HOMEOWNER Insurance Policies and the $3,000 EMS Cap Explained

Aug 28

A Common Scenario

Picture this: you return home after a long day and find water spreading across your living room floor. A pipe burst while you were away, your flooring, drywall, and baseboards are soaked. Panicked, you call a mitigation company. They arrive quickly, set up fans, dehumidifiers, and run equipment for 5 days to prevent mold and further damage. Your insurance policy actually requires you to do so to mitigate further damage. They use the term “Fiduciary” in that you have a fiduciary responsibility to protect the dwelling from further damage. So, for all intents and purposes, you are doing the right thing here. If you did not call a mitigation company to prevent further damage, and then mold grew throughout the dwelling thereby damaging other components that were not originally damaged by the water leak, those damages would not be covered.

Weeks later, when the dust settles, you receive a letter and maybe a check. To your shock, the insurance company claims they will only cover up to $3,000 of the mitigation bill, even though the total invoice is $20,000. Many insurance adjusters that work for the insurance company are either ill advised, misinterpreting policy, don’t understand policy language, or worse and potentially far more nefarious.

We see this situation playout in many cities across Florida and South Carolina to name a few. Most property insurance policies include a typical $3,000 or 1% of Coverage A cap on Emergency Mitigation Services (EMS). Which, in this case leaves you in the lurch and on the hook for $17,000. If the insurance company doesn’t pay the contractor’s bill, they are going to come looking to you for payment.

What the EMS Limit Means

Emergency Mitigation Services (EMS) are the steps you or a contractor take immediately after a loss to stop damage from getting worse. These might include:

Extracting standing water
Setting up drying equipment
Preventing mold growth
Boarding up openings or making temporary repairs
Installing a tarp on the roof

Most Florida Homeowner Insurance Policies typically limit EMS coverage to $3,000 (or 1% of Coverage A) unless the carrier authorizes more. To authorize exceeding the cap, a request must be presented to exceed the cap in writing to a specific department of the insurance company. The department email is typically listed in the paragraph that outlines the cap. If they do not respond within 48 hours of your request, the cap is automatically lifted.

Why the EMS Cap Becomes a Problem

This limitation creates several risks for homeowners when handling property damage insurance claims:

Out-of-pocket costs when invoices exceed the $3,000 EMS cap
Collections pressure from mitigation vendors who expect to be paid in full
Disputes with carriers over what qualifies as a “reasonable” emergency measure

Insurance companies often try to classify the entire water / mold mitigation bill under EMS thereby imposing the cap. This is both improper and our opinion, fraudulent. This is a practice that insurance companies employ to marginalize how much they will pay for an insurance claim, especially in Florida. Most homeowners are unaware that there is any foul play because the language in the insurance policy is seemingly clear at a 3k EMS cap. When, In reality, only a fraction of the mitigation company’s bill falls under EMS. Extracting standing water and dry out may qualify as EMS. However, the bigger chunk of their bill is demolition / removal of wet material such as drywall, insulation, cabinetry, baseboards, flooring etc. These items are a function of the overall construction process and are clearly not EMS. Most of the time, the restoration company’s work is lower than 3k in terms of EMS. However, as stated before, insurance company’s like to throw the baby out with the wash and conveniently categorize the whole mitigation / restoration scope as EMS.

How to Protect Yourself

One of the best efforts to avoid this conundrum, is to have the mitigation company prepare separate invoices. It’s best if they can create an EMS invoice that delineates all work performed to protect the dwelling from further damage. Then, they should prepare a separate invoice that falls under restoration which include removal of building materials and rebuild if applicable. If they are removing mold, they should also have a separate invoice for mold as it is a separate coverage with its own cap (typically 10k). When invoices and documentation are prepared properly, it will be crystal clear which items are allocated under the EMS cap, Mold, and the remainder under the normal Coverage A limits without an EMS cap.

In this case, that invoice may look like: $3,000 EMS , $4,000 Mold, $13,000 Restoration (Coverage A).

When an insurance company tries this EMS tactic, and without a professional pushing back, policyholders are left stuck between the contractor’s bill and the carrier’s interpretation of the policy. Often times, the homeowner just pays the remainder ( in this case $17,000) of the bill out of their own pocket because they are not unaware. We at VIP Adjusting, as your Public Adjuster, would never let that happen. The carrier may try, but they will fail.

See the charts below for a visual explanation:

How VIP Adjusting Can Help

This is where our team comes in. As your licensed Public Adjuster in Florida and South Carolina, we:

Review your policy in detail, including EMS and mold caps
Communicate with the carrier and mitigation company to ensure timely and proper approval
Work with contractors to generate properly separated invoices
Submit documentation in a way that prevents bad-faith denials and underpayment
Represent your interests, pushing back against unfair EMS cap abuse

We’ve seen this play out hundreds of times. When a policyholder is unrepresented, they often pay thousands unnecessarily. When we’re involved early, we don’t let it happen.

Bottom Line: Don't Go It Alone

The $3,000 EMS cap may seem like a minor line in your insurance policy, but it can have major financial consequences after a loss. Without a clear understanding of your policy, proper allocation of work, and a skilled advocate fighting for you, you could be left footing a bill that your insurance should have paid.

If you’ve suffered water damage, storm damage, or any other covered property loss, don’t wait until it’s too late.

Call us at 833-WITH-VIP or email Info@vipadjusting.com for a consultation.

We’re based in several locations across Florida which in include Jupiter, Fort Pierce, Port St. Lucie, St. Petersburg, Panama City to name a few. With our multiple offices, we cover the entire State of Florida with ease. So, if you are reading this from Orlando, Jacksonville or “Anywhere” Fl, feel free to call us. We proudly serve all of South Carolina out of our Charleston, SC location.

You might also find the following articles of interest:

Home Water Supply: Shut-Off Essentials

What to do in the Event of a Plumbing Leak: A Step-By-Step Guide

Back up, Overflow, Leak or Flood: What’s the Difference?

Who are the People Involved in Your Property Insurance Claim?