Tag Archives: sinkhole attorney

Insurance Policies and Coverage Issues, Sinkhole Lawyers

My Insurance Company Claims I Lied On My Application About Sinkholes

Insurance company claims I lied

Question: My insurance company completed an investigation, and reported to me that I have sinkhole activity at my home.  However, they claim they are not going to pay my claim because I “lied” on my application by not telling them that I knew there was a sinkhole (repaired) next door.

I did not know this until after we closed on the house and paid the premium.  Can they do this?

Your insurance company’s stance

Essentially, the insurance company is taking a position that they want to cancel or “rescind” your policy because you failed to provide information that you either knew they wanted or should have known to disclose.

Honestly, in my experience, these defenses are about as thin as they come.  Not a defense I would make when I represented insurance companies.  Here are the issues you are dealing with when an insurance claim asserts what is commonly referred to as an “MMR” defense to your claim, which stands for “material misrepresentation” on the application.

Why?  Because most insurance applications ask you to provide very specific information, such as “are you aware of any sinkhole activity on an adjacent property?”  If you checked “no,” and that was the truth, they have no defense and should pay your claim.

Your next steps

Most of the time, when an insurance company tries to deny a claim such as this, they do this to you after you make the claim with their lawyers in tow.  In essence, the insurance company got your claim, and then, after taking your premiums for as long as they have, decided to really look to see if they wanted to pay you.

Ask them to see your application, as most people have not actually retained a copy of their insurance application.  Engage your insurance agent in the process, by asking for his/her help.

Oftentimes, insurance agents are involved in the application process and can look to clear up these issues.  However, I can tell you that I am currently representing several homeowners who are in your shoes so it may be necessary to retain a sinkhole attorney.

Sinkhole Lawyers

Do I Hire a Public Adjuster or a Sinkhole Attorney?

Public adjuster vs. sinkhole attorney

When faced with a complicated sinkhole claim, you might get stumped from step one: finding the right kind of representation. There are different options available to you, but it requires some background information for you to be able to make the right choice.

Therefore, should you hire a sinkhole attorney to take a look at your case, or should you think about a public adjuster?

The FAPIA

Fortunately, the Florida Association of Public Insurance Adjusters, or FAPIA, is the resource you need to access professionals with the specific skill set needed to answer your question.

This is because, unfortunately, there are reasons to do both, and I cannot tell you over a blog post. Fortunately, the FAPIA provides a good framework for people looking for these services.

Requirements of the FAPIA

To inspire confidence in this organization, the FAPIA have set the following rules for its members:

  • The members shall conduct themselves in a spirit of fairness and justice to their clients, the Insurance Companies, and the public.
  • Members shall refrain from improper solicitation.
  • No misrepresentation of any kind shall be made to an assured or to the Insurance Companies.
  • Commission rates shall be fair and equitable, and strictly in accordance with the prevailing custom in the locality, and must, where laws or regulations of insurance departments exist, comply fully with such laws or regulations.
  • Members shall conduct themselves so as to command respect and confidence. They shall work in harmony with one another, with their clients, and the Insurance Companies’ representatives, so as to foster a cordial and harmonious relationship with all branches of the insurance business, and with the general public.
  • Members must be fitted, by knowledge and experience, for the work they undertake. They must not endanger the interests of the public adjusting profession, or risk injustice to assureds or to the Insurance Companies, by attempting to handle losses or claims for which they are not qualified, and for which they cannot find competent technical assistance.
  • Members shall not engage in the unauthorized practice of law.
  • Members shall not acquire any interest in salvaged property or participate in any way, directly or indirectly, in the reconstruction, repair or restoration of damaged property, except with the knowledge, consent and permission of the assured.
  • Members shall be cooperative and assist one another in every possible way.
  • Members shall not disseminate or use any form of agreement, advertising, or any printed matter that is harmful to the profession of public adjusting, or which does not comply with the rules and regulations of the Insurance Department of the state in which such member is professionally engaged, or which might subject public adjusting and public adjusters to criticism or disrespect.