Category: Insurance Disputes

Under a homeowner’s policy, there are multiple types of coverage that the policy provides. First is structure coverage; so, that is going to cover the home, for example, in a fire loss. Other structure coverage would be a detached garage that may also be damaged. There’s often debris removal coverage; coverage for trees, shrubs, etc. And then there’s . . . separate coverage for personal property.

The reason all these different types of coverage matter is that [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][there are] different limits associated with all of them. And so, it’s important that an insured [understand] “What types of coverage does my policy have,” and “What are my damages,” so that we can analyze how they match up, and what should be paid. / END TRANSCRIPT

What does a homeowner’s insurance policy usually cover?

While every homeowner insurance policy is different, most of them cover damage caused by:

• Electrical problems
• Fire
• Hail
• Theft
• Vandalism
• Water damage (in certain circumstances)
• Wind
• Plumbing problems

Catastrophic conditions, such as tornados, hurricanes and other natural disasters, are generally covered under most policies, but it is important that you review your policy carefully to ensure you have the right coverage in the event of such a disaster. If you’re not covered, you may wish to consider buying an additional policy just in case.

Generally speaking, your policy should cover structural damage (such as that discussed in the video) and property damage – both to your property (think damage to your trees or driveway) and your contents: artwork, furniture, clothing, etc. Additional Living Expense coverage should also be provided to provide for the cost of a rental home or apartment for the time your home is being repaired. This type of coverage varies, so you must make sure you have enough of it to cover you for as long as you need it, lest you end up out in the cold.

At the Gilbert Firm, we help Tennessee homeowners, business owners and non-profit organizations facing insurance disputes. To schedule a consultation with Clint Scott, or any member of our team, please call 888.996.9731, or fill out our contact form. We maintain offices in Nashville, Chattanooga, Memphis, Jackson and Knoxville.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

On November 28, 2016, Gatlinburg and the surrounding areas experienced firsthand the devastation of the wildfires. The wildfires that ripped through the Smokies led to the deaths of 12 people, and injured almost 200 more. Close to 18,000 acres burned in two separate locations, and hundreds of people either lost their homes or businesses, or need to do substantial repairs and renovations.

Even those whose homes and businesses were untouched by the fires could have significant damage from the smoke and the soot. Yet many policyholders will face pushback and even denials if they try to recoup losses because of smoke, soot or ash-related damage, especially if the building was untouched by actual flames. But soot and ash can get into places in a building that aren’t quite visible, and make that building unsafe for living or working.

If your policy covers fire, and you wish to bring a claim for fire-related damage, there are a few things you can do to protect your home or business:

1. Document everything. Take as many pictures as you can of the damage done to the building and its contents. If, however, the property may be structurally unsound, or if there is a chance that the air could be contaminated and unsafe to breathe, do not go into the building. Ash can be particularly dangerous, as it may harbor burning embers.
2. Ask for help from emergency services. Your local law enforcement and fire departments can help you keep your property secure. Not only does your insurer want proof that your belongings were damaged by ash, smoke or soot; you want to ensure that anything valuable within your home is documented by the adjuster.
3. Ask your insurance carrier to hire a Certified Industrial Hygienist to test your home or business for remnants of soot, smoke or other contaminants. As a policyholder, you should want to have those tests performed, as they may be the only way to prove just how extensive the damage is. The CIH will take surface samples, but may take air samples as well.
4. Work with a professional cleaning crew. You do not want to attempt to clean your own home if it has sustained damage for smoke or soot. We recommended getting a number of estimates before choosing one company.
5. Review your claim. If your policy states that your property is to be returned to its pre-loss condition, then your insurer should pay for the costs associated with doing so. You may need to pay out-of-pocket for some costs, so you might want to review your policy with your agent. If it looks as though they may deny your claim, you might want to review it with your lawyer instead.

Many standard insurance policies cover fire damage, but that does not mean your insurer will want to pay. If you believe that your insurance dispute is an act of bad faith by your insurer, you should seek legal counsel immediately.

At the Gilbert Firm, we help policyholders who have had their claims denied for unfair or illegal reasons. Our Tennessee insurance dispute attorneys can review your claim, help you document your evidence, and fight on your behalf if your insurer isn’t holding up its end of the bargain. To speak with Brandon McWherter, Clint Scott or Jonathan Bobbitt, or to schedule an appointment at one of our offices in Nashville, Chattanooga, Memphis, Jackson or Knoxville, please call 888.996.9731, or fill out our contact form.

Let’s say that the worst has come to pass, and your home has sustained a significant amount of damage (as it would in a house fire). In order to make your home livable again, you need to hire a general contractor, who in turn is going to work with a plumber and an electrician in order to rebuild your home. When the bill comes due and your contractor submits it to your insurance company, the adjuster tells him or her that the company won’t pay for Overhead and Profit, or “O&P.”

Overhead and Profit, however, may recoverable if they are legitimate costs of doing business. In Parkway Assoc., LLC v. Harleysville Mut. Ins. Co., 129 Fed. Appx. 955 (6th Cir. 2005), the Court found that O&P are recoverable when the insured could “reasonably be expected to hire a contractor to repair [the] property.” As per the Tennessee Department of Commerce and Insurance’s Board of Licensing Contractors, it is reasonable to hire a contractor for any projects worth at least $25,000. In fact, the State requires that a contractor be licensed in order to even bid on projects that size. It is also reasonable when the work will require at least two additional subcontractors or tradesmen. Because Overhead and Profit are standard parts of any contractor’s bill, these should be covered by the insurance company.

What constitutes Overhead and Profit?

The contractor who works on your home repairs has expenses of his or her own. Overhead is the collection of expenses he or she has in running the business itself. That may include things like:

• Cost of materials
• Licensing costs
• Salaries and benefit plans for employees
• Rent for office space
• Marketing and advertising costs

Your contractor is also entitled to make a profit (the difference between how much the services and goods cost the contractor and how much those same good and services cost the customer); after all, he or she should not be expected to work for free.

Insurance companies may claim that these line items are actually included in the overall bid cost for the project: that is not always the case. As a policyholder, you pay premiums that include O&P, and as such, those costs should be covered. If they are not, you want an experienced Tennessee insurance dispute lawyer on your side to help.

The Gilbert Firm represents policyholders throughout the state whose insurance companies are giving them the run around when it comes to payment. We also protect contractors who have been denied Overhead and Profit by insurers. To learn more about our services, or to work with a skilled Tennessee insurance attorney like Brandon McWherter, Jonathan Bobbitt or Clint Scott, please call us at 888.996.9731, or fill out our contact form. We have offices in Nashville, Chattanooga, Memphis, Jackson and Knoxville.

The holiday season is upon us, which means some of you are going to have a lot of people running around your houses pretty soon. Big parties and holiday dinners are fun, but they can also lead to property damage. The most likely culprit? A house fire – but slippery walkways and anxious pets can lead to claims, too.

Your homeowners’ insurance policy should cover your losses in the event of a fire or other destructive force, but we bet you would prefer to not to sustain any damage at all. To help you protect yourself and your belongings this year, we’re offering you a few suggestions deigned to keep your home safe.

• Never leave candles unattended. If you light scented candles to keep your room smelling fresh, make sure you’re in the same room they are. A lit candle can tip – certain kinds burn so hot they essentially explode – leading to a fire.
• Be careful with your lights. If you string lights up on your house or on your tree, you run the risk of a fire hazard or an electrical short if you plug too many in at once. Use surge protectors, and make sure your wiring is up to code.
• Keep a fire extinguisher handy. A misplaced tea towel or oven mitt can burn up quickly if you leave it on the stove. Grease splatters can also cause a flare. If you do have a fire, turn off your oven and use a fire extinguisher to put out the flame.
• Put the dogs in a safe place. Even the gentlest dog can become agitated or frightened during a big party. The Insurance Information Institute says that the average cost of a dog bite claim is more than $37,000, so you’d do well to keep your pets someplace safe, away from guests.
• Park in the garage. There are a lot of cars on the roads at the holidays, which means a lot of cars parked in front of houses. Add in some parents whose kids have been restless the whole trip and a dash of drunk drivers, and the chances of your car being hit while it’s parked on the side of the road increases by quite a bit. If you can, park in your driveway or in your garage, and keep your car or truck away from other drivers.

The holidays can be stressful, sure – but they’re supposed to be about good times with the people you love. At the Gilbert Firm, we want that to be the case for you, too. If something does go wrong, and your insurance carrier is giving you a hard time about paying for damages that are covered by your policy, we can help. To speak with a Tennessee insurance dispute attorney like Clint Scott, Brandon McWherter or Jonathan Bobbitt, please call 888.996.9731, or fill out our contact form. We maintain offices in Nashville, Chattanooga, Memphis, Jackson and Knoxville, so we’re always nearby when you need us.

The Gilbert Firm can help an insured or policyholder when an issue arises on contents coverage, whether that issues arises before a lawsuit’s filed or after a lawsuit’s filed. And the way we can assist is helping gather the information, getting in touch with and hiring the proper people to assist in sifting the debris in a fire loss, meeting with the insured to go over the different things that they had in their house, help prepare the list of inventory; and then secondly, age that inventory to the best of the insured’s ability; and then finally, to value that property, so that the claim can be paid promptly and fully.

When you sustain a loss because of a fire, or a flood, or a windstorm ­– or for any reason – and that loss is covered by your insurance policy, you can put in a claim for damages with your insurance company. A contents claim is one wherein you request damages for the contents of your home: your furniture, your pictures, your clothing, etc.

It’s also a claim that can lead to some back-and-forth between you and your insurer. We routinely represent Tennessee policyholders who have been told that they misrepresented the worth of, or the damage to, their belongings. That is why it is so important to seek the counsel of experienced Tennessee insurance dispute attorney if you sustain a loss. We work with industry experts to value your items and to categorize your losses, so that you make a strong claim for compensation. If the insurer still denies your claim, or tries to offer you less than what you are owed, we can protect your rights in court.

The Gilbert Firm has assisted thousands of policyholders throughout Tennessee who have been denied damages, or have been victims of bad faith actions. We invite you to call 888.996.9731 or to fill out this contact form to schedule your consultation with a skilled Tennessee insurance dispute lawyer. We have offices in Nashville, Chattanooga, Memphis, Jackson and Knoxville for your convenience.

At what point in the claim process do I get involved? That varies – so much so, sometimes. I’ve got clients now, former clients that have another loss that have called me the day after. So sometimes it happens very, very quickly. On the other end of the spectrum, I’ll have lawyers who are handling cases for a policyholder that kinda get in over their head and call me after a lawsuit’s been filed. So I can get in at any given time.

But as a general rule, sooner is always better than later, because along the way there are gonna be pitfalls and roadblocks, and it’s so important to have someone qualified, that knows how to read a policy, that knows what the law is, to help guide you through that process and get it set up correctly on the front end, because sometimes, at the back end, it’s already too late.

You buy insurance because you expect it to protect you in the event of a loss. But what happens when your insurance company denies your claim, or lowballs the amount they are willing to pay out?

You have rights under the law, and a skilled Tennessee insurance dispute attorney can help you obtain the insurance payment you need and deserve. There are often limitations on how long you can wait before filing a claim – and how long you have may depend on the policy itself in some cases. That is why we say it is better to seek legal counsel sooner rather than later: you want to make sure all of your options are available to you.

At the Gilbert Firm, our Tennessee insurance dispute lawyers handle complex claims involving homes, condos, commercial properties, business and non-profit organizations. Whether you have been a victim of bad faith insurance practices, are faced with an insurance carrier that has breached its contract with you, or have been harmed by agent negligence or malfeasance, we can help. To make an appointment at one of our offices serving Nashville, Chattanooga, Memphis, Jackson or Knoxville, please call 888.996.9731, or fill out our contact form.

You purchase homeowners’ insurance in case the worst comes to pass, and your home sustains serious damage. Buried within the contract is something called the appraisal provision, or appraisal clause. The International Risk Management Institute defines this as a “property insurance provision allowing either the insurer or the insured to demand a binding appraisal of damaged property in the event of a dispute as to its value and establishing the required appraisal procedure.”

So what does this mean? Let’s say your home is damaged in a fire, and your insurance company offers you a settlement amount that is not sufficient to cover the damage caused. If the policy allows, you can invoke your “right to appraisal.” Very generally speaking, appraisal is where you (the policyholder) and the insurance company engage in a process that ultimately leads to a panel of three third-party neutrals setting the dollar value of damage caused by the loss. Note that the appraisal process only leads to the setting of the dollar value of covered damage; it does not resolve coverage disputes.

If you decide to invoke your right to appraisal, then the next step is finding an appraiser you can trust to do the work. This is an out-of-pocket expense, so you want to choose the right person to help you make your case. Some options are public adjusters (adjusters licensed by the State of Tennessee; not affiliated with insurance companies), engineers, contractors, lawyers, etc. Your selection of the correct appraiser is critical because without an experienced person at the reigns the appraisal process will be doomed to failure.

If you are unsure about your appraisal rights or how should proceed, just ask us. At the Gilbert Firm, we protect the rights of policyholders every day. Our Tennessee insurance dispute lawyers can show you how to find the right appraiser for your needs. We can also handle complex claims of bad faith, should it prove that the insurance company has acted negligently or fraudulently.

To learn more about our services, or to schedule an appointment with a Tennessee insurance dispute attorney like Jonathan Bobbitt, Clint Scott or Brandon McWherter, we invite you to call 888.996.9731 or fill out our contact form. We maintain offices in Nashville, Chattanooga, Memphis, Jackson and Knoxville for your convenience.

You’ve been staring at that ugly Formica countertop since you bought this house and it’s finally time to do something about it. Maybe the roof shingles are on their last legs, and it’s time to replace them once and for all. Perhaps a surprise bonus from work means the inground pool your family has dreamed about for years. Or you love your house, but a new baby on the way means it’s finally time to convert that basement into a real living area. Whatever your reasons, home renovations and upgrades can be incredibly satisfying. They can also cause issues with your insurance policy. Certain projects are more likely to affect your coverage than others, and we wanted to go through a few of them with you, in case you have a remodel in your future.

• New roofs. One of the best investments you can make is the purchase of a new roof before it leaks or leads to damage to the inside of tour home. You need to tell your insurer that you’re having the work done, though, so your policy can be adjusted.
• An above ground pool probably isn’t considered a permanent structure – but you still need to tell your insurance company you have one, and your policy will change to reflect additional coverage in the event of an injury. In-ground pools are an even bigger issue. Many policies will not cover pool with diving boards or slides, so if you want to install either of those, you need to A) first find out if it will be covered, and then B) inform your agent.
• New additions. If your home is expanding, your policy needs to expand along with it. Make sure to tell your agent exactly what kind of room(s) you’re building, too. A bedroom or a den requires electricity, while a new kitchen or bathroom will mean changes to the plumbing and gas lines, too.
• A home office. Most homeowners’ policies do not cover damage or loss to your business, even if that business is run from a home office. You should sit down with your agent and review your policy entirely if you plan on building a full home office onto your home, or even in a separate building on your property, in order to make sure you are appropriately covered.

Any time you make major changes to the layout of your home or your land, it’s a good idea to run them by your agent. You want your policy to cover what you have, not what you used to have. You should also request a new, updated version of your policy and any paperwork you need to fill out once everything is said and done.

At the Gilbert Firm, we help uphold the rights of policyholders in disputes and bad faith actions. To learn more about how we can help, or to work with an experienced Tennessee insurance dispute attorneys such as Clint Scott, Brandon McWherter or Jonathan Bobbitt, please call us at 888.996.9731, or fill out our contact form. We proudly serve clients in Nashville, Chattanooga, Memphis, Jackson, Knoxville and throughout the state.

Imagine for a moment that a storm touches down in Tennessee and ravages your neighborhood. You put in a claim with your insurance company for the damage you sustained, dotting every “i” and crossing every “t.” Then the insurance company sends you some mail, and instead of the check you hoped for, you see a letter telling you that your claim was denied.

It happens to Tennessee homeowners all the time. We wanted to take a quick look at some of the more common reasons why an insurance company might deny a policyholder’s claim:

1. That damage isn’t covered. We have discussed policy exclusions before, and they remain one of the most common reasons why insurers deny claims. It is vitally important that you check your policy to ensure that any gaps or exclusions are covered by additional riders or policies. But remember, the insurance company bears the burden of proving the application of an exclusion.
2. The damage was too extensive. Every policy has limits. If the damage exceeded what your policy limits would cover, you’re likely to be “on the hook” for any additional damage over and above the limits. But, some policies provide extra coverage under limited circumstances. For example, many policies provide for an extra 20% of coverage if the existing limits are insufficient to make repairs.
3. There is a disagreement over the value of your loss. In this case, perhaps your claim was accepted, but the offer seems incredibly low: you say your damage was worth “X,” and the adjuster says it was worth “Y.” Under these circumstances, the insurance company has an obligation to pay what they admit they owe, but sometimes they will try to apply pressure to get you to sign a release. Don’t fall for it – insurance carriers must pay what they owe and leave the rest to fight about later.
4. There was another issue that could have led to the damage. If there is any kind of pre-existing damage or problem with your home, and the damage on your claim could have been caused by that pre-existing damage, your insurer may deny payment. The “wear and tear” exclusion is being utilized more and more to deny valid claims. These claims can be highly technical, and sometimes there can be coverage even if “wear and tear” or deterioration contributed to the damage.
5. There was an error on your original application. Even the smallest mistake can lead an insurance company to deny a claim. They may try to deny the claim if you failed to disclose a prior loss, criminal history, etc. The interaction between you and your agent on these topics can be critical.

Bad faith actions

There are also times when an insurance company’s denial of a claim is just flat out and plainly wrong. If the insurance company is “lowballing” you on purpose in order to avoid paying out a larger (more accurate) amount, or is purposely arguing for the application of an exclusion that is not applicable, you might have a claim for bad faith.

At the Gilbert Firm, we work hard on behalf of policyholders whose insurance agents and companies are giving them the run-around. Clint Scott, Brandon McWherter and Jonathan Bobbitt are skilled Tennessee insurance disputes attorneys who know what it takes to successfully prove bad faith. To make an appointment at one of our offices serving Nashville, Chattanooga, Memphis, Jackson and Knoxville, please call 888.996.9731, or fill out our contact form.

There are a variety of different coverages available under every policy. First, you should know that every policy is different. A homeowner’s policy is going to have dramatically different coverages than a commercial policy. Usually in a homeowner’s policy, you’ll have Coverage A, which is the dwelling, Coverage B, which is other structures (often times), Coverage C, which is contents, and then, in addition to that, there’s the lesser known coverages – the coverage for trees, shrubs and lawns. So when you have a fire loss, and every one of your shrubs has to be destroyed in order to rebuild, that’s covered.

There’s coverage for debris removal. There’s coverage for charges from fire departments for coming out and putting out the fire. There is a mix and multitude of coverages available in every policy, and it takes someone taking the time to dig through there to make sure that you take advantage of every coverage that you paid for. We’re not asking the insurance company to pay for anything that you don’t have, but it’s coverage that you paid good premiums for.

Are you covered for potential losses?

With so many different policies to choose from, it can be hard for Tennessee homeowners to know if they have the right coverage for their needs. You want to make sure that there are no gaps in your policy, and that you can purchase additional coverage for any exclusions, like floods. At the Gilbert Firm, we help our clients makes sense of the polices they have, and work with them to obtain compensation for damages when they are rightfully owed that compensation under their policy.

If your insurance company is giving you the run-around, or if you believe that your claim has been unfairly denied, you may be able to bring a bad faith action against your insurance company. Tennessee insurance dispute attorneys Brandon McWherter, Clint Scott and Jonathan Bobbitt help policyholders just like you every day. To learn more about our services, or to schedule a consultation at one of our offices in Nashville, Chattanooga, Memphis, Jackson or Knoxville, please call 888.996.9731 or fill out our contact form.