Aaron Fessia Aaron Fessia

Fort Pierce Beach House - Hurricane Irma Damage and Flood Damage

Flood waters, as well as wind from Hurricane Irma damaged a Fort Beach vacation property

Fort Pierce, Florida - Shortly after Hurricane Irma had passed, our public adjusters were contacted by two potential clients (B.S. and R.S.) who lived in Miami that own a beach house in Fort Pierce, just a few blocks from the Fort Pierce inlet. This home was their vacation property that they use to get out of the city and relax at the beach. 

Without having seen their property yet, they asked if VIP Adjusting's public adjusters would check out the property for them to make sure it was still standing and we were happy to oblige. Luckily, the home was still standing, but there were flood waters inside the home and pretty clear wind damage to the outside. 

 
Cabinets damaged from flood waters in Fort Pierce Beach House

The Loss - Hurricane Irma and related storm surge/flooding

Being directly adjacent to the ocean, it's no surprise that the storm caused damage to this Fort Pierce beach house. The unfortunate part for the homeowners was that they had recently purchased and renovated this property and were now looking at having to deal with two insurance companies and then renovate again.

The Flood Claim - NFIP

There was a clear flood line in the home indicating where the flood waters had risen to, causing damage to the new kitchen cabinets, flooring, and brand new appliances, as well the baseboards and about a foot of drywall.

The public adjusters at VIP Adjusting have handled flood claims in the past, which are vastly different from the average homeowners insurance claim and standard property damage. The NFIP, or National Flood Insurance Program is a program through the federal government to make sure all homeowners are able to get flood insurance. Nationwide premiums, as well as FEMA, serve to keep the premium costs low for situations such as these.

There are also a completely different set of guidelines in how to present and handle these claims. Ultimately, following the initial claim presentation, this process went pretty smoothly for this insured and all of the damaged items were fairly compensated. 

The Hurricane Claim - A Florida Insurance Company

The wind damages to the property from Hurricane Irma were a different story and went as expected. There were clear wind damages to the roof of the home and the exterior air conditioner, and interior water staining to the ceilings and upper drywall from roof leaks (not damaged by flood).

The insurance company accepted coverage but refused payment as being under deductible. After ignoring the public adjuster's estimate a lawsuit was filed and after just a few months the claim was ultimately paid fairly, but not without having to jump through all the hoops. 

Complications with split cause claims

It doesn't often happen that damages to a home from multiple sources, but when it does, it can be tricky for both the homeowner or insured and their public adjuster. It's important to claim all of the damages, while at the same time, the damages need to clearly be attributed to one cause of loss or another, instead of both. If it's unclear which source was the ultimate damage, it needs to be specified to the insurance company or companies so that the insured and public adjuster aren't pursuing double damages, which, if intentional would constitute insurance fraud. 

The flood and hurricane scenario is one of the most common split cause of loss claims, but it can also happen in daily claims where a plumbing leak and the change in pressure results in multiple leaks at once, or a leak detection finds multiple leaks which may or may not have been long term.

In this instance, for our client, it was invaluable to have an experienced and local public adjuster in the Fort Pierce area, both to handle the overlapping damages caused by wind and flood, and to facilitate the entire process at their vacation home that was several hours away from their primary residence. 

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Aaron Fessia Aaron Fessia

Miami Plumbing Leak Egregious Denial from Insurance Company - Overturned in Litigation

Miami, Florida - VIP Adjusting usually doesn't handle many claims in Miami. Our headquarters are in Fort Pierce in St Lucie County, and we normally handle claims throughout the Treasure Coast and Space Coast, from Jupiter, to Stuart, to Vero Beach, and Indialantica, but a client referral came to us in Miami.

This client, M.V., came home from work to find water spraying from the wall in his garage where his washing machine hookup connected to the wall. What happened next will probably make your head spin.

Even our public adjusters were surprised with the conduct of this insurance company!

After causing damage, the drywall was left open so the insurance company could inspect the source of the water damage

The Loss - Pressurized plumbing leak to washing machine

The homeowner/insured came home from work and entered through his garage. He immediately saw water on the floor and spraying from the wall at about chest height since the washing machine was on a raised step.

Thinking quickly, the insured snapped a quick video and turned off the water supply to the house at the main valve to the home. 

The damages to the garage and kitchen

Obviously there was water spraying in the garage. The pressure from the spray had burst a hole through the drywall and was spraying out onto the concrete floor. Aside from the drywall damage in the garage, and what would be required to open the wall and repair the pipe, the damages in the garage were minimal, but, a lot of water also ended up inside the wall, which was shared with the home's kitchen.Inside, there was visible damage to half of the kitchen's cabinets, and in one space between the cabinets, you could see extensive staining and discoloration to the drywall behind the cabinets. Adjacent to the cabinets, tile baseboards had fallen off and broken.Despite the relatively minimal visible water in the garage, this home clearly had much more extensive damage and required significant repairs. 

A plumber initially opened the garage wall, and repaired the supply line to the washing machine, leaving it open for inspection by the insurance company. What remained outstanding was removing and replacing all the kitchen cabinetry, drywall in the kitchen, replacement of the tile backsplash, and replacement of the continuous tile flooring that could not be matched throughout the home.

The Insurance Claim and Outcome

For such a small leak, there were some pretty substantial repairs to restore the home to pre-loss condition. Maybe that's what made the insurance company do what they did next.

Despite the fact the insured had a video of the active leak from the burst pipe (that wasn't leaking when he left for work), the insurance company conducted its "investigation" and DENIED the insured's claim, declaring that the homeowners' leak was the result of "constant or repeated seepage or leakage which occurs over a period of time."

This language in the insurance policy is meant to exclude coverage for leaks that have been ongoing and known to the insured for a long period, essentially reinforcing the duty to protect the property from further damages. An insured who can't be bothered to address a leak for months shouldn't be entitled to insurance coverage because the damages have likely worsened because of the insured's actions. 

A leak that occurred the same day and was actively observed and documented, however, is not that. To adopt this insurance company's view, this insurance policy would cover all plumbing leaks except when the insurance company didn't feel like paying for it. Technically, the first drop of water is a new leak and the second drop is "repeated leakage." This is just an illogical conclusion.

The real outcome

Unfortunately the insured had to file a lawsuit to obtain a fair recovery and obtain the benefits he was entitled to under the insurance policy. Luckily, it happened in short order. The time from the date of loss to the final settlement in litigation was just about 6 months, which is pretty reasonable for Florida insurance claims. 

At the end of the day, a settlement was negotiated that let the insured replace their kitchen and backsplash, but instead of replacing the full tile floor because of the broken baseboard, the insured agreed to replace the baseboard with wooden baseboards.

Had this homeowner not connected with a public adjuster, he may well have never pursued the insurance company after they issued the coverage denial, and that's exactly what most insurance companies hope for.

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Aaron Fessia Aaron Fessia

Hurricane Irma damage to West Palm Beach home denied as under deductible - Roof paid in Appraisal

West Palm Beach, Florida - A two-story 3,000+ square-foot plantation-style home in the Southland Park neighborhood of West Palm Beach was damaged by hurricane Irma, resulting in water damaging several areas of the home's interior ceilings and floors. Due to the value of this home, it unfortunately carried a high deductible on its windstorm insurance. The homeowner (G.W.) contacted the public adjusters at VIP Adjusting before reporting the claim, and although it didn't start smoothly, the insured was paid enough to replace their roof, even after their deductible was applied.

Hurricane Damaged home in historic Palm Beach Neighborhood

The Loss - Hurricane Irma

Hurricane Irma had a hurricane-force wind field that exceeded the width of the entire state of Florida, and affected nearly the entire state as it traveled from south to north. Some homes escaped damage from the storm, while others suffered only minor damages. Many homeowners weren't so lucky and had severe damages to their homes.

Luckily for this homeowner, the hurricane damage to this home fell somewhere in between. After the storm had passed, the insured noticed there was some staining in a few areas of the home, including in some of the bedrooms, the downstairs tray ceilings in the main living area, and there was also damage in some areas of the wood flooring throughout the home. 

The damages to the home

In order for the insured to have noticed the interior staining, there first had to be damages to the roof caused by the storm. VIP Adjusting's public adjuster got on that second story roof, and verified and documented the damages that allowed the water to come in.

On top of that, near the children's bedrooms, there was a musty odor and it was verified that some areas of mold did develop in the aftermath of the storm while most homes were without power.

The Insurance Claim and Outcome

Our public adjusters reported the claim on the homeowners' behalf and documented the damages while also preparing estimates of the damages. The insurance company's original inspector, perhaps in the post-storm haste, took a look at the policy's huge deductible and simply declared that the damages wouldn't exceed it. To be fair, this property's deductible was larger than most other homeowner's insurance claim value entirely.

In any event, our public adjusters persisted, submitting our estimate to the insurance company and demanding appraisal.

The appraisal process

Some insurance policies require an insurance appraiser to be neutral or disinterested in a claim. Other times it's a tactical decision to use an outside appraiser to lend credibility to the claim. In this instance, a licensed and insured general contractor with extensive insurance appraisal experience was selected as the homeowner's appraiser.

The insurance company inexplicably selected an out-of-state vice-president of a large national construction company who didn't appear to have any ties to Florida, nor had any of the reputable appraisers or umpires our public adjusters have built relationships with even heard of the guy. This struck us as odd for an insurance company marketed as a luxury homeowners insurance company, but an insurance company’s choice of appraiser isn’t up to the insured or the public adjuster. Little did we know that was only the beginning...

We initially tried to reach out to the appraiser for the insurance company, proposing umpires, only to be completely ignored. When we reached out to the insurance company after a more-than-reasonable timeframe had passed, the appraiser responded, lying that he had responded, when he had done no such thing. The insurance company's appraiser elected to carry that unprofessional behavior throughout the rest of the appraisal process. 

The insurance company's appraiser was incredibly rude to our insured's appraiser, and elected to bring in "experts" whose credentials we verified did not qualify them to provide the opinions they were offering, including unlicensed contractors and individuals from out of state who were unfamiliar with Florida building practices and Florida building code.

As a result of the ongoing dispute, the umpire was invoked and an additional inspection was conducted with both appraisers and the umpire. At the umpire meeting, the insurance company's appraiser started yelling at our appraiser in the insured's home in front of the insured who had to excuse themselves from their own home. 

The umpire cut that behavior off quickly, but not before the insured had to be subject to such an unprofessional outburst from their insurance company's representative. 

Ultimately, the umpire agreed with our appraiser and issued an award of more than $110,000. Despite the high deductible and previously having been offered $0 by the insurance company, our client was able to replace the roof and adequately repair the interior water damages to the home.

Post-appraisal follow up

In addition to the favorable award, the insurance company was notified of the unprofessional behavior by their representative in the insured's home, and were apprised of all of this insurance company’s core values that this behavior goes against. This so-called “luxury” insurance carrier offers insurance policies that waive hurricane deductibles, and also had waived hurricane deductibles in the northeast after Superstorm Sandy, so we requested that be done here, as well as refunding the insured the costs associated with the umpire, since the dispute could have easily been resolved with a reasonable and qualified appraiser on behalf of the insurance company, as evidenced by the appraisal award in our favor. The insurance company's representative declined the deductible refund, however did agree to provide compensation for the behavior including the costs of the umpire.

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Aaron Fessia Aaron Fessia

St Lucie Plumbing Leak - Broken Tiles - Successful Appraisal

St. Lucie County, Florida - A single family homeowner (R.Y.) in Port St. Lucie had a burst supply line inside the slab of his home. Water was coming out of the slab in multiple locations causing significant damage.

The homeowner contacted the public adjusters at VIP Adjusting to assist him with the insurance claim process and to make sure he was fairly paid for his homeowners insurance claim.

Fans drying water after plumbing leak

The Loss - Supply Line Plumbing Leak - Burst Copper Pipe

A copper supply pipe inside the slab of this home burst and resulted in water damage in the insured's garage. The homeowner immediately contacted a plumber who turned off the water supply and located the break between the home's main and the kitchen, as well as a leak between the plumbing manifold and the master bathroom. The plumber noted water coming from the slab in multiple locations. In order to restore the use of the home's plumbing, the plumber performed a plumbing re-route, which is typically covered by most homeowners insurance policies.


The Damages to the home from the plumbing leak

While the homeowner initially only noticed water in the garage, during the leak detection process, the plumber noticed water escaping in multiple locations from the slab, often ending up inside the slab and escaping in other locations. 

The use of a moisture meter during the inspection showed damage to drywall in several rooms, including multiple bathrooms and the kitchen, damage bathroom vanities, and damage to kitchen cabinets. In addition to the use of a moisture meter, there was also visible damage to exterior stucco where water was escaping, and multiple popped tiles and cracked tiles in the home that were not damaged prior to this plumbing leak.

The homeowner hired a water mitigation contractor to provide restoration services to the home, including removal of wet drywall, and the use of fans and blowers to dry wet materials in place, including the damaged cabinets and vanities, all to prevent mold growth. This type of water remediation was required under the homeowner’s insurance policy as part of his post-loss duty to protect the property from further damage. 

The Insurance Claim and Outcome

VIP Adjusting's public adjusters reported the claim on the homeowners behalf and documented the damages while preparing an estimate on his behalf. Based on the public adjuster's presentation of damages to the insurance company, insurance initially paid $41,000 for the damages to the home, including repair to damaged drywall, replacement of tile flooring in the kitchen (but not all of the tile flooring), and a minimal repair for refacing of the cabinetry. The insurance company also paid for content manipulation, packout, and storage, including the difficult area in the garage.

VIP Adjusting's estimate prepared by our licensed public adjusters included replacement of the bathroom vanities, replacement of the damaged kitchen cabinetry, and replacement of the tile flooring throughout, including the visibly broken tiles that the insurance company did not believe were caused by the water damage.

Our public adjusters disagreed with the insurance company’s evaluation of the flooring, since the homeowner indicated it wasn't damaged prior to this leak, the cracks to the tile looked new, and not old or worn, and the damage was consistent with the dampening and drying, expansion and contraction of the slab and mortar underneath.

Resolving the claim through the appraisal process

Ultimately, as a result of the dispute for the proper payment of this claim, it ended up in appraisal. We wrote recently about the strengths and weaknesses of resolving insurance claims through the appraisal process

For this claim, we selected an impartial third-party general contractor to act as the appraiser on behalf of the homeowner. Our appraiser and the insurance company's appraiser were able to come to agreement on the majority of the damages and reached a final appraisal award of over $85,000, more than double the initial claim payment. When all was said and done, our client was able to perform the significant renovations that restored him to his pre-loss condition.

If you've found yourself with water on the floor in your home, let VIP Adjusting's public adjuster's perform a free claim evaluation for you. Sometimes, when you think there's just a little bit of water on the floor of your garage, there can be a lot of hidden damage that can result in costly repairs. If this homeowner had waited until he started trying to make repairs to report his claim, he might have had his claim denied!

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More about damage caused by plumbing leaks

What’s covered by your insurance policy when you’ve had a plumbing leak

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