With the current state of the law many people are often confused about what their insurance company will do when they report a claim. In short, don’t talk to your neighbors that had a sinkhole claim years ago because their experiences will be very different than yours. Under the current state of the law when you report a claim the insurance company is supposed to begin the process by sending an adjuster out to look at the damages. At that tine they may take a statement from you, document damage and even write a preliminary estimate of the damages they see. The adjuster is supposed to evaluate the damages and see if there is an obvious cause for the damage other than sinkhole. Rarely, if ever, has an insurance adjuster by themselves been able to look at damage and say for sure that it is not caused by sinkhole activity. Because of this, some insurance companies skip this first step and go right to hiring an engineer or they may hire the engineer the same day they inspect the house.

If the insurance company denies your claim without ever sending an engineer out, call a lawyer. Something is wrong. Either that most likely means you don’t have sinkhole insurance at all, they found some other unusual reason to deny you or they didn’t do the proper investigation. If they can’t tell whether the damage is sinkhole related or not then they are supposed to hire an engineer. That engineer will be asked to determine whether the damage rises to the level of being “structural damage”. If they determine it is not then their investigation is complete and your claim is denied without any further testing. If they do determine that the damage is structural then they will do further testing below the ground to determine whether sinkhole activity is the cause of the damage. If sinkhole activity is found to be the cause, they pay the claim (absent some other issue). If they don’t find sinkhole activity then they deny your claim.

As you can see, there are several opportunities for the carrier to deny your claim. I commonly refer to theses as the three “gates” you have two pass through. Right at the outset they can say the damages clearly aren’t sinkhole related or find some other unrelated issue such as the damages pre-existed their policy period or that you misrepresent something on your application with them. Get through that gate and they send the engineer out who can say the damage isn’t structural (the majority of claims shut down at this stage).  If you have made it that far, then they can say the structural damage is not from sinkhole activity. The odds are good one of these gates gets slammed in your face.

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