Division of Consumer Services

The answers to coverage questions are primarily based on ISO forms generally used in Florida by most companies. However, we must keep in mind that all companies’ forms are NOT necessarily the same. Some companies may provide broader coverage and some may be more restrictive. IN ALL CASES, THE CONSUMER MUST REFER TO HIS OR HER OWN POLICY FOR SPECIFIC COVERAGE INFORMATION.

In catastrophic situations, some companies may be more lenient in their handling of claims and may make concessions, such as advancing additional living expense (i.e. ALE) payments, to expedite the claim process. Other companies may handle such claims in accordance with their normal procedures.

If you have additional questions that need to be added to this list or if you find any errors, please send them to the Division of Insurance Consumer Services, Bureau of Education, Advocacy and Research.

INITIAL CLAIMS QUESTIONS

1.                I have no insurance to cover the damage to my home and auto.  What should I do? 

Keep all receipts for damage repair and file the loss with the IRS on your income tax form.  You may also be eligible for a low interest loan or other aid from FEMA or the Small Business Administration.  Call them for further information at 1-800-462-9029. 

2.                Should I report my claim to my insurance company now or wait until things clear up? 

You should report your claim as soon as possible. 

3.                Should I go ahead and make repairs to my damaged property or wait for the insurance adjuster? 

You should make temporary repairs needed to prevent further damage only.  The adjuster will need to see the damages to evaluate your loss.  Take “before and after” pictures and keep all of your receipts for materials used in emergency repairs.  It is also recommended to not throw away damaged items until they have been inspected. 

4.                Can the company apply the deductible on my policy to the hurricane damage loss and again for a loss due to another covered peril? 

Yes, these items are considered two separate losses. 

5.                Will I need to see three adjusters to get my loss settled?  (One for the homeowners policy, one for the flood policy, and one for the windstorm policy) 

In many cases, one adjuster can handle all three policy claims.  However, not all companies follow this practice. 

6.                How long should it take for an adjuster to come to my house to assess the damages caused by the hurricane?

It depends on the severity and the extent of the damage caused by the storm.  Adjusters come into the disaster areas as soon as they are permitted to do so by emergency officials.  If you have reported your loss to the company, they may be able to give you an estimate of the day the adjuster should contact you. 

7.                How long should it take for my insurance company to respond to my reported loss?

Insurance companies are required to acknowledge a homeowners claim with 14 days of notification of your loss.  This could be as little as assigning a claim number.  Companies are further required to begin a claim investigation within 10 days of receipt of a written proof of loss statement from the insured.

8.                How do I know which policy to file my claim under?  I have a homeowners policy, a flood policy, and a windstorm policy.

File your claim with all three policies.  The adjuster or adjusters will take care of determining which policy covers which part of your loss.

9.                What kind of policy will I need to protect my contents if I have to live somewhere else while my home is being rebuilt or repaired? 

Talk with your agent to confirm that your current policy does adequately protect your belongings.  If the policy does not provide coverage while you are temporarily living in a rented apartment, condo, or home while repairs are being made to your home or it’s being rebuilt, you may need a tenant homeowners policy to cover your personal belongings and liability. 

AUTOMOBILE INSURANCE

The following discussion of coverage for damage to your Motor Vehicle applies to vehicles insured in Florida. 

A.               Generally Covered

1.                If Comprehensive coverage, sometimes called “Other Than Collision” coverage, is included in your policy, wind and flood damages are covered.  Some companies cover water damage, in certain circumstances, under collision coverage, if the vehicle collided with the water.

2.                Vehicles that are overturned by the force of the wind or blown into or against other objects by the wind are considered damaged by windstorm and are covered under Comprehensive.

3.                Broken auto glass caused by objects blown by the wind is usually considered covered by Comprehensive.

4.                Auto glass that pops out due to sudden drops in atmospheric pressure is usually considered covered by Comprehensive.

 B.               Generally Not Covered

1.                Damage which occurred before your policy went into effect.

C.               Other Issues

1.                Rental expenses for an auto to replace one that is damaged and out of service, due to a covered loss, is reimbursed only if the Rental Reimbursement endorsement has been added to the policy.  A specific daily amount and limitation on the number of days of payment is specified in the endorsement.

2.                If the insured adds the additional coverage, towing and labor for roadside assistance is generally included in the policy or it is added by endorsement. A stated amount per disablement is stated in the coverage.

3.                Most policies have a deductible for Comprehensive coverage.  Florida law states that no deductible may be applied for replacement of a damaged front windshield.  If other auto glass is damaged, the policy’s comprehensive deductible may apply.

4.                If there is a lien holder on the policy, the claim check may be made payable to the lien holder and the insured jointly.

 1.                Are there any outward signs of flood damage in a vehicle? 

Generally, right after the loss there will be a water mark/line on the interior parts, such as the floor mats, seats and console/dash, which will indicate the level of water intrusion.  Once the vehicle has either dried out or has been cleaned there is no way to detect if and to what extent there was water intrusion. 

2.                What do I need to do if my car has flood damage? 

If the damage is from salt water, and it rises to the point of reaching the inside floor boards, the insurance company will more than likely deem the vehicle to be a total loss.  If the damage is from fresh water, the extent of the water intrusion will determine whether or not the insurance company deems the vehicle repairable or a total loss.

3.                What happens to the title of a flooded vehicle?

There are two types of titles for vehicles involved in flood losses where the vehicle is deemed a total loss.  In both instances, the current title will be sent to the Department of Highway Safety & Motor Vehicles (DHSMV) for reissuance.   If the vehicle is deemed to be a total loss and not repairable DHSMV will issue a title with a certificate of destruction, meaning, the vehicle can be used for parts only. Please note the title won’t state the reason for the certificate of destruction is flood damage.  If the vehicle is a total loss but is repairable the DHSMV will issue a salvage title with a rebuildable flood designation.           

BOAT INSURANCE

1.                My boat was blown into my neighbor’s house during the storm.  Should my boat policy cover the damage to his house? 

No, his homeowners policy would cover the damage to his house unless you were negligent and are held liable due to that negligence.

2.                My boat sank during the storm.  I only carry liability coverage.  Will my claim be paid?

No.  You must carry physical damage coverage on your boat for the claim to be paid.

3.                My boat is moored at a marina.  If it causes damage to other boats or the marina, am I covered?

There wouldn’t be coverage for the other boats or the marina unless you were negligent. 

COMMERCIAL INSURANCE

Please remember that the questions and answers contained in this section are general in nature.  Commercial Insurance policies vary widely in their coverages and endorsements.  The insured’s policy may provide for different coverage or exclude coverage; therefore, they will need to review their policy for specific coverages. 

1.                Recent storms blew out the windows of my store.  Am I covered for glass breakage?

If you have a comprehensive glass insurance policy your loss should be covered.  However, the policy may require safeguards, such as hurricane shutters or a specific grade of plywood, be put in place prior to the loss for coverage to be extended.

2.                Recent storms blew debris into our Condo Association’s pool and damaged the fence.  Do we have coverage under the Condo Association policy?

You do not have coverage under the Condo Association policy for debris removal from the pool.  However, the policy may cover the damage to the fence.  Contact the Association’s Board to obtain a copy of the policy to read the coverage and exclusion sections. 

3.                I am a contractor who has several insured buildings around town under construction.  Recent rains and wind have caused damage at several sites.  Does my multi-peril builder’s risk policy provide coverage for the damage?

Multi-peril builder’s risk policies are a named peril policy.  There wouldn’t be coverage for the rain damage unless the contractor had an Inland Marine contract included with his multi-peril policy to cover specific materials located at a job site.  There is coverage for the wind damage subject to contractual provisions.  Some policies require the construction to be at a certain stage, i.e. 50% or 75% complete before coverage will be extended for the wind damage. 

4.                Wind blew down some trees that landed on cars parked at my dealership.  Is there coverage for the cars for sale on the lot?  Are my employees’ cars covered while they are parked on my lot?

Your auto dealer’s physical damage policy would provide coverage for the new cars if you included comprehensive or combined additional coverage (CAC- comprehensive coverage excluding theft) in your policy.  The coverage would extend to the new cars. Sometimes, the manufacturers provide coverage for the new cars. The used cars would only be covered if coverage was added to the policy for an additional premium.  The damage to your employees’ cars would be covered by the comprehensive coverage on their own auto policies.

5.                Wind blew over the steeple on our church and caused several trees on the church’s property to fall and damage the fence around the building.  Do we have coverage?

The damage to your steeple is covered under the multi-peril special building form or a fire and EC form.  The fence would only be covered if it was added to the policy by endorsement.

6.                Windstorm damaged the satellite dish used to provide cable to the rooms in my motel.  Am I covered?

Yes, if windstorm was covered in your policy and electronics coverage wasn’t excluded from the policy.

7.                Windstorms knocked out the power in my restaurant for three days.  I had food spoilage and was unable to serve customers or pay my employees.  Do I have coverage?

Food spoilage is covered if you have a consequential damage endorsement on your policy.  Your business interruption policy, if you have one, may cover loss of receipts and/or your employees’ loss of income.  Review your policy for coverage details.

8.                Due to recent rains and windstorms, the Governor declared that our county must be evacuated.  We had to shut down our hotel, evacuate guests, and cancel reservations for the days we were required to close.  Do we have any coverage for this?

Generally, there is no coverage, as a defined loss has not occurred.  Some companies will provide this coverage by endorsement under Business Interruption by removing the “defined loss” wording; however, this is very expensive.

9.                The water system in our city was destroyed.  I run a business that requires a generous amount of water, which the city is unable to provide.  Do I have coverage for the loss of income on the days I could not operate my business due to the restriction on water supply?

If you purchased an endorsement to cover this type of loss, you should make a claim for lost income.

10.             My grocery store was flooded and a windstorm knocked out power for several days.  All the food on the lower shelves was ruined and had to be thrown away.  Some food in the freezer also spoiled.  Do I have any coverage for this?

Your flood policy would only provide coverage if you insured the contents and you can prove the food was ruined by the floodwaters.  The spoiled food in the freezer could be covered by your policy under the consequential damage section.  Check your policy for details.

11.             Heavy rains from the storm caused my daycare center to be flooded.  The children had to have a place to stay so I rented several rooms in another building.  Does my flood policy have to pay for this extra expense?

No, flood policies do not provide coverage for loss of use.  Business package policies may have an endorsement adding Extra Expense Coverage, however, flood is also excluded from this coverage.

12.             Heavy rains and high winds knocked out the computer system at my business for a week.  Am I covered for “down time?”

Not unless you have a special computer endorsement at an additional cost on your policy that provides this coverage.

13.             Civil authorities closed the local hospital.  Fortunately, the hospital’s generators were on long enough to evacuate all the patients.  Is the hospital covered for loss of power?

No.

14.             Is business interruption coverage triggered when a business is not in the evacuation area, but is economically affected because their usual flow of customers has been cut off? 

As an example, consider a business that is adjacent to a geographical area that has been evacuated by civil authorities.  The closing of that geographical area may include the closing of a highway such as an interstate (I-95 or I-75).   Generally, coverage is not provided unless a defined loss has occurred.  Some companies will provide coverage by endorsement under the Business Interruption by removing “defined loss”.  It is always best to review your claim questions with your adjuster after the loss. If coverage is agreed upon, the deductible for business interruption insurance applies. 

15.         Is business interruption coverage provided under a Business Owners Policy (BOP) and a Commercial Package Policy (CPP)? 

Business interruption coverage isn’t a required coverage, therefore, it will depend upon the company’s form filing.  Business interruption coverage may be provided under the BOP and may be provided under the CPP.  If the property policy is written to exclude wind the business interruption coverage would be endorsed to exclude business interruption losses caused by wind damage whether direct or indirect. 

FLOOD INSURANCE

“Flood” is defined as:  A general and temporary condition of partial or complete inundation of normally dry land areas from:

·        Rising water or storm surge, whether driven by wind or not.

·        The overflow of inland or tidal waters

·        The unusual and rapid accumulation or runoff of surface waters from any source.

·        Mudslides (i.e., mudflows) which are proximately caused by flooding.

·        The collapse or subsidence of land along the shore of a lake or other body of water as a result of erosion or undermining caused by waves or currents of water exceeding the cyclical levels which result in flooding. 

1.                If I remove the furniture from my house and store it in a warehouse to keep it from being damaged in a flood, am I covered for that expense? 

Yes, subject to limitations, your property is covered for 45 days if you remove it to protect it from flood damage. 

2.                What types of losses are not covered by flood insurance? 

·        Additional Living Expense (i.e. ALE) coverage is not included as part of flood insurance. 

·        Sewer backup or seepage of water is not covered unless the property is, at the same time, damaged by flood. 

·        Water or moisture damage resulting from a condition primarily confined to the insured building. 

·        Losses caused by the insured’s failure to use reasonable means to preserve property after a flood. 

·        A loss already in progress at the time a policy goes into effect. 

·        A loss caused by off premises power failure. 

3.                What types of property are not covered? 

·        Accounts, bills, deeds, evidences of debt, money, coins, postage stamps, manuscripts, etc.

·        Fences, piers, seawalls, outdoor swimming pools, bulkheads, wharves, bridges, docks, boat houses on or over water.

·        Land values, lawns, trees, shrubs, plants, growing crops, livestock, animals, birds, fish.

·        Walks, driveways, and paved surfaces outside building foundation walls.

·        Motor vehicles (with exceptions), aircraft, watercraft. 

In addition, there are very important exclusions regarding contents and machinery, equipment, fixtures, etc. located at an elevation lower than the lowest elevated floor of a building.  The best thing to do regarding coverage questions of this type is to refer the consumer to the terms and conditions of his or her policy. 

4.                How are losses by flood paid?  Is replacement cost coverage available? 

Losses are paid on an Actual Cash Value basis.  In some cases, replacement cost is available.  Refer to the policy. 

6.         Federal Flood Insurance – Increased Cost of Compliance (ICC) Provision (a.k.a. 50% Rule)

This new coverage is available on National Flood Insurance Program policies written or renewed on or after June 1, 1997.  It is designed to help flood insurance policyholders take the steps required to reduce future flood damage to their homes or businesses.  It may pay up to $15,000 to offset costs associated with flood-proofing, elevating, demolishing or relocating buildings that are substantially damaged or subject to repetitive flood loss. 

The ICC coverage is adjusted separately from the flood damage claim.  You can only file a claim for the increased costs associated with repairing your property to flood-safe standards if your community determines that the structure has been substantially or repetitively damaged.  Substantial damage exists when the community certifies that a home or business has been damaged by flood to the point that repairs will cost 50 percent or more of the building’s pre-damage market value.  Some communities include a repetitive loss provision in the floodplain management ordinances.  This could trigger eligibility for ICC coverage if a property owner has filed at least two flood insurance claims over the past ten years with damage averaging 25% of the market value of the property each time. 

7. How do I determine what is wind versus flood damage?

Generally, there is a visible water mark in the dwelling.  Any damage below the water mark is considered flood, and any damage above the water mark is considered wind. 

8. If I have flood coverage for dwelling and contents, how many deductibles will I have?

The policy carries a deductible for each coverage and would be applied independently. 

HOMEOWNERS AND DWELLING INSURANCE—AN OVERVIEW 

I.                 Coverage for the dwelling, other structures and personal property (contents):

A.               Generally covered:

1.               Windstorm damage, unless specifically excluded.

2.               Damage caused by rain that enters through a structural break or opening in the roof or walls caused by windstorm.  CAUTION – see B.2. for an important exception.

3.               Food spoilage caused by power outage when the interruption of power is caused by direct damage to the insured premises.

4.               Theft, including looting.  However, all policies have dollar limits on theft losses to certain types of property such as jewelry, furs, silverware and guns.

5.               Other types of personal property have dollar limits regardless of the type of loss.  These include, but are not limited to: money, securities, business property, and watercraft.

B.               Generally NOT covered:

1.               Flood and rising water, including storm surge.  A separate flood policy is necessary to cover these damages.

2.               Rain, other than rising water, which seeps or is blown into a dwelling due to the force of wind when there is no structural break in the roof or walls.  Coverage for seepage may be provided by certain Special Coverage or “All Risk” type policies.

3.               Power surge or “brown out” caused by restoration of power which damages sensitive electronic equipment like computers, VCRs or microwave ovens. 

II.               Other types of losses

A.               Generally covered

1.               Debris removal for trees downed by windstorm IF THE FALLEN TREE HAS DAMAGED AN INSURED STRUCTURE on the premises.  Most policies limit the coverage to $500 total payment.

2.               Reasonable Additional Living Expenses while the insured is forced to temporarily relocate due to damage to the dwelling, which renders the home uninhabitable by a covered loss. 

B.               Generally NOT covered

1.               Windstorm damage to trees, shrubs, and plants.

2.               Debris removal for trees downed by windstorm that do not cause damage to an insured structure on the premises. 

III.              Other issues

A.               Valuation of property losses

1.               Buildings may be covered on an Actual Cost Value (ACV) or a Replacement Cost (RC) basis. 

2.               Personal Property (contents) is subject to ACV unless a replacement cost endorsement was added to the policy. 

3.               Structures that are not buildings, such as swimming pools or fences, are paid on an ACV basis.

B.               Duties of the insured following a loss

1.               Protect damaged property from further damage, make temporary repairs, and save receipts as reasonable expenses are reimbursable.

2.               Save damaged property for inspection by the claim adjuster.

3.               Provide an inventory, receipt, or other evidence of value and ownership, as necessary to assist in the claim settlement process.

C.               Miscellaneous

1.               If there is a mortgage on the policy, the claim check for the structure will usually be made payable to the insured and the mortgagee jointly.

2.               Generally, policies have deductibles that are taken out of the total payment for the claim.  Some policies may have more than one deductible depending on the coverage involved.

3.               Personal property stored in a mini-warehouse when the dwelling is uninhabitable as a result of a covered peril is generally not subject to any limitations of the Coverage C amount.  Personal property otherwise stored in a mini-warehouse is generally subject to a limit of 10% of Coverage C or $1000, whichever is the greater amount.   

4.               Fences, satellite dishes, and pool screening may be subject to special limitations for damage by windstorm.  In cases where such property is detached from the dwelling, most policies contain specific dollar limits. 

The following are representative of some typical questions and answers that might arise following a hurricane or tornado.  Please remember that the answers are of a general nature; the insured’s policy may apply differently to the losses in the following questions. 

1.                The hurricane caused high tides with storm surge that flooded my home.  Since my homeowners policy covers a loss caused by windstorm, will my company pay for this water damage? 

No.  Homeowners policies contain an exclusion for water damage, including flooding, whether or not the water was driven by wind.  If you have flood insurance, you should file your claim under that policy. 

2.                I don’t know if windstorm or flood caused the damage to my home.  What coverage will pay for my loss? 

You should submit your claim to your flood carrier and your windstorm carrier.  They will investigate your claim and decide which policy should pay for the applicable damages. 

3.                A tree fell on my roof during high winds and caused extensive damage.  Will my company pay for removing the tree as well as fixing my roof? 

You should check the terms of your policy, but usually the company will pay up to coverage limits for removal of the tree because it damaged your insured dwelling.  The cost of repairing the damage to your home would be covered under Coverage A (Dwelling). 

4.                My mobile home was damaged in the storm.  Will my policy pay for the repairs even though my mobile home was not tied down? 

If the company issues a policy on a home that was not tied down, they are still obligated to provide coverage in the event of a loss.  The only exception might be if the company can show that there was misrepresentation on the application for coverage by the insured, and that the company would not have issued the policy if they had known the true facts regarding tie downs. 

5.                Wind blew one of my trees down in my yard.  Am I covered for the loss of the tree?  Am I covered for the ornamental shrub that was crushed by the tree?   What about for the expense of removing it from my yard? 

Because the tree did not damage insured property on the premises, you are not covered for the cost of removal.  Trees and shrubs are specifically excluded from coverage, so no payment is owed to you.

6.                Wind blew two of my neighbor’s healthy trees down on my property.  One of them crushed my fence but nothing else was damaged.  Whose policy should pay for the damages and what is covered? 

Your policy pays for the damage to your fence.  Since the tree was healthy, your neighbor was not liable for the damage so his policy will not pay.  You have coverage under your policy for the removal of the tree that damaged your fence since it was considered a “covered structure.”  There is no coverage to pay for the cost of removal of the tree that did not damage any insured property. 

7.                What if the neighbor’s tree that damaged my property was rotten? 

Your policy will still pay for the damage to your insured property and for the removal of the tree.  However, if you can prove that your neighbor was negligent, he may be responsible for your damages. 

8.                Wind blew down one of my trees and it fell on the garage.  My car was in the garage and was also damaged.  Does my homeowners policy cover this damage? 

Your homeowners policy will pay for the damage to the garage but not to your car. Your auto insurance policy will pay for the damage to your car if you have comprehensive coverage.

9.                The wind blew a large limb off one of my trees and it crashed through the picture window in my living room.  Rain poured in and soaked my TV and the carpet.  Am I covered? 

Yes, you have coverage for the damage to the window, the TV, and the carpet due to the structural damage. 

10.             The wind blew rainwater underneath my sliding glass door of my condo.  The floor was soaked and there is also damage to the wallpaper near the door where water seeped up from the wet floor.  Am I covered? 

Since the sliding glass door was not damaged, there is no coverage for this loss. 

11.             The wind uprooted a big tree near my patio and the tree’s roots came up and tore up the patio.  Do I have any coverage? 

Yes, both the damage to the patio and the cost of removing the tree are covered. 

12.             I stored personal property, such as furniture, electronics and clothes, in a mini-warehouse after the storm because my home was badly damaged.  Now I have discovered someone stole some of my property.  Do I have any coverage since my belongings were not in my house when they were stolen? 

Yes, you have coverage for direct loss by any cause covered by the policy for 30 days after your property was removed from the house.  After 30 days, you should check your policy to see what coverage is provided. 

13.             When we were ordered to evacuate, I had to leave my boat and trailer in my yard.  A tree fell on it during the storm.  Is the damage to my boat and trailer covered?  Will my company pay to have the tree removed? 

In order to be covered, your boat and trailer usually would have to be inside an enclosed structure like a garage or a shed, so you probably do not have coverage for the damages.  There is no coverage for the tree removal either since an insured structure was not damaged. 

14.             The electrical service pole next to my mobile home was blown down and broke in half during the hurricane.  My electricity was off for four days and all the food in my refrigerator and freezer spoiled.  Do I have any coverage? 

Some policies consider the electrical service pole and breaker box to be a part of the mobile home and some others require it to be listed on the policy in order to be covered.  Check your policy to see if it provides coverage for the pole.  Your policy does provide coverage for the spoiled food but may have a specific dollar limit. 

15.             Due to an off premises power interruption I had food spoilage, but there was no damage to my premises that caused the power outage.  Do I have coverage? 

Since there was no direct damage, you probably do not have any coverage. 

16.             My yard is a mess!  Will my company help pay the cost of cleaning up the debris from the hurricane? 

No, there is no coverage for this expense. 

17.             If I make a claim for damages caused by the hurricane, can my insurance company cancel my policy? 

No, companies cannot cancel or non-renew a homeowners policy for losses caused by an Act of God.

18.             If I file a claim for hurricane damages, can my premium be increased because of it? 

No. 

19.             I live in a condominium that was damaged by the storm.  My unit was damaged as well as the common areas of our complex.  What part of the loss am I responsible for and what part should the Condominium Association policy pay for? 

You should check the by-laws of the Association to see who is responsible for what property.  In general, your policy would pay for damages to your unit.  The Association’s policy would pay for damages to the buildings (roof, exterior walls, etc.) and to the common areas.  You may be responsible for an assessment to help pay for damages not covered by the Association’s policy.  Check your unit owners’ policy to see what coverage you have to help you pay this bill.   Most policies include a minimum of $1,000 for loss assessment coverage for damages resulting from the hurricane. Some policies do not provide loss assessment coverage if the assessment is to pay the unit owner’s portion of the deductible on the association policy. 

20.             How will the claim for my in-ground pool be handled? 

In-ground pools are considered to be like the foundation of the house and damages to the structure of the pool are covered.   If a tree or debris cracked the walls or floor of the pool or the concrete decking surrounding the pool, your homeowners’ policy should cover repair costs.  However, if damage was caused by water – usually undermining or pop-up caused by water pressure – there is no coverage. 

Note:  Your flood policy also excludes damage to swimming pools whether in or above ground. 

21.       Civil authorities issued a mandatory evacuation order in my county.  Does my homeowners policy (HO3) provide coverage for Additional Living Expenses (ALE) even if my dwelling has not been damaged?  Does the “All Peril” deductible apply?  What coverage limits apply? 

            The answer to these types of questions may be different between companies.  Generally, there is coverage when a civil authority prohibits the use of the “residence premises” because of direct damage to neighboring premises by a peril insured against in the policy.  However, you must discuss the policy with your agent or read the policy for specific answers. 

22.       Is my insurance company required to offer replacement cost coverage for the contents of my home? 

            No, your company does not have to offer replacement cost coverage on your contents.  They must, however, offer this coverage for your home. 

23.             What is the current system of hurricane deductibles on a residential property insurance policy?  

A.               Companies must offer a $250 hurricane deductible on residential property valued at less than $50,000.  For homes valued from $50,000 to $100,000 companies must offer either $500 or up to a 2% hurricane deductible.

B.               On properties valued between $100,000 and $250,000, companies may require a 2% hurricane deductible if they guarantee the policy will be renewed for a second year.  They may also offer higher deductibles up to 10%, but they must offer the 2% deductible.

C.               On property valued above $250,000, companies can require a minimum 2% deductible without guaranteeing a second year renewal, and they may offer higher deductibles up to 10%. 

24.             When does the hurricane deductible apply? 

The hurricane deductible applies when damage results from a named hurricane storm system recognized by the National Hurricane Center and assigned a catastrophe “CAT” code.  The company can apply the hurricane deductible to another area of the state if damages are caused as a result of the hurricane. 

25.             How is the amount of the hurricane deductible determined? 

The amount of the deductible is determined based on the amount of dwelling coverage you have for your dwelling.  For example, if your dwelling Coverage A limit is $150,000 and you have a 2% hurricane deductible, the amount of your hurricane deductible is $3,000. 

26.             Are there any exceptions that would allow a deductible for less than $500? 

In Industrial Fire policies that provide windstorm coverage the standard deductible is $250 or less.  Mobile home policies can have deductibles varying from $250 up to 10%.  For homes valued less than $50,000 the deductible may be as low as $250. 

27.             What is a “force placed” policy? 

“Force placed” polices are issued to a mortgage company when the mortgagor fails to purchase a homeowners policy of their own.  Most often times the named insured will be the mortgage company and this type of policy only covers the dwelling.  Some “force placed” policies may provide coverage for the contents in addition to the dwelling coverage. 

28.        Would the “All Other Peril” deductible apply to a hurricane loss? 

It’s possible that the “All Other Peril” deductible could be applied.  If an insured incurs damage from multiple hurricanes sufficient to exhaust the hurricane deductible, the “All Other Peril” would be applied to any subsequent claim.  For each hurricane loss the deductible amount to be applied will be the greater deductible amount of either the hurricane deductible or the “All Other Peril” deductible.  For example, the homeowner’s hurricane deductible is 2% of a $100,000 home, which is calculated as a $2,000 dollar hurricane deductible.  Hurricane A does $1,000 dollars worth of damage to the homes structure.  No payment was made because the amount of the covered loss was less than the hurricane deductible.  Hurricane B does another $1,000 dollars worth of damage to the home’s structure.  The insurance company will take the higher of the hurricane deductible balance of $1,000 dollars as opposed to the “All Other Peril” deductible of $500.  Therefore, there is no payment made by the insurance company because the loss did not exceed the hurricane deductible.   Hurricane C does $700 dollars worth of damage to the homes structure.  The hurricane deductible has been exhausted, so the company applies the “All Other Peril” deductible and therefore pays $200 dollars on the loss.  Hurricane D then caused $1,000 dollars worth of damage to the homes structure.  The company will apply the “All Other Peril” deductible and pay $500 dollars on the loss.  Any subsequent hurricane loss will be subject to the “All Other Peril” deductible. 

29.        Due to medical needs, I rented a generator to have electricity in my house.  Will my insurance company cover this expense? 

Some companies consider this an additional living expense and will provide coverage under ALE.  Check with your company to verify how they handle this. 

MEDIATION 

Several years ago, the legislature passed a law requiring companies to offer mediation on property insurance claims to customers when the amount of the claim dispute exceeds $500 over the policy deductible.  The Department of Financial Services administers the property mediation program and certifies the mediators.  This procedure is governed by Rule 69O-166.031. 

1.                My company says they do not have to offer mediation to me.  Why not? 

Mediation does not have to be offered if there is no coverage for the loss or if fraud is suspected.  The company also does not have to offer mediation on claims involving less than the policy deductible or less than $500.00 in disputed amounts. 

2.                I want to go to mediation with my company.  What should I do? 

If you want to take advantage of the property mediation program, you must notify your insurance company.  Unless you request the Department to choose the mediator, the insurer will select a mediator from the list approved by the Department.  You will have an opportunity to reject this mediator if you desire. 

3.                Do I have to pay for mediation? 

There is no charge to you for using the property mediation program.  The insurance company pays a fee to cover the cost of administration and to pay the mediator for his or her services. 

4.                My claim was settled in mediation, but now that I have had time to think about it, I don’t think the settlement was fair.  What can I do? 

Mediation settlements can be rescinded within three business days of the agreement as long as you have not cashed the check.  The company must provide a representative with full authority to settle the claim with you at the mediation conference.  The conference will be held at a location near where you live. 

5.                I’m going to mediation with my company.  Do I need an attorney? 

            No, an attorney is not necessary.  You may have your attorney present if you choose to do so, but you must let the company know beforehand. 

6.                I already have an attorney helping me with my claim.  Do I have to bring him to mediation? 

            You should discuss the settlement offer and mediation with your attorney. 

7.                What if a mediation conference is scheduled and I can’t go or the insurance company representative doesn’t show up? 

            If you fail to appear for the mediation conference, it can be rescheduled after you pay for the mediator’s fee.  If the insurer fails to appear, without good cause, they must pay actual cash expenses incurred by you in attending the conference and they must pay the mediator’s fee for the rescheduled conference. 

WINDSTORM INSURANCE 

            Citizens Property Insurance Corporation (Citizens) was formed in 2002 when the Florida Legislature merged the Florida Windstorm Underwriting Association (FWUA) and the Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA).  Now Citizens provides residential and property coverage previously available under the FRPCJUA, as well as windstorm coverage previously available under the FWUA. 

If your homeowners or business policy excludes coverage for windstorm, you may purchase a separate policy with Citizens to insure your property for these kinds of losses.  If you are not in an eligible area to purchase a windstorm policy from Citizens, your insurer cannot exclude windstorm coverage on your dwelling (this does not apply to Surplus Lines companies). 

            The best way to determine what coverage you have is to refer to your Citizens policy.  In general, Citizens writes coverage for buildings, including mobile homes, and personal property located within their specific coverage areas.  Coverage is provided only for direct loss by Hurricane, other Windstorm, or Hail to insured property. 

1.                What is Citizens Property Insurance Corporation (CPIC)? 

The State of Florida does not sell homeowners' insurance.  Citizens Property Insurance Corporation (Citizens) was created by the Florida Legislature to provide residential insurance to "applicants who are in good faith entitled, but are unable, to procure insurance through the voluntary market” F.S. 627.351 (6).  Citizens is not a state agency, it is a quasi-public association overseen by an eight member Board of Governors whose membership is prescribed by state law. In other words, an applicant may be able to obtain coverage from Citizens, if another company is unwilling to insure the home. For more information about Citizens visit their website at: www.citizensfla.com or call toll-free 1-888-685-1555.  Individuals cannot purchase insurance directly from Citizens.  If a homeowner wishes to purchase insurance through Citizens, contact a licensed insurance agent who is appointed with Citizens.  Citizens may write risks rejected by other insurance companies due to claims frequency, or other underwriting issues.  However, Citizens does have underwriting guidelines and may not accept every applicant.  For specific underwriting guidelines contact an agent, visit Citizens website (www.citizensfla.com), or call them at their toll-free number (1-888-685-1555).   

2.                What limits of coverage are available for Citizens policies? 

Dwellings (*) can be insured for limits up to $1,000,000.  This limit can apply to the building only, the contents only, or a combination of the two.   

Mobile Homes can be insured to a limit of $1,000,000 at any one location.  The limit applies to buildings only, to contents only, or to a combination of building and contents coverage written for the same “location” whether or not they are on the same policy and regardless of the named insured. 

Commercial-Residential (*) property can be insured to a limit of $10,000,000.  Once again, the limit applies to buildings only, contents only, or to a combination of building and contents coverage written for the same “location” whether or not they are on the same policy and regardless of the named insured. 

Commercial Property can be insured to a limit of $1,000,000. The limit applies to buildings only, to contents only, or to a combination of building and contents coverage written for the same “location” whether or not they are on the same policy and regardless of the named insured. 

(*) These items may be increased if coverage is not available in the authorized market.  Citizens required submission of the Market Availability Document form to consider increased coverage for these properties. 

3.                How should I report my damages and file a claim with Citizens? 

Call your agent.  He or she will complete a Citizens claim form and send it in.  You will be asked for your homeowners and flood policy information when you report a claim to Citizens so have the name of your insurance companies and your policy numbers ready.  The Citizens toll-free claim line is 1-800-808-7647. 

4.                My roof has a big hole in it.  Rain is coming in!  What should I do? 

You are responsible for making temporary repairs to prevent further damage.  Take “before and after” pictures and keep all your receipts to turn in with your claim. 

5.                For homeowners, what are Citizens policy limits? 

Citizens homeowner multi-peril policy has limits available for dwellings with coverage up to $1,000,000.  This limit applies to the structure only.  Contents can be insured up to fifty percent of the insured structures value.

6.                Does a Citizens wind only policy require an additional flood policy? 

Citizens policyholders or applicants who live in either Flood Zone A or V must purchase flood insurance or sign a flood waiver form to acknowledge that Citizens does not provide coverage for flood (rising water) losses and agree they have the burden of proving that a water damage claim was not caused by flood.  However, a mortgage company may require a flood policy as a condition for a loan. 

7.                When is the Hurricane deductible applied in a Citizens policy? 

The Hurricane deductible is applied in a Citizens policy to windstorm damages occurring from a named hurricane and includes tornado and storm winds outside the eye of the hurricane.  When there is a named hurricane, the hurricane deductible may be applied from the time a watch, or warning is issued by the National Hurricane Center until 72 hours following the termination of the last watch or warning issued anywhere in Florida.  This is covered per F.S. 627.4025. 

8.                What kind of deductible applies to my dwelling fire policy with Citizens? 

Your deductible for each loss applies to building and contents combined.  There are some special class items, which have a separate deductible.  Refer to your policy for details.  The standard deductible amount is 2% of the amount of dwelling coverage or a minimum of $500.  You can get an optional deductible of 5% with a minimum of $500.  

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