Frequently Asked Questions

The questions I get asked before anybody hires me.

Every question on this page is one a policyholder, an owner or a board generally asks prior to retaining me, grouped by the kind of loss it came from. The answers are general, because your policy is the one that decides your claim. If yours isn’t here, call and ask it.

Call 561-281-6990 Request a claim review

Common questions about a claim

Is a private adjuster or a personal adjuster the same as a public adjuster?

Most people call a public adjuster a private adjuster, and some call it a personal adjuster. Those are the phrases I hear on nearly every first call. Florida licenses the profession as public adjusting, and it means the same thing — an adjuster you hire, who works for you rather than for the insurance company. The adjuster your carrier sends is a company adjuster, or an independent adjuster working on the carrier’s behalf. There is no private adjuster license and no personal adjuster license in Florida, so if either is what you’re searching for, this is it. §626.854

My insurance company denied my claim. Is that the end of it?

No. A denial is a position, not a verdict, and denials get reversed. What reverses them is putting the policy language and the physical evidence side by side and making the insurance company answer for the difference. Read the denial letter closely — it has to tell you the ground they denied it on, and that ground is what gets answered.

They paid, but the check won’t cover the repairs. Can I dispute the amount?

Yes, and this is far more common than an outright denial. A claim you already reported can be supplemented, and in Florida you have 18 months from the date of loss to do it. Ask for a copy of their adjuster’s estimate first — you’re entitled to one, and most policyholders argue about a number they have never actually seen.

Can I reopen a claim that’s already been closed?

Yes. Asking for more money on a claim you already reported is a supplemental claim, whether the damage was found at the time and underpaid or nobody saw it until later. The same 18-month window from the date of loss applies, which is why damage that surfaces months after everyone moved on is worth a phone call rather than a shrug.

Do I actually need a public adjuster?

Maybe not, and you should find out before you hire anyone. Call and ask. I’d rather spend twenty minutes telling you your insurance company is treating you fairly than have you find out two years from now that something was overlooked or missed entirely. The call costs you nothing either way. What a public adjuster may charge is set by statute — §626.854.

Common flood questions

Does flood insurance pay for a hotel while I can’t live in my house?

No. There’s no additional living expense on a standard flood policy — no hotel, no meals, no clothing. Your homeowners policy generally covers that under Coverage D for a covered loss, but flood is a separate policy and it doesn’t. Plan for it before you need it, because finding out afterwards is expensive.

Is my sunken living room covered?

Generally the structure is, but the contents in it aren’t. Under most flood policies anything below grade is treated the way a basement is treated, and there’s no contents coverage below grade — including the carpeting. The narrow exception is an appliance that services the dwelling, such as a refrigerator or a water heater.

My adjuster isn’t getting back to me. Is there anyone else I can call?

Yes. The adjuster who came to your house is the field adjuster. Inside the insurance company there’s a desk adjuster handling your claim, and they’re the source on where your claim stands and when a payment is going out. Ask for their name, phone number and email, and go to them directly when the answers stop coming.

I didn’t have flood insurance. Is there anything I can do?

Yes. You can apply for FEMA assistance after a declared disaster even without flood insurance, and even in a high-risk flood zone. If you carry any other insurance, FEMA needs proof of the settlement or a denial letter first — so report the loss and get their position in writing. Know that accepting FEMA money for flood damage in a high-risk area commits you to carrying flood insurance on that property from then on.

Common hail, lightning and wind questions

Do I have to pay my hurricane deductible on a summer storm?

No. A hurricane deductible applies to a named storm. A thunderstorm, hail cell or straight-line wind event falls under your ordinary all-other-perils deductible, which is normally a flat amount and normally much smaller. Check your declarations page before you decide the claim isn’t worth making.

The roof looks fine from the ground. Is it worth having it looked at?

Yes, and the ground is the problem. After winds over 60 to 70 mph, tile needs to be checked from above for damages — especially on a roof twenty years or older. Hail breaks tile and bruises shingles, and the aluminum roof vents usually go first. None of that reads from the driveway.

Lightning killed my air conditioner and my television. Is that covered?

Usually, yes. Get an electrician out and get their assessment in writing — they see fried circuit boards constantly and can tie the failure to the strike. And don’t throw anything away until the claim has been paid on that item and you’re satisfied with the payment.

Nobody else on my street filed a claim. Does that matter?

It makes proving the date harder. When a whole neighborhood reports, the event usually already has a catastrophe number behind it and nothing needs establishing. If you’re on your own, be ready to verify the storm with a weather report for that date and location, which can be obtained for a fee.

More on this: Hail, lightning and wind claims.

Common water loss questions

The leak was behind a wall. Doesn’t that mean it’s covered?

It depends entirely on the wording in your policy. Most policies exclude repeated seepage by stating whether hidden or not or even if it’s hidden. Some policies generally cover repeated seepage, by stating unless it’s hidden behind the walls, ceiling or floors and unknown to all insureds. This is the most important section of your policy after a water loss that was hidden. Find that sentence in your own policy before you assume either way.

They denied it because there was mold. Can they do that?

Not on the strength of ordinary mold, which appears on wet material quickly. Mold on a two-day-old leak proves nothing about how long the water had been there, whatever the denial letter says.

My pipe was old and corroded. Is the claim dead?

Not necessarily. A corroded pipe and a long-running leak aren’t the same thing. A line can sit rusted and pitted for years before it finally lets go, and the condition of that pipe says nothing about when your damage started. In most policies the exclusion runs on damage to the dwelling, not the age of the pipe. If the damages are more consistent with an accidental discharge, that generally supports a covered loss under most policies.

Does my policy pay to replace the pipe that failed?

In most policies, generally, no. The failed component itself isn’t usually covered — that repair is yours to pay for. But the tear-out to reach it is: cutting the wall, breaking the slab, opening the ceiling to get at the line, and putting all of that back afterwards. That work is part of the claim, along with the water damage itself. So the plumber’s bill for the pipe is on you, and the damage caused getting to it belongs on the claim.

Is flooding the same as water damage?

No, and this catches people badly. Flood — water from outside or rising from the ground — is excluded from your homeowners policy entirely and needs a separate flood policy. Flood claims work differently, with their own deadlines and their own rules.

Common mold questions

The endorsement on my declarations page says two different numbers. What does that mean, and how much coverage do I have?

It depends. Mold coverage is written as two numbers — damage first, liability second. The larger figure is usually the liability limit, which is for claims somebody else makes against you. Look at the first number.

There’s mold in my bathroom. Is that covered?

It depends. If a failed plumbing line caused it, it may well be a claim. If it came from steam and poor ventilation over time, there was no covered peril — and no amount of growth turns it into one.

The mold limit ran out. Do I have to pay for the repairs myself?

It depends on the policy. Putting the dwelling back together is generally Coverage A work rather than mold work, and in most policies damage the mold didn’t cause isn’t limited by the mold endorsement. But what sits inside the mold limit isn’t worded the same way everywhere, so read your own endorsement in your policy to confirm.

They found mold and denied the water claim. Can they?

Not on the strength of ordinary mold, which appears on wet material quickly and says little about duration. Water claims are determined on certain provisions within the policy, not on whether mold is present.

Common fire, smoke and soot questions

The fire was only in the kitchen. Why would the bedrooms be affected?

Because the smoke went into the air conditioning system and came back out of the vents. Soot ends up on contents, clothing and surfaces in rooms the fire never reached, and the particles can be too small to see. Have it inspected rather than assumed.

The fire department did more damage than the fire. Is that covered?

Yes. Their job is to stop the fire and keep people safe, and whatever that took — saturating the structure, opening up ceilings and walls — is part of the loss. It goes in the claim.

They cleaned my things but I can still smell smoke. Do I have to keep them?

No. If an item still smells of smoke or soot after cleaning, it hasn’t been restored. Say so, and it can go back on the claim for replacement rather than being something you live with.

Can I stay in a hotel until the house is repaired?

You can, and it’s usually the wrong choice on a serious loss. Additional living expense has a limit, and hotels consume it far faster than a rental house. Ask your insurance company for its housing placement company and get into a property early.

More on this: Fire, smoke and soot claims.

Common theft and vandalism questions

There’s no sign of a break-in. Am I going to have a problem?

Call the police immediately and leave everything exactly as it is until they have investigated. How someone got in becomes the central question when there’s no forced entry, and the answer is in a scene nobody has touched. Don’t tidy, don’t test the locks, don’t shut the drawers.

They took $4,000 in cash. Is that covered?

Almost certainly not in full. Cash, coins, bullion and stored value cards sit under a special limit that’s commonly $200 for the whole category — and in the policy example, virtual currency is in there too. Look at your own special limits and see the number for yourself.

Can I board up the window before the adjuster comes?

Yes, once the police are finished. Secure the property — that’s your duty. Photograph and video everything first, and keep the damaged material on the property until it has been inspected.

My jewelry was stolen. Why is the payment so small?

Because jewelry, watches and furs usually carry a special limit written specifically for theft, often around $1,000 for the entire category. Scheduling valuable items removes them from that cap. It’s worth doing before a loss, not after.

Nothing was stolen, they just wrecked the place. Is that a claim?

Vandalism and malicious mischief is its own loss and it needs its own police report. Photograph it before anything is cleaned up or painted over, and report it the same way you would report any other loss.

The house was empty while it was on the market. Does that end my coverage?

Not automatically. The provision uses the word vacant, and vacant has a definition in your policy that’s different from unoccupied and different from empty. A furnished dwelling with the utilities on isn’t lacking what a person would need to live there. Read both definitions before you accept anything.

More on this: Theft and vandalism claims.

Common homeowners association questions

A member says the association owes for their roof. Do we?

No. The homes belong to the owners and so do their policies. The exception worth checking is a townhome or villa community, where the governing documents sometimes put roofs, exteriors or party walls on the association. Read the documents before you answer, not what the board did last time.

Does the board need a vote to bring in a public adjuster?

The association is the policyholder and the board acts for it. Get the authorization into a resolution and the minutes, and have your association counsel confirm what your governing documents require. That record protects the board, which is the point of it.

The storm took out half a mile of fence and a lot of trees. Is that a claim?

It generally can be. Fencing, walls and landscaping are usually covered property on an association policy, and they’re also where sublimits live. Find the sublimits before the estimate is built rather than after, because that number often decides how the claim gets presented.

We assessed the members. Can they claim it?

Possibly. Many homeowners policies include loss assessment coverage, and members should check their own declarations page for it. There’s no statutory minimum for an association member, so the amount is whatever each owner bought. Tell them the day the board votes so nobody finds out late.

Can we clean up and sort the claim out afterward?

Emergency mitigation, yes, and you should — keep the invoices. Permanent repair, no. Once the damage is gone so is the proof of it, and the code upgrades that permanent repair triggers belong in the claim before the work is done rather than after.

Common condominium association questions

Does the board need a vote to bring in a public adjuster?

A unit owner says the association owes for their flooring. Do we?

Generally no, unless the flooring is in a common area. The statute requires the master policy to exclude floor, wall and ceiling coverings, so any of those surfaces inside the unit itself is generally the unit owner’s responsibility under their HO-6. Read your declaration alongside the statute, though, because a more generous declaration can put more on the master policy than the statute requires.

We already assessed for the deductible. Are the owners just out that money?

Not necessarily. A unit owner’s residential policy issued or renewed since July 1, 2010 has to include at least $2,000 of loss assessment coverage, with a deductible of no more than $250 — and plenty of owners carry more than that minimum. Have every owner check their own declarations page. Then tell them the day the board votes, because there’s a 90-day window that runs from that vote.

The carrier’s engineer says it’s wear and tear.

That’s a common report for a board to get, and it isn’t the end of it. What answers it is a scope that separates what the storm did from what age did, supported by someone qualified to say so. On a building that has a milestone report, that report is often the strongest evidence of what the condition actually was before the loss.

Can we repair it now and sort the claim out afterward?

Common multifamily questions

Does my deductible apply once or to every building?

It depends on how the policy is written, and it’s the first thing I look for. Per occurrence means one deductible for the event. Per building means one for each damaged structure, and on a complex that difference can be larger than the entire roof scope. Find the answer before the estimate is built rather than after.

The adjuster looked at one roof and priced the rest from it. Is that normal?

It happens, and it isn’t a scope. Buildings on the same site take wind differently depending on exposure, height and what stands upwind of them. Every roof should be inspected on its own, and a building that was skipped is a building nobody has evidence for.

My tenants moved out. Can I claim the rent?

Generally yes, where the units came offline because of covered damage — but the proof is the rent roll, not an estimate of what you would have collected. Pull it as it stood the day before the loss, and keep notes of who left and when. Say in writing that you’re claiming loss of rents, because reporting the building isn’t always reporting the rent.

Can I put units back in service to stop losing rent?

Once they’re documented and properly dried, yes, and you should. Before that, no. A unit rushed back into service is a mold claim in six months, and the proof of what the damage was is gone the moment it’s cleaned out and made ready.

A tenant’s furniture was ruined. Am I responsible?

Their belongings are generally theirs, under a renters policy they may or may not carry. What you owe a displaced tenant comes from the lease rather than from your property policy, so read the lease alongside the policy before you answer anyone.

Common commercial property questions

The adjuster says I’m underinsured and there’s a coinsurance penalty. Is that the end of it?

Not necessarily, and it’s worth pushing on before anyone accepts the arithmetic. A coinsurance penalty is measured against a value, and that value has to be right. I look at how the figure was built, what it assumed about construction and code, and whether an agreed value provision was in force for the policy period. Any of those can move the number, and sometimes the penalty is smaller than it first looked.

Can I get back open before the claim is finished?

Usually, and often you should — every week closed is income you have to prove later. What matters is the order. Document the damage first, keep the temporary work temporary, and keep every invoice separate from the permanent repair. Getting open in a way nobody recorded is how a building claim and an income claim both get argued about six months later.

My tenant wants out of the lease because of the damage. What does that do to my claim?

It generally moves the loss from the building side to the income side, and the lease decides whether they can go. Read the termination and abatement clauses before you answer them. Then keep notes of who left, when, and what they were paying, because that becomes the proof of what the shutdown cost you.

The repairs will trigger code upgrades. Is that part of the claim?

It depends on whether ordinance and law coverage is on the policy and what its limit is, which is the first thing I check on an older building. The upgrades themselves are usually the largest figure nobody budgeted for — sprinklers, accessibility, wind-load and electrical are the common ones. Find out what you carry before the estimate is built, not after.

Do the Florida claim deadlines apply to a commercial building?

The notice deadline isn’t residential only, and missing it generally bars the claim outright. §627.70132 The carrier’s duties to acknowledge, inspect and estimate carry no commercial carve-out either. The 60-day pay-or-deny duty is narrower and depends on the size of the insured structure. §627.70131 The commercial overview lays out both clocks.

Common business interruption questions

The building is being repaired. Why isn’t my income claim settled?

Because it isn’t finished. The income claim runs until the business is back and the months of reduced revenue have been measured, and the building settles first almost every time. That sequence is normal — which is exactly why you don’t close everything out to get the building check.

My accountant does my books. Isn’t that enough?

Your accountant knows your business, and that’s essential. A forensic accountant knows what a carrier will accept and where it will look hardest. On a large loss you want both, they aren’t the same job, and it will be your responsibility to retain one yourself.

I reopened. Does the claim stop?

Usually not. Most policies keep paying while revenue climbs back toward where it would have been. Keep measuring every month after you reopen — half-capacity months are part of the loss, and they’re only provable if somebody measured them.

The road was closed but my building wasn’t damaged. Am I covered?

Possibly, under civil authority, and it’s narrower than people expect. There’s usually a radius requirement, a waiting period, a sublimit, and a requirement that the damage somewhere else was caused by a covered peril. Read that provision before you count on it.

How long is this going to take?

Longer than a property claim. Plan on monthly reporting for the length of the shutdown and past it, and ask for advances as you go rather than carrying the whole shutdown yourself.

The call that matters

If your question isn’t here, call or email me and ask it. It’s a twenty-minute phone call about the loss, and I’ll tell you plainly where you stand.

You stay in control of your claim. That’s the whole point.

Call 561-281-6990 Email brian@thepeoplesadjuster.com