On July 8th, Anthony DiUlio, partner at Wheeler, DiUlio & Barnabei, hosted a lunch & learn webinar, Common Denials You Are Arguing Wrong.
Anthony DiUlio discussed the language of coverage policies by common insurance companies. The webinar began with DiUlio breaking down specific policies by major insurance players including State Farm, Allstate, and Farmers. In addition, DiUlio listed and explained various notable types of claims relating to vandalism, stucco issues, frozen pipes, and more.
Overall, DiUlio describes how these common coverage policies are often interpreted incorrectly or are contradictory in nature and how this language can be argued against.
Here’s a recap of some of the tips and information from the lunch & learn webinar:
Language
Oftentimes, the written word from these popular insurance companies is anything but clear. Phrases like “sudden and accidental” from the Allstate policy are very ambiguous and difficult to explain. However, it is important to pay attention to all aspects of the policy to uncover language and contradictory statements that could support your case.
For example, State Farm included a provision stating that the addition was “not intended to change coverage.” Yet, State Farm ended that same provision saying that it could be viewed as a “reduction or elimination of coverage.” These statements are contradictory and are misleading to the policyholder.
Other key tips for language-related questions include the following:
- Remember that the policyholder has zero responsibility to say what caused the damage under an HO-3/all-risk policy.
- Use the written language against the insurance companies. They are responsible for their word.
- The language you use as a policyholder is just as important. Be sure to call and claim things as they are, not just what you think it is. Let the insurance companies conduct their investigations.
- If you are ever unsure about the exclusionary, misleading, or ambiguous language of policies, contact an attorney to help support your case.
Proof
As Partner DiUlio mentioned in his webinar on Bad Faith Claims, documentation can help support and boost your position in arguing with insurance companies. While not required by the policy, you can take photographs of damage with specific time stamps and keep a record of all receipts between you, contractors, and anyone involved with your claim.
During the webinar, DiUlio answered a question from a viewer, “What do I do when I need a contractor to repair a roof to protect from further damage but the repair will destroy the evidence of damage (i.e. flat roof)?” In reality, most policies do not require inspection or documentation. There is only a responsibility to protect from further damage and have accurate receipts. This is an example of how photographs and documentation will help your situation but it isn’t actually required by the policy.
Other Provisions
In addition to the “sudden and accidental” language as previously mentioned, DiUlio discussed other common claims including the following:
- Long-term leak and 14+ day leak provisions
- Frozen pipe claims versus broken plumbing lines
- Stucco and siding claims
- Contents insured anywhere including storage facilities
- Coverage for locations under construction versus vacant
- Claims due to collapse, hidden decay, vandalism, and theft
- Tenant issues
Interested in learning more? Register for our next lunch and learn webinar.
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