How Does Insurance Work When It Is Your Fault?

What do you do when something you own breaks and you know it was your fault?

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How this article will help you

You will learn how insurance works when you cause damage to property. You will see what you must do first. You will read how an insurance company checks a claim. You will learn how a public adjuster can help you. The words stay simple. The steps stay clear. The focus stays on property claims in Florida.

What “your fault” means

If you caused the damage, you are at fault. You acted or failed to act, and harm happened. You slipped and left a candle burning. You did not fix a leaking roof. A pipe burst after you ignored a cold night. Those situations are your fault.

Fault does not mean you will always pay everything. Your insurance may cover some costs. You must report the damage and follow the rules in your policy.

Two kinds of claims you must know

You will see two main kinds of claims. One is first-party. One is third-party.

  • First-party claim: You claim your insurer for damage to your own home or property. For example, a kitchen fire damages your house. You file a first-party claim.
  • Third-party claim: Someone else claims your insurance for damage you caused to their property. For example, water from your broken pipe floods your neighbor’s home. They file a claim against you or your homeowner policy.

You must treat each type differently. You must act fast in both cases.

First things to do right after damage

You must stay calm and protect people first. Then follow these steps.

  1. Make sure everyone is safe.
  2. Stop the damage if you can do so safely.
  3. Call emergency services if needed.
  4. Take photos and video of the damage and the scene.
  5. Contact your insurer right away.
  6. Do small repairs to prevent more damage and keep the receipts.
  7. Do not throw away damaged items until an adjuster sees them, unless they are a health risk.

You will want a paper trail. You will want proof. Photos and receipts help.

How your insurance company reacts

You call your insurer. They open a claim. They assign an adjuster. The adjuster checks the damage. The insurer will decide if the policy covers the loss.

The adjuster will check when the loss happened, what caused it, and how much damage you have. The insurer looks at your policy language. The insurer looks at exclusions and limits.

If the damage is covered, the insurer will pay up to policy limits minus your deductible. If the damage is not covered, the insurer will deny the claim. If the damage affects another person’s property, the insurer may handle a third-party claim.

The role of the insurance adjuster

An insurance adjuster works for the insurer. The adjuster inspects the damage. The adjuster asks questions. The adjuster estimates the cost to repair or replace.

The adjuster uses rules and guidelines set by the insurer. The adjuster writes a report and recommends a payment. The insurer often follows that recommendation.

You must treat the adjuster politely. You must give the adjuster access to the damaged area. You may disagree with the adjuster’s estimate. You can hire a public adjuster to check the estimate.

Who is a public adjuster and how they help

A public adjuster works for you, not the insurance company. A public adjuster reviews the damage and your policy. They prepare a claim on your behalf. They negotiate with the insurance company.

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You may hire a public adjuster if you think the insurer undervalued your loss. You may hire one if you feel confused or overwhelmed. A public adjuster speaks the technical language of claims. They translate terms into plain words for you.

Public adjusters in Florida must follow state rules. They must show a license. They often work on a contingency basis. That means they get paid a percentage of the settlement only if you get paid. Otero Property Adjusting & Appraisals offers a free initial inspection. Otero works on a contingency basis and only gets paid when you do. They serve homeowners across Florida. Contact Otero Property Adjusting & Appraisals at 3105 W Michigan Ave, Pensacola, FL 32526, (850) 285-0405, https://oteroadjusting.com/.

How damage gets valued: ACV vs RC

Insurers value property loss two main ways.

  • ACV (Actual Cash Value): The insurer pays what the item was worth at the time it broke. They subtract wear and tear.
  • RC (Replacement Cost): The insurer pays to replace the item with a new one of similar kind and quality. They do not subtract for age, if your policy includes RC.

You must check your policy. You must know if you have ACV or RC. The difference can be thousands of dollars.

Your deductible and policy limits

Your deductible is the amount you pay before the insurer pays. If your damage costs $5,000 and your deductible is $1,000, you pay $1,000 and the insurer pays $4,000.

Your policy has limits. The insurer will not pay more than the limit. If your damage is greater than your limit, you pay the rest.

Your policy also has different sections. You may have limits for the dwelling, for other structures, for personal property, and for liability. You must know each limit.

Liability coverage in homeowner policies

Your homeowner policy usually has liability coverage. Liability coverage may pay for property damage or bodily injury you cause to someone else. The insurer defends you if someone sues you over the damage, up to your policy limit.

If your dog runs into the street and causes an accident, liability may help. If your pipe floods your neighbor’s house, liability may pay for their repairs.

Liability coverage does not pay for your own home damage. For your own home, you use first-party coverage.

If you caused the damage to your own home

If you caused damage to your own home, you check your first-party coverage. Many common causes can be covered. Fire, lightning, wind, and sudden water loss may be covered. Gradual wear and tear is usually not covered.

If you left a candle unattended and your carpet caught fire, your policy likely covers fire damage. If you failed to fix a slow leak and mold grew over months, your policy may not cover the mold because the damage was gradual and preventable.

You must read your policy or ask a public adjuster. A public adjuster can explain the terms in simple words and check whether a claim should be paid.

If your actions damage someone else’s property

You must report to your insurer. You must tell the affected person to file a claim. Your insurer may accept responsibility and pay the other person. Your insurer may defend you in court if the other person sues.

You must not admit fault loudly or in writing. Saying “I am sorry” in person is kind, but do not sign statements about fault. Let the insurance companies decide responsibility.

Subrogation: when insurers chase each other

Subrogation is when an insurer pays a claim and then tries to get money back from the party that caused the loss. For example, your insurer pays your neighbor and then asks your insurer to recover costs from you or from the responsible party.

You must know that subrogation can affect your premium or standing with the insurer. A public adjuster can help explain how subrogation may operate in your case.

Will your rates go up if it is your fault?

Your premium may go up after a fault claim. Insurers look at your claims history. A fault claim may show you have a higher risk.

The amount and time of increase depend on the insurer, the size of the claim, and your prior record. In Florida, insurers sometimes raise rates after multiple claims in a short time. A public adjuster can help you submit strong evidence to reduce the chance of a big increase.

Mitigation: stop more damage now

You must act to prevent more damage. You must do immediate repairs that keep the loss from growing. For example, you must cover a hole in the roof with tarp or shut off a leaking valve.

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Keep receipts for any emergency work. The insurer often pays for reasonable mitigation costs, subject to the policy. If you wait and let the damage get worse, the insurer may deny parts of the claim.

Document everything

You must keep a claim file. Put these items in it:

  • Photos and videos
  • Receipts for emergency repairs
  • Copies of letters, emails, and texts
  • Your notes of phone calls (who you spoke with, date, time, and what they said)
  • Estimates from contractors
  • Police or fire reports if relevant

This file helps you and the public adjuster make your case. A clear file makes the process faster.

Repairs and hiring contractors in Florida

Pick contractors with a license. Ask for proof of insurance and references. Ask contractors to give written estimates.

In Florida, be careful with Assignment of Benefits (AOB) agreements. An AOB lets a contractor file the claim and collect payment directly from the insurer. An AOB can speed repairs. An AOB can also lead to disputes. Read the AOB carefully before you sign. If you sign an AOB, you give the contractor power to manage the claim.

A public adjuster can check repairs and invoices. A public adjuster can negotiate with the insurer on your behalf while you focus on repairs.

How a public adjuster fits in when you are at fault

You may think a public adjuster only helps when the insurer underpays your first-party claim. A public adjuster also helps with third-party claims and liability issues.

You may cause a water loss that affects several units in a building. A public adjuster can:

  • Help you report the claim correctly
  • Document the damage and the cause
  • Communicate with the insurer and the other party
  • Negotiate liability and payment with the insurer
  • Protect you from making admissions that hurt your case

A public adjuster acts as your advocate. The adjuster focuses on getting fair value under your policy and reducing your exposure.

What public adjusters charge

Public adjusters usually charge a percentage of the recovered amount. The percent varies. The adjuster only gets paid when you get a settlement. This contingency fee aligns their goals with yours.

Ask for a written contract that states the fee and what services you will get. Make sure the public adjuster is licensed in Florida.

Otero Property Adjusting & Appraisals provides a free initial inspection. They negotiate with insurers for you and do not get paid unless you do. Call Otero at (850) 285-0405 or visit https://oteroadjusting.com/ for more details.

Common scenarios in Florida and what you should do

Florida has specific risks. Hurricanes, heavy rains, and storms cause many claims. Your policy may have hurricane deductibles that are higher than standard ones. You must check your policy.

Scenario 1 — Hurricane wind damages your roof and your neighbor’s fence:

  • You call your insurer and report a first-party claim for your roof and a potential third-party claim for the fence.
  • You take photos and make temporary repairs.
  • You contact a public adjuster to review the damage and your policy.

Scenario 2 — A water pipe in your attic bursts and floods the unit below:

  • You shut off the main water valve.
  • You call your insurer and tell them about the water damage.
  • You get a licensed contractor to stop the leak and make emergency repairs.
  • You call a public adjuster to document the flood and coordinate with your neighbor and both insurers.

Scenario 3 — A cooking fire in your kitchen damages your home:

  • You call 911 if needed.
  • You call your insurer and start a claim.
  • You collect receipts for food, shelter, and emergency services if you must leave your home.
  • You hire a public adjuster to ensure you get the full replacement cost if your policy covers it.

In all scenarios, contact Otero Property Adjusting & Appraisals for a free inspection and help that does not cost you up front.

How investigators decide fault

Investigators use facts. They look for evidence of cause. They inspect the scene. They check timelines, maintenance records, and witness statements.

You must be honest with investigators. Do not guess. If you do not know, say you do not know. Do not sign papers that say you caused damage if you are unsure.

If an investigator says you caused the damage but you disagree, you may hire an independent expert or a public adjuster. A public adjuster can get a second opinion and challenge the investigator’s findings if needed.

When disputes happen

Disputes can arise over cause, coverage, or payment. You may get a denial letter. You may get a low estimate. You may disagree with the insurer on whether the damage is sudden or gradual.

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You can file an appeal with the insurer. You can hire a public adjuster to reopen and negotiate the claim. If negotiation fails, you may file a complaint with the Florida Office of Insurance Regulation or seek legal help. You must check deadlines for appeals and lawsuits.

A public adjuster helps you gather evidence and present a clear case to the insurer.

Common mistakes people make

People often make these errors:

  • Waiting too long to report the claim.
  • Not taking photos or collecting evidence.
  • Letting the damage spread without fixing it.
  • Saying too much to the other party or the insurer without proof.
  • Hiring the first contractor who knocks on their door after a storm.
  • Signing an AOB without reading it.

Avoid these mistakes. Use a checklist. Ask a public adjuster for advice.

A simple checklist to follow

Step Action
1 Ensure safety.
2 Stop further damage if you can.
3 Take photos and videos.
4 Call your insurer and open a claim.
5 Keep receipts for emergency repairs.
6 Do not admit fault in writing.
7 Contact a licensed public adjuster for help.
8 Keep a file with all documents and notes.

This checklist keeps the process clear for you.

Frequently asked questions (simple answers)

Q: Will my insurer pay if it was my fault?
A: Sometimes. It depends on your policy and the cause. Liability coverage may pay for damage to others. Your first-party coverage may pay for sudden damage to your home.

Q: Do I need a public adjuster if I caused the damage?
A: You often benefit from a public adjuster. They protect your rights and help with complex liability issues.

Q: Will my rates always go up?
A: Not always. Insurers review many factors. A public adjuster can help manage the claim to reduce the chance of a large increase.

Q: What if the other party sues me?
A: Give the lawsuit to your insurer right away. The insurer may defend you under liability coverage. Call a public adjuster and a lawyer if needed.

Q: Can a public adjuster help with contractor problems?
A: Yes. A public adjuster reviews contractor estimates and invoices. They check for fair pricing and proper work.

How to choose a public adjuster in Florida

You must check a few things:

  • License: Verify they have a Florida public adjuster license.
  • Experience: Ask how many claims like yours they handled.
  • Fees: Ask for the written fee agreement.
  • References: Ask for recent client references.
  • Communication: Make sure they explain things in plain words.

Otero Property Adjusting & Appraisals meets these checks. They offer a free initial inspection and work only when you get paid. Call them at (850) 285-0405 or visit https://oteroadjusting.com/ for service across Florida.

Real advantages of using a public adjuster when you are at fault

You get several benefits:

  • You get a professional who speaks insurance language for you.
  • You get help documenting cause and loss.
  • You get an advocate who negotiates with the insurer.
  • You reduce the risk of paying more than you should.
  • You avoid mistakes that make the insurer deny coverage.

A public adjuster helps you stay organized and calm. They let you focus on repairs and daily life.

What to expect during a claim with a public adjuster

A public adjuster will:

  1. Inspect the damage.
  2. Review your policy.
  3. Document loss and cause.
  4. Prepare a claim packet for the insurer.
  5. Negotiate with the insurer.
  6. Help you hire contractors if needed.
  7. Close the claim once the insurer pays.

You will get regular updates. You will sign only what you agree to. The public adjuster will work under a written agreement.

Special note about hurricanes and named storms in Florida

Hurricanes can change how claims work. Some policies use a separate hurricane deductible. The deductible may be a percentage of your dwelling limit. You must read your policy to know your hurricane deductible.

After a storm, many people file claims at once. That can slow inspections and repairs. A public adjuster can help you stay ahead by documenting your claim early and prioritizing your needs.

Final simple advice

Act fast. Document everything. Call your insurer. Call a public adjuster if you feel unsure or if the damage involves other people’s property. Do not sign away your rights. Keep copies of all documents.

If you live in Florida, consider using a local public adjuster who knows state rules and hurricanes. Otero Property Adjusting & Appraisals offers free inspections and works on a contingency basis, so they do not get paid unless you do. Contact Otero at 3105 W Michigan Ave, Pensacola, FL 32526, (850) 285-0405, https://oteroadjusting.com/. They help homeowners across Florida with claims for hurricanes, water damage, mold, roof leaks, and fires.

Short example to show how it works

You burn a pan and smoke damages the kitchen. You call your insurer. The insurer sends an adjuster. The adjuster inspects and gives a repair estimate. You think the estimate is low. You call Otero. They inspect for free. They find the damage is larger and the smoke has affected walls and cabinets. Otero writes a new estimate and negotiates with the insurer. The insurer raises the offer. You pay your deductible and get the repairs done. Everyone sleeps easier.

Closing thought

You will make mistakes. You will cause accidents. Insurance exists so you do not have to pay everything alone. You must act responsibly. You must follow your policy rules. A public adjuster helps you get a fair outcome. For help across Florida, call Otero Property Adjusting & Appraisals at (850) 285-0405 or visit https://oteroadjusting.com/. Their first inspection is free, and they only get paid when you do.

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