Answers to Frequently Asked Questions About The Insurance Claim Process

Your home or business suffered damage in a hurricane or other major wind event, but the insurance company says you have “pre-existing damage” and is ruling your roof insurance claim will be denied. 

What’s going on, and what can you do now?

At The Voss Law Firm, P.C., we have seen firsthand how often insurance companies use any excuse possible to get out of paying a legitimate insurance claim.

The truth - Insurance companies often deny claims to save money.

Many people who have had their roof insurance claim denied by their insurers don’t know that they can appeal the company’s decision and fight back.

You can appeal their claims of pre-existing damage or wear and tear.

However, some insurers will declare a roof insurance claim denied due to “pre-existing damage,” “maintenance,” or “wear and tear.”

What can you do to avoid having your roof insurance claim denied?

Hurricane Insurance Claim or General Roof Insurance Claim Denied Due to Maintenance Issues or Previous (Pre-existing) Damage?

Here’s What You Should Do Next.

Property insurance policies are designed to cover losses from sudden events, such as hurricanes and other large wind events.

However, even if you did sustain some wind-related losses, property insurance companies typically will not cover any losses involving the following.

• Lack of appropriate maintenance
• Issues that existed before you bought your property
• Wear and tear over time
• Damage from lack of temporary repairs after a loss

You may also run into trouble with a claim for hurricane losses or have your roof insurance claim denied if you previously received compensation for a different insurance claim on that part of your house.

For example, you can’t file a claim on a roof you received reimbursement to repair if you didn’t follow through with that maintenance at the time.

If the insurance company believes your hurricane damage was pre-existing and declares your roof insurance claim denied, this may be a legitimate cause for denial.

If the damage was your fault, it’s unlikely that you’ll be able to recoup the total amount of your losses.

There are many reasons a hurricane insurance claim may be legitimately denied, and there may be little that a home or business owner can do if the insurance company says their losses fall under a “pre-existing damage” exclusion.

However, if you have read over your policy and believe your claim has been unfairly denied or wrongly blamed on old damages, don’t give up, we’re here to help.

Instead, pursue your questions about the denial with an experienced insurance litigation lawyer and avoid having your roof insurance claim denied.

An attorney can look at your policy, review the decision, and help you understand the reason your claim was denied.

Suppose he or she determines your claim has been unfairly denied. In that case, the attorney can communicate with the insurance company, have an outside expert look at your home, and build a case for you to receive the compensation you and your family deserve. 

Hurricane insurance claims are underpaid or unfairly denied more often than most policyholders know, and it’s always worth digging deeper into your rights if you’re unsure.

How to Avoid Having Your Roof Insurance Claim Denied Due to Pre-existing Damages in the Future

Insurance companies generally set out strict rules about pre-existing damage, whether you’re buying insurance for a new home or already have a homeowner’s policy in place. 

If you’re concerned or live in a hurricane-prone area, there are a few steps you can take to help avoid having your roof insurance claim denied due to pre-existing damage.

• Review your insurance coverage.

Understand how your insurance policy handles pre-existing damage and maintenance issues, and see what tactics they can use to have your roof insurance claim denied.

Even after reading through your current policy, call your insurer directly to clarify your coverage if you aren’t sure.

• Inspect your property regularly.

If you don’t know there is a potential problem or that you previously sustained a loss, you can’t expect your insurance company to know—or to pay. Always check your properties with regularity. 

• Pay special attention to your roof.

It’s easy to miss small leaks or tears that can eventually lead to significant damage. 

Roof damage is the main reason for hurricane insurance claims, aside from damages caused by a storm surge.

Hurricane winds can lift shingles, puncture roofing material, and even remove or shift the entire roof.

• Take “before” photos.

Most people end up taking “after” photos of hurricane damage when it happens, but “before” condition photos make it easy to show that damages did not exist before the storm.

Take pictures or shoot a video of your home and property before storm season starts, date the footage, and retain this documentation just in case it’s needed for an insurance claim. If you can add a date stamp of a newspaper to show the date the video was created, it will only help further.

Evidence will help you avoid having your roof insurance claim denied.

• ​Bring in a professional.

Roofing or repair professionals can not only help you inspect your home for hard-to-spot problems but also repair gaps and holes, secure loose roof shingles or siding, and even install precautions such as hurricane straps.

If you’ve already sustained damage from a hurricane, a professional can also help provide thorough assessments and estimates for insurance purposes.

It is significantly a wise choice to get the help of an insurance litigations lawyer to help you avoid having your roof insurance claim denied.   Precautions provide peace-of-mind, but hurricanes and tropical storms can still wreak havoc on your home and cause damage.

If you are denied insurance claim coverage or getting the runaround from your insurer, please call The Voss Law Firm, P.C. at 1-281-549-8911 to set up a free strategy and review session with a skilled insurance claim attorney.

RELATED LINKS

Preparing for a Hurricane Claim Businesses Suffer More Than Physical Damages in a Hurricane Moving Forward After a Hurricane Insurance Claim

Tornado coverage can be complex, as most people’s insurance policies cover damage from an Act of God; however, if you live in an area that is susceptible to tornadoes, then your homeowner’s insurance policy may exclude coverage for tornado damage. 

As experienced hail damage insurance claim attorneys, our law firm recommends that you read your insurance policy and if you still aren't sure if you are covered for tornado damage then call your insurance agent. You may have to purchase a separate rider to cover damage that occurs from wind and hail due to a tornado. 

In addition to checking if you are covered for tornado damage, you should also look at how much you are covered for. Many people don't have adequate coverage anymore, as they bought their homes a long time ago and purchased enough insurance at that time. However, the costs of labor and materials have gone up. So, if your home was destroyed in a tornado and you needed to rebuild it, you may not have enough coverage anymore.

Most homes are underinsured and only have enough coverage to rebuild about 80 percent of the home. Because of this, we urge you to review your policy to determine your coverage today. Also, if you are a renter, you are not off the hook. Renters need to make sure they are covered and have enough coverage for their personal belongings in the event of a tornado.

If you still aren't sure how much coverage you have or if you are covered for tornado damage, please feel free to call a knowledgeable hail damage insurance claim attorney at the Voss Law Firm to help you determine your coverage at 888-614-7730 in a free consultation today.

Pelvic mesh devices are implanted through surgery. According to the FDA, contributing factors to complications may include the patient’s health, mesh material, the size and shape of the mesh, surgical procedures and estrogen levels.

In September 2011, the FDA issued a recall of transvaginal mesh devices. Boston Scientific Corporation’s Pinnacle Pelvic Floor Repair Kit--Anterior/Apical STERILE and Pinnacle Pelvic Floor Repair Kit--Posterior STERILE were recalled because they may exhibit low tensile strength between the needle and suture and lead to needle detachment during mesh leg placement. An FDA advisory panel also met to discuss the safety of medical drugs and devices, including transvaginal mesh, and recommended tougher premarket testing of vaginal mesh products and the reclassification of the devices to a Class III—the highest-risk category for medical devices—without recalling existing products.

A  2011 study released by the Journal of Obstetrics and Gynecology Canada (JOGC) on pelvic mesh procedures stated, “Until adequate effectiveness and safety evidence is available, the use of new TVM devices for prolapse repair should be considered experimental and restricted to use in investigative trials.” 

The FDA warned patients and healthcare providers in July 2011 of the risks associated with the use of transvaginal mesh and recommended they consider alternatives to for treating  POP and SUI, conditions that may occur after childbirth and pregnancy. According to the FDA, nearly 40 percent of women between the ages of 35 and 54 suffer from SUI. In 2010, more than 10,000 women underwent vaginal mesh surgery to repair POP alone.

In an article published in an August 2010 issue of the Obstetrics & Gynecology, researchers reported that scientists had to stop a target="_blank" title="">transvaginal mesh clinical trial early because women implanted with the mesh experienced too many complications. In the trial, which began in 2007, 65 women with POP underwent either surgery using the pelvic mesh or a procedure known as colpopexy that uses ligaments to help support the muscles. The trial was cut short in 2009 after researchers found that more than 15 percent of the women implanted with the mesh suffered within a period of only three months from vaginal mesh erosion, a potentially serious complication involving the protrusion of the mesh when the skin splits.

In October 2008, the FDA issued a public health notification alerting healthcare providers and the public about the increasing number of serious health issues associated with the transvaginal mesh. Reported complications include mesh from nine different manufacturers.
 

Vaginal mesh has become a popular way for doctors to treat pelvic organ prolapse (POP) and stress urinary incontinence (SUI), but a high rate of pelvic mesh failure has some medical professionals thinking twice about these devices.

Vaginal mesh is a synthetic implant used to hold pelvic organs in their original positions by providing internal support to structures and tissues that become lax through childbirth and the natural aging process. The mesh was first approved by the FDA to treat stress urinary incontinence in 1996, and the FDA expanded their approval of these devices in 2002 to address pelvic organ prolapse.

While many women have experienced successful treatment with vaginal mesh devices, others have suffered from serious gynecological mesh failure that has resulted in pain, infection and bleeding. Many instances of pelvic mesh failure have required additional surgery to correct the complications.

Surgical treatment may result in pelvic mesh failure

Many women experience POP during the menopause years, when pelvic structures change as part of the aging process. When the pelvic organs collapse, they place additional pressure on the vagina, which may result in discomfort, constipation, urinary incontinence and painful intercourse.

Traditional treatment for POP included surgery to internally adhere pelvic organs to their original positions through stitches made in vaginal tissue. However, surgical mesh was introduced as another treatment option that could be inserted vaginally, sparing a woman from more invasive surgery and a longer recovery time.

Recent studies, however, have noted the higher than expected rate of pelvic mesh failure makes this a less-than-optimal solution for many women.

Reasons for pelvic mesh failure

There are many complications that can contribute to pelvic mesh failure. Some of these problems might include:

• Recurrence of pelvic organ prolapse, requiring further repair
• Perforation of internal organs like the bowel or bladder
• Gynecological mesh failure when the device migrates through the vagina and affects surrounding tissue and organs, including the bowel, bladder and rectum
• Infection around the treatment site
• Urinary incontinence or recurring urinary tract infections
• Painful sexual intercourse or the inability to engage in intercourse completely after treatment
• Pelvic or vaginal pain that may be intermittent or ongoing

 

The FDA warning on pelvic mesh failure

Incidences of gynecological mesh failure were high enough to initiate a formal warning by the FDA in July, 2011. In their report, the agency stated that problems associated with pelvic mesh failure were not uncommon and other means of treating POP and SUI might be more effective.

The report also states that some women who had multiple surgical procedures to correct their pelvic mesh failure continued to experience problems long after corrective surgery was completed. At an FDA subcommittee meeting a few months later, it was recommended that manufacturers of vaginal mesh devices conduct additional studies to address ongoing safety issues.

At this time, thousands of injuries associated with pelvic mesh failure have been reported to the FDA, and hundreds of lawsuits alleging gynecological mesh failure have been filed against the manufacturers of these devices.

One of the most common of the many vaginal mesh complications is vaginal mesh erosion. According to one large analysis of nearly 12,000 women, about 10 percent reported vaginal mesh erosion within a year after surgery.

In addition, an FDA Safety Communication issued July 13, 2011, noted that a review of published scientific literature from 1996-2011 showed vaginal mesh erosion through the vagina was the “most common and consistently reported mesh-related complication” from transvaginal pelvic organ prolapse (POP) surgeries using mesh.

 

What is vaginal mesh erosion?

Vaginal mesh erosion, sometimes referred to as vaginal mesh exposure, extrusion, or protrusion, occurs when the mesh fails to remain in place and instead works its way through the vaginal wall, eroding skin and tissues. The mesh may then become visible around the vaginal area.

Women who experience vaginal mesh erosion often suffer pain, bleeding, and painful sexual intercourse, sometimes leading to an inability to engage in sexual intercourse at all. Men may also experience irritation and pain to the penis during sexual intercourse with a woman who suffers vaginal mesh erosion.

Women who have experienced these vaginal mesh complications may require additional surgical repairs to attempt to remove the mesh, but the FDA has noted that sometimes even multiple surgeries may not resolve serious transvaginal mesh complications such as vaginal mesh erosion.

 

Women seeking relief for POP may experience vaginal mesh complications

POP occurs when the muscles and tissues that hold the pelvic organs in place become weakened or stretched due to childbirth, surgeries, menopause, or other causes. As a result, the internal organs—including the bladder, uterus, rectum, and bowel—may bulge (prolapse) into the vagina or even past the vaginal opening.

Some women can cope with POP through lifestyle changes, but others suffer more serious symptoms. These may include pain and pressure, painful sexual intercourse, disruption of normal urinary and defecatory functions, and stress urinary incontinence (SUI)—a condition in which normal activities such as coughing, sneezing, laughing, or exercise causes leakage of urine.

Women with more serious symptoms of POP may opt for surgical repair. Traditional methods do not employ the use of mesh, but newer methods adopted mesh to provide additional and supposedly superior support the pelvic organs. Unfortunately, surgery with mesh has been found to increase risk of transvaginal mesh complications.

 

FDA’s recommedation to reduce risk of vaginal mesh erosion

The FDA has recommended that patients considering surgical repair with mesh be aware of potential vaginal mesh complications like vaginal mesh erosion, and discuss with their doctors other repair alternatives. Patients should also be sure their doctors are well trained in surgical mesh implantation with the product they intend to use.

After a severe hail storm, cleaning up and making repairs may be your first priority. However, it’s not always a good idea to start fixing up the damage right away. When you should start making repairs may depend on your answers to the following kinds of questions:

• Will you be submitting an insurance claim for the hail damage? If you will be submitting an insurance claim, realize that the adjusters will want to see the damage for themselves, and you may need to contact a professional to help you conduct a damage assessment of your own.
• Does the damage pose a safety risk or potential for further loss? If the damages to your property could hurt someone or cause further damage, some repairs may be necessary for safety and to prevent a bigger or more costly problem.
• Has the hail damage been thoroughly documented and assessed? You will want to have your own informal photographs of damage, as well as any other professional assessments that are required for recovery documentation. If the damage hasn’t been documented before repairs start, it can be extremely difficult to go back later and prove that your property was affected in the storm.

So, before you start repairs, make sure you know what to expect. If your damages are very severe, or if you plan to file a significant insurance claim, it’s important that you take the steps to do make repairs the right way and on a reasonable timeline.

To Repair or Not to Repair Before Filing Your Hail Insurance Claim

If you find yourself wondering whether or not to make repairs, here are some things you can do to help you protect your property and your insurance claim:

Temporary repairs

If needed, you can make temporary repairs on your property. Make repairs that are just sufficient to protect your property immediately against theft and further damage. Your goal is to make your property habitable. Make sure that broken windows and damaged rooftops are covered properly. Use plywood, tarps, or other materials to cover broken windows and damaged rooftops, and keep the receipts of any materials or services that you purchase to make these repairs.

Consult your insurance agent

Major repairs should ideally be funded or financed by your insurance proceeds. To be on the safe side, it would be best to consult your insurance agent and inform him or her before you make any temporary repairs. This will help you avoid a situation where the insurance company denies your claim due to the repairs you undertook.

Keep proof before repairing

Before making your temporary repairs, or before you even clean up, make sure to have sufficient documentation of the damage on your property. Take pictures of the damage both inside and outside your home. These pieces of evidence will come in handy when the insurance adjuster arrives to inspect your home, which can occur long after you have completed your temporary repairs.

Consult professionals

The most important thing that property owners can do after a strong hailstorm is to call in a professional to inspect their roofs. While some dings are easily noticed, some dimples and damage can be easily missed. When a professional looks at a roof, he or she can tell if there was damage to the protective layer of granules, shingles, and more. Generally, you are free to select any contractor you wish. It is usually best to select one who has operated in the area for several years, is insured and bonded, and will give you a written guarantee for the work performed. Make sure the roofers or contractors have liability insurance, or else you could end up liable if they get injured on your property.

Keep proof after repairing

If you make temporary repairs on your property, make sure to keep receipts for the materials, labor, and other services that you purchased to undertake the repairs. Most likely, your insurance adjuster will go over these supporting documents to determine whether or not these expenses are covered by your insurance policy and are reimbursable. It can also be helpful to have photos of the new repairs soon after they were completed.

Temporary relocation

In some instances, the damage to your property may be so severe—and the repairs and restoration would be so major—that you and your family would need to move out temporarily. In such a case, you need to find an alternative accommodations. Make sure to keep receipts and other records of the additional expenses you incur because of this temporary relocation. These added expenses can fall under the “loss of use” provision which is commonly found in homeowners insurance policies.

Appeal or dispute resolution

If you encounter problems with your insurance claim because of temporary repairs done on your property, do not simply give up. You can go through your insurance policy’s appeal or dispute procedure. You can engage the services of a public adjuster or an insurance claims lawyer to assist you in this process.

Keep in mind, too, that you may not be able to collect damages from your insurance claim immediately. Policyholders are often surprised that their seemingly straightforward insurance claims are delayed or denied, and it may be necessary to prioritize which repairs will be addressed with limited funds while you work toward a resolution.

If you have any question about whether or not you should make repairs after a storm, it is highly recommended that you consult with a legal team that has the relevant experience needed to review your policies, document the extent of the damage, and hasten the claims process. For more information, contact the Voss Law Firm today at 1-888-614-7730.

RELATED LINKS

Will the insurance company cover both roof and water damage caused by hail? Hail Damage: Step-by-Step Procedures Understanding Hail Storms

Because of defects in manufacturing and design, some of pain patches allowed excessive pain medication levels into the bloodstream without the patient’s knowledge. The Fentanyl patch and Duragesic skin patch, along with other generic products, have caused deaths and serious side effects from overdoses of Fentanyl in patients. This defect has been linked to respiratory depression, decreased blood pressure, coma and even death. 

If you were injured or you lost a loved one due to the Duragesic skin patch or the Fentanyl pain patch, medication error may be to blame. You may qualify for benefits under the Fentanyl patch lawsuit if one of the following occurred:

• You received a prescription for the pain patch without the doctor finding out what other medication you or a loved one was on. These patches are not intended to be used with other medication that affect how Fentanyl is broken down in the body or combined with medicines that affect brain function.
• You received a prescription for the skin patch for pain that was not persistent or constant. If this pain patch was prescribed to you or a loved one after an operation for short-term pain, you may qualify for the Fentanyl patch lawsuit. This is because these types of skin patches should only be given to people with chronic pain who are already taking other narcotic painkillers. 
• You received a prescription for the Fentanyl patch or Duragesic patch without warnings about the medication. The FDA has indicated that patients should be informed about the dangers of this medication and directions for safe use of the patch. 

If you were injured or lost a family member due to the Fentanyl pain patch, you should speak with a caring and experienced Texas dangerous drug attorney at the Voss Law Firm at 888-614-7730 to find out your rights in a free legal consultation.

Reasons Insurance Companies Deny Fire Claims

What Can I Do?

When people are dealing with a fire, insurance companies will look for any reason to deny fire loss claims.

You do not deserve more stress when dealing with loss to your home or business caused by a fire. You could’ve had severe property damage, lost your property entirely, or even a life.

You deserve the chance to pick yourself up and recover. You will need help.

Will your insurer help you?

The sad part is that most insurance companies will try to deny any insurance claim.

However, for the insurance company to deny your residential fire claim, they have to have facts. 

They cannot simply deny your claim due to their speculation or suspicion that the fire was started by arson - these are the usual reasons insurance companies deny fire claims and they will always find a way to have such rulings.

We have seen many reasons insurance companies deny fire claims and most of them are done in bad faith. They attempt to deny homeowners what they deserve, by stating reasons like the fire department was unable to effectively locate the source of the fire or some other excuse.

One of the most used reasons insurance companies deny fire claims is to accuse you of arson or insurance fraud. But, not everyone will do these things and, like you, most are just a victim of an unfortunate disaster.

The problem is that an insurance company will always try their best not to pay you or give you less than you deserve because they want to keep their money. They will always try to find an excuse.

Remember that the nature of an insurance company’s business is to get as much money from as many people as possible and hope none to only a few will claim their benefits.

One of the worst-case scenarios when claiming fire insurance is when a massive fire affecting many homeowners occurs, like a forest fire damaging houses in a certain area.

The homeowners in that area, affected by the same situation, will most probably have the same insurer. Because of the fire affecting these homes, the insurer will have to face more than one fire insurance claim, which is bad for their business, they are facing “financial loss.”

During such an event, an insurer will try their best to deny, delay or underpay claims by affected homeowners in an attempt to “save” their company. They will resort to all possible excuses and reasons insurance companies deny fire claims.

Claiming fire insurance can be a hassle and you do not deserve more unneeded stress when dealing with a loss from fire. You deserve the time and chance to fix your home and life back together.

It is in your best interest to hire a skilled insurance claim attorney. An insurance litigation expert lawyer will help you see clearly and dodge the excuses and reasons companies deny fire claims and ensure that you get what you deserve.

To fight back against an insurer acting in bad faith, you will need to have another fire investigator inspect your home in order to receive another opinion. If the second report contradicts the initial fire report, then you could have the fire investigator read his testimony on the stand, if needed.

If your insurance company has denied your Texas fire insurance claim, you need to contact an attorney who handles fire loss claim denials at The Voss Law Firm. Our attorneys will fight to get you the full amount of insurance benefits that you are entitled to.

We will help you get your home or business back by getting the insurance claim you deserve without the added stress that your insurer would otherwise give you.

Please call one of our knowledgeable and experienced Texas residential insurance litigation lawyers to schedule a free, no-obligation case consultation at 281-549-8911 today.

You can also get a FREE copy of insurance litigation lawyer Bill Voss’ e-book: Disputes With Your Insurance Company – What All Consumers Need to Know.

Although it seems rather simple and easy to purchase gold coins from TV, it is more dangerous than you realize. There are numerous reasons that it may not be a good idea to purchase gold off of television shows.
First, you have to call the phone number listed on the television. The person who picks up the other end of the line is a trained salesperson who has many different angles to try to upsell you. You may have just wanted to purchase one coin, but they generally don’t let you off that easy. 
They will try to keep you on the phone and use their unethical sales practices to try and sell you rare gold coins or something else, such as a higher-priced coin. They may make whatever they are selling you sound great and promise that the coin will appreciate in value, but remember that they probably make commission off of you. 
Additionally, they often sell gold well over the melt value and they may trick you on the spot price. Their tricks are countless, and you do not really know who you are dealing with on the other end of the phone. 
While not every gold company on TV is perpetrating gold coin scams, many are. It is best to not purchase gold coins or gold bullion on TV, but to call a reputable dealer instead. 
If you feel like you were the victim of gold coin fraud, please call a concerned and experienced Texas gold coin fraud attorney at the Voss Law Firm today at 888-614-7730 for a free legal consultation. You can also request you FREE copy of coin fraud attorney Bill Voss’s book Coin Fraud – Is Your Investment at Risk?

If after your deposition is taken, the other attorney believes your story and believes that your testimony will be compelling to a judge or jury, he or she will likely tell the Defendant that the settlement offer should be increased. Furthermore, if the Defendant says anything damaging or does not come across trustworthy, his or her attorney will also encourage settlement.