coverage are usually listed in a policy’s “duties after the loss” section. Sometimes, an insurance company will argue that the insured failed to do one of those listed duties and deny coverage completely. Insurance companies often try to make crafty arguments to deny coverage even when a loss is covered, so it is crucial to have a substantial understanding of Wilmington insurance claims.
An Insurance Company’s Duty to the Insured
In addition to an insurance company’s contractual obligations to the insured, there is case law which outlines reasonable insurer duties. For example, some have to do with promptly investigating claims after they are reported.
Insurance companies owe thorough investigations based on all of the available information, prompt notice to the insured about their decision, and explanations about why coverage is being denied. The insurer also has a general duty to communicate reasonably with the insured about the process, the claim denial, or what coverage is afforded.
There are also cases in which a person has asked their insurance agent to obtain a certain type of insurance such as wind and hail coverage, but the agent fails to procure it. If that policyholder later suffers damage to their home that otherwise would have been covered had the insurance agent not breached that duty, the company could be held liable. Although, insurance agents are often covered by errors and omissions policies, which cover them if they make a mistake like failing to procure. For more information, contact a seasoned lawyer.
Circumstances Leading to an Insurance Denial
A homeowner’s insurance claim could be denied if it is not a covered loss under the policy or if the cause of loss falls under a listed exclusion. Also, an insurance company may deny a claim by arguing that the damage was pre-existing or that it was caused by the insured’s negligence.
For example, the company might argue that a claimant failed to take reasonable steps to protect their property. This argument appeared in many claims related to Hurricanes Florence and Michael. An insurance company may also try to deny coverage by alleging that the insured did not perform one or more of their duties following the incident. Even if an insurance company allows a claim, it may underpay the insured, so it may be critical to have a lawyer look at the compensation to make sure it is fair under the policy. For help with understanding Wilmington insurance claims, get in touch with a seasoned attorney today.
