Insurance Company Delays with Boilerplate Document Requests
Some Florida insurance companies submit boilerplate document requests to create delays and set claimants up for failure
There’s one insurance company in particular that does it on every single claim. The claim gets reported and an automated boilerplate letter gets sent with ten or more vague document requests without anything known about the claim or if the requests are even relevant.
Other insurance companies do it, too, but there’s on in particular. Ask our public adjusters and we’ll tell you who it is, but for now, we’ll tell you how it creates unnecessary delays and could prevent you from recovering altogether.
The insurance policy says the insurance company will “adjust all losses with you”
When you submit a residential or commercial insurance claim for property damage, it’s supposed to be a two way exchange of information. The claimant or insurance policyholder is supposed to provide information relevant to the insurance claim, which includes information on causation and damages, valuation, and sometimes, prior claim history.
Likewise, an insurance company is supposed to provide information to the insured and their public adjuster as well. The insurance company should share its valuation of the damages, and other information related to its investigation, like conclusions and engineer reports, and any other information related to the claim. After all, if the claim isn’t covered loss, a homeowner still needs to stop the problem and repair the damages to make sure the home remains livable and is safe for those who visit.
When this two-way exchange of information breaks down, it invariably favors the insurance company.
Vague boilerplate document requests
A claim for water damage might get a response from the insurance company that looks like this:
We are formally requesting that you provide the following:
1) A signed, sworn statement in proof of loss and detailed repair estimate pursuant to policy language highlighted below
2) Any Emergency Mitigation Invoice/Documents
3) Any Emergency Mitigation Dry out logs & Contract
4) Any Emergency Mitigation Color Photographs
5) Any and all plumbing receipts, invoices, reports, proposals, photographs related to the alleged loss
6) Any and all receipts for repairs completed or commenced by you relative to the damages you claim arose out of the loss
7) Copies of all receipts, contracts, estimates, invoices, reports, permits, or material purchase receipts for any and all repairs, remodeling, or renovations begun/completed in the last 5 years
8) A photo of the damaged property prior to any repairs/EMS
9) Any photos or video taken by the insured (or anyone else) at time of loss
10) Water Usage Records or water bills for the preceding two years
11) Electric bills for the preceding two years
12) Condo/Homeowner Association Incident Reports
13) Prior Claim Information and proof of repairs
14) Recorded Statement of the insured
All of these requests for documentation and other actions related to an insurance claim are often followed by a regurgitation of language and provisions from the insurance policy that may or may not say you actually have to provide any of that (that’s a whole other topic entirely, but the short answer is that it is usually limited to whether or not a request is “reasonable”).
Sure, an insurance company is entitled to many of these things, but the reason that the vague requests are made in writing are twofold: first, it creates delays that favor the insurance company, and second, if you don’t respond to just one of these requests, they may try to claim later on (usually incorrectly) that if you file a lawsuit that you’ve prevented them from conducting their investigation and you shouldn’t be allowed to recover at all.
Each one of these requests is a potential landmine and it pays (pun definitely intended) to have an experienced public adjuster by your side when reviewing and responding to these requests.
Insurance companies creating delays saves them money
The more an insurance company can drag out a claim, statistics show, the more money they save, either from the time that they hold on to your money, or that an insured will inevitably get frustrated and give up or take less.
These requests are designed to create just these types of delays that favor the insurance company.
Five years worth of documents related to home maintenance and repairs? Do you need to go back through old credit card statements for that thing you bought at Home Depot four and a half years ago? They seem to imply you should. You may not have those records in your possession or they may not even be stored online anymore and after you take the time to look and that one specific delay is over, the insurance company can later use that missing item to point the finger back at you and try to undercut your claim.
What about the utility bills? Do you even keep those? Are they stored online? If not, you might have to request them from the water company or municipality, or get power bills from Florida Power & Light (FPL). It might take 30-60 days to get copies, and every 30-60 day delay adds up in favor of your insurance company. Before you know it, your claim that was supposed to take 90 days has taken a year or more.
How about reports from a condominium association or homeowners association (HOA)? These may be helpful for your claim, but a lot of condominium associations and HOAs take a while to get you documents, or may even refuse to provide it as some type of work product, especially if the association is not professionally managed. This can put you in an indefinite holding pattern while you’re waiting for your claim to be paid. This is a tough situation to wait in while your home is damaged and you’re waiting to do repairs.
Creating “conditions precedent” to avoid paying
Insurance policies in Florida all have a vague provision that says no suit may be brought unless there has been full compliance with the policy. That means you can’t file a lawsuit, should the need arise because an insurance company is unreasonably delaying or hasn’t fairly paid for your claim, if you haven’t complied with the insurance policy. They may be in the wrong, but then again, technically, so are you.
As we mentioned before, a lot of those requests above are conditioned on whether or not the request is reasonable, and a lot of time the standard is whether you attempted to comply or substantially complied. For example, that Home Depot receipt from 4.5 years ago? If you at least tried to get it, but couldn’t obtain it, that doesn’t prevent you from filing a lawsuit.
The first item on the sample list above, however, the proof of loss, is almost always absolutely mandatory. Florida’s courts have routinely held that if a proof of loss is requested and you don’t provide one, your suit will be dismissed. Unfortunately for homeowners, a proof of loss can be complicated and usually requires a public adjuster or attorney to explain and assist in its completion. It’s worth noting that a general contractor cannot legally assist you in completing a proof of loss and an attempt to do so would be a felony by the contractor.
Didn’t you say the exchange of information with the insurance company was supposed to be a two-way street?
Yes! We did! Thanks for remembering. Florida’s legislature has written a series of requirements prescribing good faith claims handling procedures that insurance companies often ignore.
Fla. Stat. 626.9541(1)(i)3.h. Requires that an insurance company clearly explain the nature of requested information AND the reasons why such information is necessary. VIP Adjusting’s public adjusters often respond to these boilerplate requests with the good faith intent of fairly resolving an insurance claim and ask for this very simple request; that the insurance company explain why such information is necessary. It is almost uniformly ignored.
That response, however, protects an insured homeowner in the event they need to file a lawsuit.
Many of the items on that list may be duplicitous. If a pipe leaked and you have provided a photo of the damage pipe, video of the leak, and a repair invoice from a plumber (or better yet, saved and produced the damaged plumbing component that caused the leak), do you need to provide water bills for several years and condo/HOA incident reports? Maybe. If the insurance company thinks the leak was ongoing for an extended period of time, or if another party was responsible for the pipe and the insurance company can subrogate. Maybe not, though. It’s up to the insurance company to have that dialogue with you.
What about prior claim information? Again, maybe, maybe not. It depends on the insurance company’s intent and investigation. If you had a prior claim that was similar in the same location, they may want to know if you have overlapping damages and completed repairs to the prior reclaim so you aren’t double-dipping. If you’ve never had another claim, or a prior claim was on the opposite side of the house, the request may not be valid.
Often, VIP Adjusting’s public adjusters have noticed that the insurance company’s intent often isn’t on ultimately receiving the document requests, it’s usually just for the purpose of creating delays and trying to set you up for failure. (Reading between the lines, yes, we’re saying that many of these requests are made in bad faith)
Sometimes, the delays work despite a public adjuster’s best efforts
A public adjuster can battle the insurance company’s tactics for you and do most of the heavy lifting, but some participation is required from an insured. We had a claim recently where our public adjusters prepared an estimate for the insured and provided it for approval with a sworn statement in proof of loss form, which requires a notarized signature of the insured. Despite repeated follow ups, the insured took more than seven months to get the document notarized, and even then wouldn’t provide any other documentation, validating the insurance companies tactics and rubber stamping the delays.
We understand all homeowners are different. Some people just aren’t good with paperwork, and some procrastinate. In these instances, this tactic from the insurance company is targeted directly at you because it allows them to justifiably delay and possibly prevent you from recovering altogether. If you’ve paid your insurance premium and you’ve suffered covered damage to your home, you should be fairly compensated for your claim.
If you’ve made a claim and received a document request like the one above, call the public adjusters at VIP Adjusting today for a free claim review. We’d be happy to go over the requests with you and come up with a strategy that puts the power back in your hands.