Does An Insurer Have To Pay Based On A Homeowner’s Account Of Wind Damage?
After a bad storm, a homeowner might notice damage to their property and assume that the weather was responsible. From the insurance company’s perspective, however, correlation does not necessarily mean causation. In other words, the evidence may show that the damage to the property was the result of normal wear and aging and not a specific weather event. When these type of disputes arise, the homeowner may assume that a judge will simply “take their word for it” that the storm was responsible and thus the insurance company is responsible for the damages. But that is not how insurance law works. If the homeowner disputes the insurance company adjuster’s findings, they need to respond with credible evidence beyond their own say-so. Judge Strikes “Expert” Testimony Due to Unreliable Methodology A recent decision from a federal judge in Jacksonville, Dias v. GeoVera Specialty Insurance Company, provides a helpful illustration. In this case, a homeowner filed a claim with an insurance company, alleging that his roof was damaged in a storm that occurred on December 20, 2018. More precisely, the homeowner told the insurer the damage “may have been due” to this particular storm. The insurance company retained an independent adjuster to conduct an inspection. The adjuster noted the homeowner’s roof had been in place since the initial construction in 1985, more than 30 years ago. Critically, while the adjuster did observe some cracks in the roof tiles, he concluded this was not the result of wind from a storm but rather “wear and tear over time.” Since the homeowner’s policy excluded coverage for “wear and tear” of this sort, the insurer denied the claim for roof damage. The homeowner sued. In court, the homeowner presented a conflicting expert report from his own adjuster. The insurer also retained a second expert to re-inspect the property. As you might expect, the dueling adjusters came to different conclusions. The insurer’s expert found the roof damage was not caused by wind from the 2018 storm; the homeowner’s expert said just the opposite. The judge, however, ruled the testimony from the homeowner’s expert inadmissible. Federal and state courts follow certain rules when admitting expert testimony of any kind. These rules require the judge to decide, among other things, if the expert is qualified and whether they used “reliable” methodology in reaching their conclusions. In this case, the judge said the homeowner’s adjuster did not use a reliable methodology in concluding the roof was damaged by the storm. To the contrary, the judge said the adjuster’s “methodology” was basically accepting what the homeowner had told him, i.e., that wind caused the roof damage. The adjuster only examined the roof personally one time and he “did not review other records or documents.” As such, the judge found the testimony inadmissible. And since the homeowner had no other evidence to support his case, the judge dismissed in favor of the insurance company. Speak with a Florida Homeowners’ Insurance Lawyer Today Insurance companies must balance their responsibility to policyholders with their fiduciary duty to shareholders. No insurer is required to pay a claim that lacks any substantiation. If you are involved in a dispute and need representation from a qualified Tampa insurance litigation attorney, contact HD Law Partners today to schedule a consultation. Source: scholar.google.com/scholar_case?case=813-253-5333202774204 Posted in Insurance Litigation | No Comments » Connect with us Archives May 2026 April 2026 March 2026 February 2026 January 2026 December 2025 November 2025 October 2025 September 2025 July 2025 June 2025 January 2025 January 2024 December 2023 November 2023 October 2023 September 2023 August 2023 July 2023 June 2023 May 2023 April 2023 March 2023 February 2023 January 2023 December 2022 November 2022 October 2022 September 2022 August 2022 July 2022 May 2022 April 2022 March 2022 November 2021 October 2021 September 2021 August 2021 July 2021 May 2021 April 2021 March 2021 February 2021 January 2021 December 2020 November 2020 October 2020 August 2020 July 2020 June 2020 May 2020 April 2020 March 2020 February 2020 January 2020 December 2019 November 2019 October 2019 September 2019 August 2019 July 2019 June 2019 May 2019 April 2019 March 2019 February 2019 January 2019 December 2018 November 2018 October 2018 September 2018 August 2018 July 2018 June 2018 May 2018 April 2018 March 2018 February 2018 January 2018 December 2017 November 2017 October 2017 September 2017 August 2017 July 2017 June 2017 May 2017 April 2017 March 2017 February 2017 January 2017 December 2016 November 2016 October 2016 November 13 Categories Alimony Appellate Arbitration Auto Accidents Auto Insurance Business Corporate Business Insurance Law Child Custody Child Support Criminal Law Divorce Family Law FEMA Insurance Payments Florida’s Mandatory 2‑Hour Legal Professionalism CLE: Foreclosure Defense Fort Myers Hurricane Insurance Attorney General Guardianship HD Law Partners Service HOA/Property Management Homeowners Association Homeowners Insurance Hurricane Claims Hurricane Insurance Insurance Bad Faith Insurance Claims Insurance Defense Insurance Litigation Landlord Tenant Law Enforcement Liability Loan Modifications Mold Water Damage Parental Rights Paternity Personal Injury Premises Liability Law Prenuptial Agreements Private Security Property Distribution Property Owner Law Sarasota Insurance Litigation Attorney Slip Fall Tampa Business and Corporate Attorneys tampa family attorney Tampa Insurance Attorneys Timeshare Timesharing Uncategorized HD Law Partners is proud to be your trusted full-service law firm Quick Links Property & Casualty Business & Corporate Litigation Family Law Contact Us Careers Get In Touch 2002 North Lois Avenue Suite 510 Tampa, FL 33607 813-253-5333 Contact Us