Navigating Insurance Deductibles

In the world of insurance claims, the concept of deductibles is a crucial aspect that policyholders often encounter. These deductibles are designed to discourage unnecessary claims, yet their implications can have a significant impact on the policyholder’s financial burden of damage to their property.

 

Flat-Rate Deductibles vs Percentage-Based Deductibles

When exploring the realm of deductibles, policyholders encounter two main variations: flat-rate deductibles and percentage-based deductibles. Flat-rate deductibles entail a fixed dollar amount that the policyholder must pay before their insurance coverage kicks in. On the other hand, percentage-based deductibles involve a percentage of the total insured value (TIV) of the property, which the policyholder must cover out-of-pocket. While flat-rate deductibles are straightforward and easy to understand, percentage-based deductibles can lead to varying commitments depending on the property’s value.

 

Perils 

One significant aspect of deductibles is the concept of “all other perils” (AOP) deductibles. These encompass a wide array of perils that may affect your property such as Wind, Hail, Hurricanes, Sinkholes, Collapses, and Floods. As you might anticipate, more severe perils tend to carry higher deductibles. While opting for a lower deductible may seem appealing, it can inflate your premium significantly. Insurance agents often suggest higher deductibles as a strategy to reduce premium costs, which can be a tempting proposition for policyholders.

 

Things to Consider

Imagine you reside in a condominium complex consisting of eight buildings, each with varying liability limits. Let’s say your property carries a 5% Hurricane deductible. In this case, the total insured value (TIV) is multiplied by the deductible percentage to determine the out-of-pocket expense in the event of a claim. For instance:

You own a condo where there are 8 buildings ranging liability limits of $1,684,874 and $2,026,302, and you have a 5% Hurricane deductible. The total TIV (Toal Insured Value) is multiplied by the deductible percentage, 5%.

Building A: TIV $2,000,000= Deductible $100,000

Building B: TIV $1,500,000= Deductible $75,000

Considering all eight buildings:

Total TIV: $14,000,000

Total Deductible: $700,000

Now, if a 1% deductible were in place instead:

Total Deductible: $140,000

 

The Implications and Beyond

While the calculations above solely focus on the deductible, other provisions can significantly impact coverage and claim outcomes. A high deductible might seem insignificant initially, but it can prove pivotal in determining the success of your claim. This hold especially true if you reside in an area prone to natural disasters, such as hurricanes.

 

In conclusion, comprehending the nuances of insurance deductibles is crucial for policyholders seeking to safeguard their assets effectively. Empower yourself with knowledge on the complexities of insurance claims and your policy. By making informed decisions about your deductible, you can not only manage your premium costs but also ensure that your claim process is smooth and financially viable in times of distress. Connect with us today to explore how Premier Claims can assist you on your journey to comprehensive coverage and peace of mind.

 

Negotiations Lead to a Full Roof Replacement and Warrantied

Edwards Electrical & Mechanical

Indianapolis, Indiana
Hail & Water Damage
January 2022


Facing an insurance carrier that was only willing to approve minor spot repairs and attribute the issues to old damage, our team swung into action. Leveraging detailed evidence from our on-site investigations, along with storm data and policy coverage specifics, we successfully negotiated a complete roof replacement. This victory not only addressed the immediate concerns but also furnished the policyholder with a brand-new, warrantied roof.


Insurance Carrier Offer: $8,990

Premier Claims Settlement: $2,039,000

 

The Impact of Hail: Understanding Size, Formation, and Damage

Hail, a type of solid precipitation that forms within thunderstorm updrafts, has fascinated and intimidated humans for centuries. Frequently causing damage to homes, cars, and aircraft, and posing a significant threat to people and livestock, these formidable ice orbs are a spectacle of nature’s power.

From Raindrop to Hailstone: How Hail Forms

Hailstones take birth when ordinary raindrops are lifted by thunderstorm updrafts into the frosty regions of the atmosphere. Here, they freeze and start their journey of growth, colliding with other liquid water drops that freeze onto their surface. This growth process can result in hailstones having layers of clear and cloudy ice, depending on the conditions they encounter during their ascent.

Interestingly, these layers don’t form due to the hailstone going through up and down cycles within the thunderstorm, contrary to popular belief. Thunderstorm winds are not just vertical; they also have a horizontal component that can significantly influence the hailstone’s trajectory and growth.

Gravity’s Pull: How Hail Falls To The Ground

A hailstone’s descent is all about timing and balance. It falls when it becomes too heavy for the thunderstorm’s updraft to support or if the updraft weakens. Smaller hailstones, due to their lightweight, can be blown away from the updraft by horizontal winds. As such, larger hail tends to fall closer to the updraft than smaller hail.

The speed of falling hailstones depends on a plethora of factors: their size, the friction they encounter with the surrounding air, local wind conditions, and even the degree of their melting. The expected fall speed ranges from 9 mph for small hailstones to over 100 mph for those with diameters exceeding 4 inches.

The Geography of Hail: Where it Strikes the Most

Despite Florida being the thunderstorm capital, it’s Nebraska, Colorado, and Wyoming that often bear the brunt of the most hailstorms. The convergence of these three states forms ‘hail alley,’ averaging seven to nine hail days per year. Other hail hotspots around the globe include China, Russia, India, and northern Italy.

Hailstorms create paths known as hail swaths as the storms move while the hail falls. These swaths can vary from a few acres to an area 10 miles wide and 100 miles long. Some storms churn out a mass of small hail instead of large hailstones, which can create hazardous conditions resembling icy winter roads when covering roadways completely.

Hail Size: From Peas to Grapefruits

According to NOAA National Severe Storms Laboratory, the largest hailstone recovered in the United States fell in Vivian, South Dakota, on June 23, 2010. It had a massive diameter of 8 inches, a circumference of 18.62 inches, and weighed almost 2 pounds. However, hail sizes vary significantly. They’re often compared to everyday objects for easier estimation:

In the end, it’s crucial to remember the damage potential of hail and take appropriate safety measures during hailstorms. From car windshields to rooftops, and from crop fields to livestock, hail can wreak considerable havoc. Stay informed and stay safe!

 

Correcting Date of Loss Leads to a 570% Claim Increase in 5 Months

Garner Industries

Lincoln, Nebraska
Hail & Wind Damage
December 2021


Our team stepped in after the initial claim had already been filed with the insurance carrier. Following a deep-dive investigation and thorough research, we discovered previously overlooked damage to another section of the roof. We also pinpointed a more accurate date of loss that aligned better with favorable deductible terms. After fine-tuning the claim and negotiating up-to-date costs for materials and labor, we achieved a 570% increase in the claim’s value—all within just 5 months.


Insurance Carrier Offer: $162,000

Premier Claims Settlement: $1,085,000

 

 

Meticulous Documentation Leads to a 683% Increase in the Settlement

Elite Transportation Warehouse

Emporia, Kansas
Hail & Water Damage
November 2021


Despite presenting evidence from forensic damage experts that proved water intrusion had caused phenolic insulation to become acidic and cause damage to the steel decking, the insurance carrier remained steadfast with their $139,000 estimate. They also denied coverage for business losses, even though the policy clearly included it. Undeterred, we connected the policyholder with a legal team, sharing all our findings to build a solid case. The outcome? A victory that resulted in a 683% increase in the settlement offer from the insurance carrier.


Insurance Carrier Offer: $139,000

Premier Claims Settlement: $1,088,000

 

 

Despite Delay Tactics $1.4M Settlement Secured in 3 Months

Luxtor Self-Storage

Prescott, Arizona
Hail Damage
February 2022


Before even filing a claim for hail damage to a high-end self-storage facility, our team was already on the case. Within a week of initiating the claim, we coordinated a joint inspection with the insurance carrier. Despite receiving a ‘reservation of rights’ letter from the carrier—a common delay tactic—we pressed on. We assessed the damage to all four buildings and submitted a comprehensive estimate. Although the insurance carrier countered with lower estimates, we stood our ground. The result? A robust final settlement of $1,428,000 in just 3 months, which even included the cost of private security during the restoration process.


Insurance Carrier Offer: Stated No Coverage Available

Premier Claims Settlement: $1,428,000

 

 

Understanding Ordinance or Law Coverage in Property Insurance

Ordinance or Law Coverage is a term property owners often face when reviewing insurance policies. But what’s its significance? This coverage safeguards owners, ensuring compliance with changing building codes. Our article explains Ordinance or Law Coverage, its categories, and its importance for policyholders. By understanding this often-overlooked aspect of property insurance, you can make informed decisions that protect your property and investment.

 

What is Ordinance or Law Coverage?

Ordinance or Law Coverage is an essential part of many property insurance policies, designed to cover the increased costs associated with complying with current building codes and regulations after a loss. Without this coverage, property owners may find themselves facing significant out-of-pocket expenses to meet the latest building standards, especially if codes have changed since the original construction.

 

What Does It Cover?

Ordinance or Law Coverage extends beyond standard property insurance, offering protection for situations often left out of traditional coverage. Here’s what it generally includes:

  1. Compliance with Current Building Codes: If local codes require specific materials or construction methods, this coverage helps pay for those requirements.
  2. Demolition Costs: If part of a damaged building must be demolished to comply with current codes, this coverage assists with those costs.
  3. Increased Construction Costs: If rebuilding to current codes costs more than restoring the property to its pre-loss condition, this coverage covers the difference.

Three Categories of Coverage

These Ordinances or Law Coverage categories ensure property owners’ financial protection and compliance with current building regulations. They address challenges after a loss, from outdated structure parts to demolition costs and modern building requirements. Understanding these aspects helps policyholders value comprehensive Ordinance or Law Coverage, guarding investments against changing codes.

1. COVERAGE A – Undamaged Portion Coverage: Designed to protect the property owner when local building codes or regulations require alterations or demolition of undamaged parts of the building. It covers the loss in value of the undamaged portion due to enforcement of building laws.

Why It’s Important
          1. Protection Against Obsolescence: Even if a structure remains undamaged after a loss, outdated building codes may render parts of it non-compliant.
          2. Financial Security: This coverage prevents added expenses that can arise from the need to update or demolish undamaged portions of a property.

2. COVERAGE B – Demolition Cost Coverage: Demolition Cost Coverage pays for the cost of demolishing the undamaged portion of a building when required by current building codes. It includes removing debris and preparing the site for reconstruction.

Why It’s Important
          1. Legal Compliance: Some local laws may require complete demolition, even if only part of the building is damaged. Without this coverage, owners could face significant costs.
          2. Safety Considerations: Demolition may be necessary to ensure the safety of future occupants or neighboring properties.

3. COVERAGE C – Increased Cost of Construction Coverage: Designed to assist with the extra expenses associated with rebuilding a property to comply with current codes and standards. This could include implementing energy-efficient technologies, handicap accessibility, or other mandated upgrades.

Why It’s Important
          1. Keeping Up with Modern Standards: Building codes evolve, with advancements in safety, energy efficiency, and other societal needs. This coverage ensures that rebuilt structures meet these modern demands.
          2. Avoiding Out-of-Pocket Expenses: The costs of upgrading to current standards can be substantial. This coverage helps property owners avoid unexpected financial burdens during the rebuilding process.

Why Do Policyholders Would Need It?

Ordinance or Law Coverage offers essential protection for property owners, ensuring alignment with legal and societal norms, protecting against unforeseen expenses, and preserving property value. In an ever-changing landscape of building regulations and community needs, understanding the importance of this coverage helps policyholders make informed decisions that safeguard their properties and investments.

  1. Changing Regulations and Building Codes: Compliance with evolving building standards is a legal requirement. Non-compliance can lead to fines and legal challenges, making this coverage essential to meet current and future regulations.
  2. Financial Protection Against Unexpected Costs: Upgrading, demolishing, or reconstructing parts of a building to meet current codes can be costly. Ordinance or Law Coverage protects property owners from these unexpected financial burdens.
  3. Aging Properties and Historical Buildings: Older buildings, constructed under outdated codes, may require extensive modifications. Specialized needs, particularly for historical structures, may entail further expenses, highlighting the need for this coverage.
  4. Location-Specific Risks: In areas prone to natural disasters or urban growth, specific and often stringent building codes apply. Ensuring compliance in these regions may be complex and expensive, making coverage vital.
  5. Investment and Property Value Considerations: This coverage safeguards property investments by ensuring buildings remain insurable and compliant with legal standards. It also helps preserve the market value, making properties attractive to potential buyers.

Additional Information for Policyholders

Understanding Ordinance or Law Coverage requires a careful review of policy details and potential exclusions. Here are some key considerations:

 

Ordinance or Law Coverage is a crucial part of property insurance, protecting property owners from shifting building codes and regulations. Understanding its coverage, importance, and categories allows owners to make informed decisions when protecting investments and legal compliance. For homeowners, commercial property owners, and real estate investors, this coverage offers assurance and financial security amid intricate regulations.

 

Date of Loss: Key to Successful Property Insurance Claims

The date of loss (DOL) in a property insurance claim is one of the fundamental elements that influence the entire process of claim settlement. Yet, it’s often overlooked or misunderstood by policyholders. In this guide, we’ll explore what the date of loss means, why it’s vital to have an accurate date, how it should align with weather data, the relevance of your policy coverage period, and common mistakes to avoid.

Importance of Having an Accurate Date of Loss

The date of loss holds more significance than a mere timeline point; it influences numerous aspects of an insurance claim. An accurate date is vital for policy compliance, as insurance policies often demand timely claim reporting linked to this date. This also impacts coverage determination, requiring the loss to fall within policy dates. Legal dimensions, such as statutes of limitations for lawsuits against insurers, are also tied to this date. Errors or discrepancies in this date can lead to complications, delays, or even the denial of a claim.

Understanding the date of loss isn’t just about following procedures; it’s about securing the rightful value of your claim. The value of the loss may vary depending on the date, impacting the settlement amount. In scenarios involving weather-related damages, such as storms or hurricanes, aligning the date of loss with weather data becomes crucial for both verifying the claim and determining the cause of damage. With a dispute, accurate weather records can be pivotal. In essence, the date of loss serves as the foundation upon which the claim is built, influencing everything from timelines to valuation, and ensuring its accuracy is paramount to a successful claim process.

Aligning the Date of Loss with Weather Data

In many property damage claims, particularly those related to storms, hurricanes, hail, or other weather events, aligning the date of loss with the corresponding weather data becomes a significant step in the process. Here’s why:

Verifying the Claim

Weather records play an essential role in confirming the occurrence of a weather event on the claimed date of loss. Accurate alignment between the date and weather conditions can strengthen the credibility of the claim.

Determining the Cause of Damage

Accurate weather data helps in pinpointing the specific cause of damage, such as wind, rain, or hail. This alignment becomes especially important in disputes where weather conditions may be contested.

Professional Consultation

Engaging meteorologists or weather experts may be necessary to ensure the alignment of the date of loss with actual weather conditions. This expert input adds authority to the claim.

Legal Implications

In some cases, weather data alignment can have legal consequences, especially if fraudulent claims are suspected. Authentic weather records linked to the date of loss can help in resolving such legal issues.

Public Sources and Technologies

You can utilize various public weather sources and technologies, including satellite imagery and meteorological reports, to corroborate the date of loss with weather events. tools help in building a robust claim.

Aligning the date of loss with weather data is not just a validation step; it’s a comprehensive approach to establishing the authenticity, cause, and legal standing of a claim. The correct alignment ensures that the claim reflects the reality of the event, avoiding potential disputes or misunderstandings.

Knowing Your Policy Coverage Period

Understanding the coverage period of your insurance policy goes beyond merely knowing the start and end dates; it encompasses several crucial aspects:

Eligibility for Coverage

The date of loss must fall within the policy’s effective dates to be eligible for coverage. Any loss outside this period may lead to claim denial.

Renewal Considerations

If the loss occurs near the renewal or expiration date of the policy, special attention must be paid to ensure the claim falls within the correct policy period. A slight discrepancy can have significant implications.

Understanding Exclusions and Endorsements

The policy’s terms might change over time, affecting coverage for specific perils based on the date of loss. Being aware of these changes helps in avoiding surprises during the claim process.

Policy Extensions and Transitional Periods

Some policies may have extensions or transitional periods that might affect the coverage. Understanding these nuances ensures that the claim is handled appropriately.

Impact on Future Coverage

The reporting of a loss within the policy period might have implications for future coverage, affecting premiums or eligibility for renewals.

Knowing your policy’s coverage period is not just a matter of compliance; it’s an integral part of managing your insurance effectively. It determines the eligibility, scope, and even the future implications of a claim. Attention to this detail helps in avoiding unnecessary challenges and paves the way for a smoother claim experience. If you have questions on property insurance policy and coverage, submit your policy review questions with our legal team.

Common Claim Mistakes

Navigating the date of loss in an insurance claim might seem straightforward, but it’s a complex aspect that can lead to several mistakes. Here are some common pitfalls that policyholders, and even professionals like public adjusters, may encounter:

Using the Date of Discovery Instead of the Date of Loss

Mistaking the date of discovery for the date of loss when it doesn’t apply is a frequent error. This can lead to confusion and potential disputes, especially if the damage occurred much earlier than when it was discovered.

Failing to Consider the Policy Effective Date

Selecting the date of loss without considering the policy’s effective date may lead to a denied claim. The loss must fall within the coverage period, and ignoring this essential factor can have costly consequences.

Missing Proof of Loss Deadline

The proof of loss deadline is when policyholders submit a formal statement to their insurer about claimed loss. The deadline varies based on policy type, insurer, and jurisdiction. Mistakes risk reduced payouts or claim denial.

Using an Incorrect Date of Loss for Gradual Damage

In cases of gradual damage, such as slow water leaks, using an incorrect date of loss can complicate the claim process. Identifying the actual date of damage in such scenarios requires careful consideration and may need professional evaluation.

Ignoring Weather-Related Evidence

 Lack of weather-related evidence can lead to disputes or claim denials, particularly in claims involving weather events. Proper alignment of weather data with the date of loss is vital.

Overlooking Policy Timelines

Different insurance policies may have varying timelines for reporting and other processes tied to the date of loss. Ignoring these specific timelines can lead to rejection or complications in the claim.

To sidestep these errors linked to the date of loss, focus on detail, policy awareness, and potential expert advice. Precision and adherence in this area facilitate a successful claim process, while missteps can trigger delays, conflicts, and claim rejections.


The date of loss is a seemingly simple yet profoundly influential factor in property insurance claims. It’s a cornerstone that supports compliance, coverage determination, damage valuation, and legal considerations. Understanding its definition, importance, weather alignment, policy period, and common mistakes helps policyholders navigate property insurance claims successfully.

 

Increase Settlement by 208% with Code Upgrades with O&P Included

Galisteo Center Condominium Association

Santa Fe, New Mexico
Hail Damage
August 2021


Right from the start, our team was involved. After an initial joint inspection, the insurance carrier proposed a settlement of $629,000. We knew that wasn’t enough. By highlighting the need for code upgrades and the replacement of outdated materials, we successfully increased the claim’s value. Although the insurance carrier initially resisted covering overhead and profit, our team’s tenacity paid off. The end result? A remarkable final settlement of $1,935,000.


Insurance Carrier Offer: $629,000

Premier Claims Settlement: $1,935,000