Did you ever wonder if you should file an insurance claim or if you should fix the problem yourself?
When Should You Not Submit An Insurance Claim?
You must think before you file a claim. You must check your policy. You must measure the damage and the cost. This article will help you understand when you should not submit an insurance claim. I write as a public adjuster who works in Florida. I write in simple words so you can read it easily.
What is an insurance claim?
You make a claim when your home gets damaged. You tell your insurance company about the damage. The insurance company sends an adjuster to inspect. The company may pay money to fix your home.
Why you must think before you file
You may file and get paid. You may file and get a denial. You may file and raise your premiums. You may file and use up benefits that help later. You must weigh these things first.
How an insurance claim can affect you
A claim can change your life in small ways and big ways. A claim can mean money now. A claim can mean higher premiums later. A claim can mean more paperwork. A claim can mean delays and stress. Know these before you file.
Florida matters
Florida has many storms, wind losses, and flooding problems. Florida insurance rules and prices can change fast. Your policy may have wind, hurricane, or sinkhole rules. Your policy may use a higher deductible for hurricanes. You must know Florida rules before you file.
Who is a public adjuster?
A public adjuster works for you. The public adjuster inspects, documents, and negotiates with the insurance company. The public adjuster helps you get fair pay. Otero Property Adjusting & Appraisals offers free inspections in Florida. You can call them at (850) 285-0405. Their address is 3105 W Michigan Ave, Pensacola, FL 32526. Their website is https://oteroadjusting.com/. They only get paid when you do.
When you should NOT submit a claim — quick list
- The repair cost is less than your deductible.
- The damage is cosmetic only and does not reduce home value.
- The damage existed before you bought the policy.
- The damage is small and you can pay for it now.
- The damage may lead to higher premiums or cancellation.
- The event is excluded by your policy.
- The claim will be hard to prove and likely denied.
Each of these needs a short explanation. Read the next sections for details.
Your deductible is bigger than the repair cost
You pay the deductible first. The company only pays the amount over your deductible. If your deductible is $1,000 and the repair is $700, the company will not pay. You will still have a claim on record. That may raise your premiums. Do not file for repairs below your deductible.
The damage is cosmetic only
Cosmetic damage means looks only. Paint chips, small scratches, scuffs on cabinets, or minor dents may be cosmetic. If the damage does not hurt how the home works, you may fix it yourself. The insurance company may not pay for looks alone. You may file and get little or no money. Weigh that against possible premium hikes.
The damage existed before you bought the policy
Your policy covers new damage after the start date. Your policy does not cover long-term problems that started before you bought the policy. Insurance can deny claims for pre-existing damage. Do not file for old damage unless new damage made it worse.
The damage is small and you can pay now
If you can pay and the cost is small, pay now. You will avoid a claim on your record. You will avoid higher premiums. You will avoid a long claims process. Save receipts for repairs. You may need them later.
The claim may raise your premiums or cause cancellation
Insurance companies look at claims history. Many claims in a short time can raise your rates. Some companies may cancel your policy after many claims. Ask your agent how a claim will affect your rates. If the hit to your premiums costs more than the payout, do not file.
The policy excludes the event
Your policy may exclude certain events. For example, flood damage usually needs flood insurance from FEMA or the National Flood Insurance Program. Termites and pests often do not have coverage. Roof wear and tear from age may not be covered. If the event is not in your policy, do not file.
You lack proof and the claim may be denied
The company asks for proof. The company wants photos, receipts, and a detailed list. If you do not have proof, the company may deny the claim. A denied claim can still affect your record. Fix the damage first and keep receipts. Then decide if you need to file.
When you should consider filing anyway
Do not use fear to avoid filing when you have a real loss. You should file when:
- The damage is large and expensive.
- The damage affects safety or structure.
- A storm caused the damage.
- You cannot pay for the repair.
- The damage limits your use of the home.
If you are unsure, call a public adjuster. Otero Property Adjusting & Appraisals will inspect for free. They can tell you if filing helps.
A simple cost test you can use
You can ask a few questions before filing. These questions help you decide.
- What is the repair cost?
- What is my deductible?
- Will my premiums rise after a claim?
- Does my policy cover this event?
- Do I have proof to support the claim?
If repair cost is less than deductible, do not file. If repair cost is close to deductible, call a public adjuster. If repair cost is much more than deductible, file.
Table: Examples to help you decide
| Damage type | Repair cost | Deductible | File a claim? | Why |
|---|---|---|---|---|
| Small roof shingle loss | $400 | $1,000 | No | Cost below deductible |
| Tree fell on garage roof | $8,000 | $1,000 | Yes | Big cost, safety issue |
| Paint scratch on door | $150 | $500 | No | Cosmetic, small cost |
| Water leak from old pipe | $2,500 | $1,000 | Maybe | Check if pipe age excluded |
| Hurricane roof damage | $20,000 | $5,000 (wind) | Yes | Big loss, hurricane deductible |
| Minor mold spot | $600 | $1,000 | No | Below deductible, but watch mold spread |
How claims can change your premiums in Florida
Insurance companies check claims. Many claims tell the company that your home is risky. The company may raise your price at renewal. The company may shift you to a different plan. The company may choose not to renew you. Florida rates can change fast after storms. A Florida homeowner must watch claims carefully.
Assignment of Benefits (AOB) and Florida
Assignment of Benefits (AOB) lets you sign over your claim to a contractor. The contractor then deals with the insurance company. This can speed repairs. But some AOB cases lead to fights and higher costs. Florida has rules about AOB. Talk with a public adjuster before you sign AOB. Otero Property Adjusting & Appraisals can advise you.
Examples kids can picture
- You spill juice on a couch and make a small stain. The couch will cost $50 to clean. Your deductible is $500. You pay for the cleaning yourself.
- A big storm rips off your roof. Rain pours in. The roof will cost $12,000 to fix. You cannot pay. You file a claim.
- A little crack in plaster sits behind a bookshelf. You want to fix it next summer. The crack cost is $300. You pay now and do not file.
How a public adjuster helps you decide
A public adjuster looks at your damage with you. The adjuster checks your policy and explains coverage. The adjuster estimates repair costs. The adjuster tells you if filing helps. The adjuster may find hidden damage you do not see. Otero Property Adjusting & Appraisals offers a free inspection. They help Florida homeowners. They only charge when you get paid.
Table: What a public adjuster does vs. what the insurance adjuster does
| Task | Public Adjuster (for you) | Insurance Adjuster (for company) |
|---|---|---|
| Inspect damage | Yes | Yes |
| Explain your policy | Yes | Sometimes |
| Estimate full repair cost | Yes | Yes |
| Negotiate for more money | Yes | Represents company |
| Work only for you | Yes | No |
| Free initial inspection | Otero: Yes | Usually Yes, but not for you |
Hidden costs of small claims
A small claim may have hidden costs. The company may raise your premium. A higher premium can last years. A claim may make you pay more at renewal than you gained from the payout. A claim may lower your chance to get future discounts. You must count these future costs.
Keep good records even if you do not file
Do not throw away photos, receipts, or notes. If you fix the problem without filing, save receipts. If the problem returns or gets worse, you can file later. The company will ask for proof. A public adjuster can help you document damage now.
When you can fix now and file later
If you fix now, you may still file if the damage gets worse. You may file within the policy time limits. Keep your receipt for the repair. Keep photos of the original damage. Keep notes of dates. Some claims allow you to file later. Check your policy for time limits.
How to estimate repair cost for small jobs
Get two or three quotes from local contractors. Ask each contractor to list parts and labor. Compare the quotes. Add a small buffer for unexpected issues. If the average cost is below your deductible, do not file.
What to do after a storm
- Take safe actions to protect your home.
- Record damage with photos or video.
- Make temporary repairs to stop more damage.
- Save all receipts for supplies and labor.
- Call a public adjuster for a free inspection.
You must not risk your safety to take photos. Wait for safe conditions.
Document examples that help a claim
- Date-stamped photos of damage.
- Receipts for emergency supplies.
- Contractor estimates.
- Weather reports or storm IDs.
- Police or fire reports when relevant.
These items make claims more likely to pay.
Small claim vs large claim: what you need to know
Small claims move faster. Small claims may pay less than the cost to raise premiums. Large claims take longer. Large claims may need more proof. You must file large claims.
What if the company denies your claim?
If the insurance company denies you, you can appeal. A public adjuster can help with the appeal. The adjuster will gather more proof. The adjuster will negotiate or file a complaint with the Florida Office of Insurance Regulation. Otero Property Adjusting & Appraisals can help you through this process.
Table: Steps after a denied claim
| Step | What you do | Who can help |
|---|---|---|
| Ask for reason for denial | Call your insurer | Your agent |
| Get a public adjuster | Hire one | Otero: free inspection |
| Gather more proof | Find photos, receipts | You and adjuster |
| File an appeal | Submit documents | Adjuster or attorney |
| Contact regulator | File formal complaint | Florida Office of Insurance Regulation |
Why filing too many small claims hurts you
Insurers see patterns. If you file two small claims every year, the insurer may think your home is risky. The insurer may raise your rate. The insurer may refuse to renew you. You may then have to buy a policy at a higher price. You may also find it hard to get a new insurer.
When you must file even for small damage
- If the damage affects your safety, like a broken porch step.
- If the damage affects your roof and leaks may cause mold.
- If the damage is part of a bigger pattern after a storm.
- If a lender requires documentation for repairs.
In these cases, do not skip the claim.
How to talk to your insurance company
Use short simple sentences. Ask direct questions. Ask how a claim will affect your rate. Ask about your deductible. Ask what proof they need. Ask how long the claim will take. Record the date and name of the person you spoke with.
The cost of being wrong
If you file when you should not, you may pay higher premiums. If you do not file when you should, you may lose money to repairs. If you are not sure, use a public adjuster. The adjuster helps you choose the right path.
How Otero Property Adjusting & Appraisals can help
Otero Property Adjusting & Appraisals works across Florida. They inspect damage for free. They judge if you should file a claim. They find hidden damage. They negotiate with insurers for a fair payout. They only get paid if you get paid. Their office is at 3105 W Michigan Ave, Pensacola, FL 32526. Call (850) 285-0405 or go to https://oteroadjusting.com/.
Common myths about claims
- Myth: Filing one claim will always cancel your policy. Fact: One claim may not cancel you, but many claims may.
- Myth: Insurance always pays the full cost. Fact: Insurance pays only covered losses and only after your deductible.
- Myth: You must file for any damage. Fact: You do not have to file. You may pay for small repairs yourself.
How to check your policy for pitfalls
Read your policy with the simple questions in mind. Find your deductibles. Find coverages and exclusions. Find the time limit to file a claim. Find special deductibles for hurricanes or wind. If you do not understand, call a public adjuster. Otero Property Adjusting & Appraisals will explain.
When to get a contractor estimate first
If you are close to your deductible, get one or two contractor estimates first. A contractor may find hidden damage. A contractor may tell you if the repair will cost more than you think. Use those estimates when you decide to file.
How to handle contractors who ask for AOB
Do not sign over your claim without thought. A contractor with AOB can file the claim for you. The contractor then deals with your insurer. Some contractors do good work. Some sign AOB and then sue the insurer for more. Talk with a public adjuster for advice before you sign.
The timeline for claims in Florida
- Report damage soon after the event.
- The insurer will schedule an inspection.
- The insurer will review and respond.
- The process can take days to months.
- Hurricanes and big storms slow everything down.
If time worries you, get a public adjuster to help.
What to do if you decide not to file
- Fix the damage if you can.
- Keep all receipts and photos.
- Keep notes about what you did and when.
- Call a public adjuster if the damage grows.
This path keeps your claims record clean and gives you the option to file later.
How to keep your insurance healthy
- Maintain your home and fix small issues early.
- Keep trees trimmed away from the house.
- Replace an old roof before it leaks.
- Store proof of upgrades and repairs.
- Avoid small claims for cosmetic or minor issues.
A well-kept home has fewer claims.
When a claim is a long-term problem
Some damages get worse with time. Mold, water rot, and structural shifts may start small. If you ignore them, the cost grows. If growth becomes large, a later claim may be valid even after small initial fixes. Keep proof of the start and progress of any damage.
How to make the best choice: simple checklist
- Is the repair cost above deductible?
- Will the claim likely pay?
- Will the claim affect your premiums more than the payout?
- Do you have proof?
- Will the damage grow or affect safety?
If you answer yes to most, file. If no, do not file. If unsure, call Otero for a free inspection.
Final thoughts for Florida homeowners
You must balance money now against money later. You must balance peace of mind with future cost. You must make clear choices. A public adjuster can explain your policy in plain words. Otero Property Adjusting & Appraisals will inspect your home for free and help you decide. Their address is 3105 W Michigan Ave, Pensacola, FL 32526. Call (850) 285-0405 or visit https://oteroadjusting.com/. They work for you and only get paid if you get paid.
If you feel nervous, write down the facts. Take photos. Get estimates. Call a public adjuster. You do not have to face your insurance company alone.
