Insurance confusion: What's covered, what's not after hurricane

Insured homeowners share their lessons learned after Irma's devastation

MIDDLEBURG, Fla. – So many of you across our area, devastated by Hurricane Irma, have told News4Jax you still can't move forward because of fights with insurance companies.

You've told us that you thought the insurance you bought would leverage your losses, but after Irma, many of you have been left in limbo instead.

We have some answers to help explain the insurance confusion, after speaking with some pretty angry homeowners and insurance experts who can help you get prepared before the next storm threatens our area.

Insured homeowner: Edna Wade

"Did you look at the pictures?" Middleburg homeowner Edna Wade said as she recalled her conversation with an insurance adjuster six months ago. "They didn't evidently because this whole Florida room was gone. It wasn't on the survey they had taken."

Wade is most frustrated by the fight she's had filing a claim for flood insurance.

Hurricane Irma blew three-foot waves of water from the Black Creek into her Middleburg home -- which was already built nine feet off the ground.

She said when a newly-hired insurance adjuster showed up to assess the damage to her home from Irma, their site survey didn't show an entire room of their house.

Then, Wade said she and her husband had to resend their flood insurance claims four times, because each time they were given incorrect "How To" instructions by different people during the process.

"I wound up educating our insurance agent," Wade laughed. "They sell the flood policy, but it's the national flood insurance; a lot of agents don't have experience with that."

Insured homeowner: Frances Baylor 

Edna Wade's neighbor, Frances Baylor, told us her dream home was built seven feet off the ground back in 1967, and it had never flooded. Baylor did her homework.

"When I purchased the home," she said adamantly, "I got the FEMA records and made sure what the neighbors said was true."

Baylor said despite the reassurances from neighbors, she and her husband still bought the best homeowner's and flood insurance policies money could buy.  With her homeowner's policy they have:

  • $189,000 worth of coverage for their home's structure
  • $100,000 worth to cover all the contents inside their home
  • $18,500 worth for "loss of use" coverage, in case their house was so damaged they couldn't live in it anymore.

However, when Baylor first reached out to her homeowner's insurance company for help after Hurricane Irma, she said she was told she can't file a claim with them because Irma was a "flood event."

She said, so much for using that "loss of use" clause.

Baylor then filed a claim with her flood insurance company, but she said they told her the structural damage was not caused by a flood. She was covered to rebuild the parts of her home damaged in the storm.

The problem? Baylor said the structural damage was so severe to the pilings on which the home sits, the roof, the building, even the inside walls; that her home is uninhabitable.

"The flood insurance wants to pay to fix it," Baylor said as her voice grew with anger as she recalled the phone conversations. "You can't fix it. You can't. The structural damage, you can't fix."

Baylor told us she ultimately filed a dispute with the Federal Emergency Management Agency (FEMA), asking the agency to declare her home a total loss so she could prove she needs the flood insurance policy to help her rebuild -- not repair.

She said FEMA responded with a later stating it could be months more before the agency can even respond to her because it's so backlogged with similar claims from so many others.

Baylor explained the flood insurance money she did receive for repairs, she and her husband instead used it to pay down their mortgage to try and lessen the cost of the inevitable: Demolishing their home and rebuilding.

Frustrated Irma victims share their lessons learned

As we start a new hurricane season, both Edna Wade and Frances Baylor have priceless advice for all homeowners, regardless of where you live.

After several go-rounds with filing for flood insurance after Irma, and dealing with different local insurance agents, Wade said she and her husband wound up educating themselves through the entire process and relying on friends who had been through it all before.

"I've done my homework," Wade said after bouncing around from agent to agent for an explanation. "I did what I needed to do. Whether (this agent) knew what to do or (that agent) knows what to do, I found out what to do (myself)."

Wade also said she learned the $10,000 worth of insurance she bought to cover the contents inside her home, wasn't enough. After Irma, they claimed $22,000 worth.

"We just didn't expect to flood." she said. "Just like a lot of people."

Wade said homeowners need to make sure they understand the limits to their insurance coverage.
For example, she thought flood insurance would reimburse her for having to temporarily live in a hotel until she could move back into her home.

"After Irma, I went through my policy and found out what was really covered -- after the fact," Wade admitted.

She found out she wasn't covered for temporary housing, and she wound up staying with family before buying a small camper for herself, her husband and their two dogs to live in right next to their home.

Wade said taking pictures and documenting everything you have before a storm blows through is the best move a homeowner can make.

"We had pictures, but we took them after the flood," Wade said.  "I found myself saying, 'OK, I forgot all of the shoes, and my purses; how many was that, and what shoes were they? How was the baseboard, our flooring, our designer tile? I didn't have a picture of that, but we had it." 

After losing her filing cabinet to flood waters, Frances Baylor said homeowners also need to make sure those photos and documents taken before a storm are then protected from the elements.

"I had everything in email folders and kept it," she said. "I could pull my policy up and read it and say, 'Hey, I had my documentation.' A lot of people didn't. Don't save it on your computer because I lost my computer too. Have backups for your backup."

Insurance agent: "You can't cover everything"

After working as an insurance claims adjuster for years, Almeta Monroe has been an insurance agent since 2001.

"You can't cover everything," she explained. "There will likely be some issues that could happen during a hurricane that are not covered."

Monroe said when it comes to your insurance policies -- homeowner's versus flood insurance -- it's a challenge to determine what exactly caused damage to your property.

Remember all the people in Clay County who lost their boat docks?

"Was it the hurricane? Was it debris in the water?" Monroe asked. "Was it just the waves that washed the dock away? That's why the boat docks can be a little bit difficult."

Monroe added, "When an adjuster comes out if there's nothing there, we have to sometimes get with an engineer to get an idea of what caused the damage to the dock."

She agreed with what homeowners Edna Wade and Frances Baylor told us: Having photo or video proof of items actually in your home is an important first step.

"If you don't have the opportunity to make a formal list, take your camera," she said as she picked up her own. "Just take your cell phone and go around, and {take a} video of everything you have, because what you're trying to do is get the claims adjuster, should you have damage, and idea of what do you have."

Also, a reminder from Monroe about coverage for your vehicle in the event of a hurricane.

"If someone just has collision insurance, and your car is damaged from the hurricane, then that wouldn't be covered." she explained. "However, if you also have comprehensive coverage, that would cover damage from the hurricane."

Monroe's best advice is to sit down with your insurance agent each year to review your policies and possibly update them.

"If there been any changes with your property, you may have added a pool, or an extension to your home which may increase the value of your home that (may require you) to increase the insurance," Monroe said.

Insurance myths

To help keep you covered on all angles, we checked in with Florida's Chief Financial Officer Jimmy Patronis about myths and misunderstandings when it comes to insurance and preparing and recovering from a tropical weather event.

"The 2017 Hurricane Season impacted virtually every county in Florida, with Hurricane Irma resulting in more than $8.6 billion in insured losses," Patronis said in a statement. "From property damage ranging from wind to flood, my office fielded more than 9,300 calls and received about 2,500 complaints stemming from the nearly 1 million insurance claims filed from Hurricane Irma alone."

Patronis, who is a native of Florida and familiar with tropical weather impacts said, "We recovered millions for Floridians, but found the majority of the complaints stemmed from a few common misunderstandings."

The following are Patronis' answers to many of your questions:

MYTH: I already have homeowner's insurance, so everything on my property is covered and I'm financially prepared for the storm season.
FACT: All homeowner's insurance policies contain limitations and exclusions. Also, you may need a separate policy for windstorm or flood if these coverages are not included in your homeowner's policy. It is important to review your policy to understand your coverages and exclusions.

MYTH: When an insurance company denies a claim, or provides an inadequate claim payment, I must pay out-of-pocket to cover any additional expenses from damages that occurred to my property.
FACT: You should always get a second opinion to verify the cause of loss and/or the cost to repair or replace the damage. 

MYTH: When contractors offer to waive my insurance deductible to provide repairs at a discounted rate, this is simply a kind gesture. 
FACT: Waiving the deductible or providing a discounted rate directly to you is a form of insurance fraud.

MYTH: An Assignment of Benefits (AOB) agreement is the only way to get immediate assistance for Floridians who have damage to their property.
FACT: You do not need to sign an Assignment of Benefits to get your residence repaired, even for emergency repairs. You should make first contact with your insurance company by immediately reporting the claim.

MYTH: Insurance companies can take as long as they want to respond to an insurance claim filed by Floridians. 
FACT: Typically, insurance companies must acknowledge your insurance claim within 14 days from the date the claim was reported and they must pay undisputed amounts of your claim within 90 days from the date of damage.  

MYTH: If my neighbor's property is blown into my yard and damages my own property, my neighbor's insurance will cover the cost of damage.
FACT: The damage to your property is covered by your own homeowner's insurance policy, unless, you can prove your neighbor was negligent then the damage would be covered under their homeowner's policy. 

MYTH: My insurance agent is the only person I need to contact when filing an insurance claim.
FACT:  While you may call your agent, you should immediately report the claim to your insurance company. Most insurance companies have a toll-free claim number to report your claim.

Florida's Insurance Consumer Helpline

If you are having trouble with your insurance company or if you have questions about your insurance coverage and how to financially prepare for the upcoming hurricane season, you can call Florida's Insurance Consumer Helpline at 1-877-MY-FL-CFO (1-877-693-5236) Monday - Friday from 8 a.m. to 5 p.m.  Or, you can go online to MyFloridaCFO.com.

This Helpline that Patronis' office oversees, also provides you with a place to obtain contact information for your own insurance company, and verify the license of an insurance agent or adjuster.

Since July 1, 2017, Patronis' Insurance Consumer Helpline has recovered more than $37.9 million for Floridians, with $10.7 million stemming directly from inquiries related to Hurricane Irma. Patronis said these are funds the consumer would not have recovered from their insurance companies had they not reached out to the Helpline for assistance.