Can an insurance company deny your claim because you failed to immediately notify the insurer of damages?

David P. Stark and Evelyn Stark v. State Farm Florida Insurance Co.-4th District Court of Appeals

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The Starks’ home sustained roof damages as a result of Hurricane Wilma on October 24, 2005. They made immediate repairs to the roof, then received FEMA funds to repair more extensive damages to their roof caused by the storm. They did not believe that the damages would require more than their insurance deductible to cover, so they did not notify their insurance company about the damages.

As the next few years passed, the Starks’ roof continued to leak and the house sustained further damages as a result. Over three years after the initial storm damages, the Starks reported their claim to their insurer.

The insurer sent an investigator to the home who reported that he was “unable to establish a date and cause of loss” when he discovered the repaired and replaced roof tiles on the Starks’ roof. The insurance company pointed to the Starks’ policy which requires them to give notice to the insurer immediately following the discovery of damages. Because the company’s investigator reported that he was unable to establish when or how the damages occurred, the insurance company denied the claim.

A trial court issued summary judgement in favor of the insurance company, finding no issue of material fact as to whether the insurer was prejudiced by the timing of the notice given by the Starks.

The Starks appealed the trial court’s summary judgement. They filed affidavits from their own experts who concurred that the pattern of damage to their roof could only have been caused by a storm like Wilma, which was the only storm of it’s kind to have affected the area in the time period in question.

The appeals court reversed the trial court’s summary judgment and remanded for further court proceedings.

While insurance policies usually stipulate that a claim must be made immediately following a loss, circumstances sometimes cause insured persons to forego putting their insurance company on notice. Although Florida courts will presume a prejudice against the insurer in a case like this, the presumption can be negated with the right evidence.

Only an experienced attorney working for you, and with only your best interests in mind, can assist you in receiving compensation you may be owed by your insurance company. The team of attorneys at Canan Law are ready to answer your questions today and help you achieve the result you deserve if you’re currently in an insurance dispute with your coverage provider.

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