What Qualifies As Damages?

? Do you want to know what counts as damages in an insurance claim and how you can prove them?

What Qualifies As Damages?

You will read clear, simple words about damages. You will learn what damages mean for homeowners in Florida. You will see what types of damage insurance may cover. You will learn what proof you need. You will learn how a public adjuster can help you. You will get steps to take after damage. You will get a checklist and a table that makes things easy.

What does “damages” mean?

You see harm to your house or things after a bad event. You call that harm damages. Insurance uses the word to say what you can ask to get fixed or replaced. Damages can mean the roof broke, a wall got wet, or your TV stopped working.

Who decides if damage qualifies?

Your insurance company reviews your claim. You may hire a public adjuster to help. The public adjuster checks the damage. The public adjuster makes a claim that lists the damage and the cost. The insurer pays what the policy covers.

Why you might need help

You feel confused after damage. The insurance language may feel like a puzzle. You want the right amount of money to fix things. A public adjuster helps you speak with the insurer. The adjuster knows how to value damage. The adjuster knows what proof you need.

How Florida matters

Florida faces storms, hurricanes, wind, and flood risk. Your policy may treat these events differently. Florida policies may have special hurricane deductibles. Flood damage may not be covered by a homeowners policy. You must read your policy for Florida rules.

Types of damages that commonly qualify

You will see a list of common damage types. Each type has a short explanation. The list helps you know what to claim.

Structural damage

Your roof can break. Your walls can crack. Your floors can warp. Your house frame can bend. Structural damage affects the main part of your house. Policies usually cover this when a covered event causes it.

Personal property damage

You keep clothes, furniture, and electronics in your house. Storms, fire, and water can damage these items. Policies often cover personal property. The policy may pay the cost to replace or repair those items.

Other structures

You may have a fence, a shed, or a detached garage. Insurance often covers these other structures. The policy may list a limit for these items.

Loss of use or Additional Living Expenses (ALE)

You cannot live in your house after serious damage. You pay to stay in a hotel and eat out. Insurance may pay these extra costs. The policy may call them ALE or loss of use. You must keep receipts to prove these costs.

Debris removal

Damage leaves a mess. You must remove broken wood, wet drywall, and ruined furniture. Your insurer may pay to remove debris. You must show what the debris came from and why removal is needed.

Ordinance or law upgrades

Building rules can change. If your home needs upgrades to meet new codes after damage, insurance may pay for that. The policy may limit this coverage. Florida building codes often affect the cost of repairs.

Mold and secondary damage

Mold can start after water damage. Insurance may cover mold if it comes from a covered event. If the policy excludes mold, you may not get payment. You must act fast to stop mold and document the steps you take.

Water damage from plumbing or appliances

A burst pipe or a broken appliance can cause water damage. Many policies cover sudden water damage from pipes. Policies often exclude slow leaks that you knew about. You must show the loss was sudden and accidental.

Wind and hail damage

Storm wind can rip shingles off a roof. Hail can break windows. Most homeowners policies include wind and hail coverage. In Florida, insurers watch wind claims closely. You must prove wind caused the damage.

Fire and smoke damage

Fire can ruin rooms and items. Smoke can stain walls and ruin clothing. Policies usually cover fire damage. You must report the fire and keep records of fire department reports if possible.

Sinkhole and earth movement

Florida has sinkhole risks. Some policies exclude sinkhole damage. Some policies include sinkhole coverage. You must check your policy. You must show experts’ reports if you claim sinkhole damage.

Flood

Flood damage comes from rising water from outside. Most standard homeowners policies do not cover flood. You must have separate flood insurance, often from the National Flood Insurance Program (NFIP). If you live in Florida, you may need flood insurance.

How insurers measure damages

Insurers use methods to value damage. You must know the terms on your policy. These terms affect how much you may recover.

Actual Cash Value (ACV)

ACV is the value of an item after age and wear. Insurers subtract depreciation. You may get less than the full cost to buy new.

Replacement Cost Value (RCV)

RCV pays the full cost to replace the item with a similar new one. The insurer may pay RCV only after you replace the item and show receipts.

Agreed Value

Some policies set a fixed value for special items. The insurer pays that amount after loss. You must have that value in your policy.

Limit and deductible

Your policy sets a limit for each type of coverage. The insurer will not pay more than that limit. Your policy also has a deductible. You pay the deductible before the insurer pays.

Percentage hurricane deductible

In Florida, some policies use a percentage deductible for hurricanes. The deductible may be a percentage of the dwelling limit. You must check the deductible for wind and hurricane events.

What insurance may exclude

Your policy may exclude certain damage. You must read your policy carefully. Common exclusions include:

• Flood damage without flood insurance.
• Normal wear and tear.
• Damage from lack of maintenance.
• Damage from pests or rodents.
• Some mold or mildew claims.
• Intentional damage by the insured.

If you see an exclusion, you may still have a path to recovery. A public adjuster will review the policy and help you decide.

How to prove damages

You must gather proof to support your claim. Proof helps the insurer pay the right amount.

Take photos and videos

You must take clear photos and videos of the damage. You should show close views and wide views. You should show dates if possible.

Keep receipts and invoices

You must keep purchase receipts for damaged items. You must save repair bills and contractor estimates. You must collect receipts for hotel stays and meals if you claim ALE.

Make an inventory list

You must make a list of lost or damaged items. You should include the brand, model, age, and value if you can. You should note where you kept each item in the house.

Get professional reports

You may need roof reports, structural engineer reports, or plumber reports. You may need an expert for sinkhole or mold claims. You must hire licensed professionals.

Preserve damaged items

You should keep damaged items until the insurer inspects them. You should not throw out key evidence. You can remove trash or unsafe items after you document them.

Open a claim quickly

You must report the loss to your insurer as soon as you can. You may lose rights if you delay reporting. You should file a claim even if you think the damage is small.

The public adjuster’s role

You may hire a public adjuster to represent you. The public adjuster works for you, not for the insurance company. The adjuster will inspect your home and document the damage. The adjuster will help value your losses. The adjuster will present the claim to the insurer. The adjuster will negotiate for a fair settlement. The adjuster may help you with the appeals process.

Why hire a public adjuster

You may hire a public adjuster when the claim is large or confusing. You may hire an adjuster if the insurer offers less than you expect. You may hire one if you want help making an inventory. You may hire one to save time and stress. In many cases, a public adjuster increases the final payment you receive.

What to expect when you file a claim

You will call your insurer or file a claim online. You will give the insurer some facts about the damage. The insurer will assign an adjuster. The adjuster will inspect your property. The adjuster will write a report. The insurer will make an offer or request more information. You may accept, reject, or negotiate the offer.

Steps to take right after damage

You must take steps to protect your home and your claim. The steps are simple and clear.

1. Ensure safety first. You must get people out of danger. Call emergency services if you need help.
2. Stop further damage if you can. You should turn off water or electricity if it is safe.
3. Document the damage. You must take photos and videos.
4. Call your insurer to report the claim. You must give basic facts and dates.
5. Keep receipts for emergency repairs and hotel stays. You must show these to the insurer.
6. Avoid permanent repairs until the insurer inspects, unless you must to reduce further harm. You should ask the insurer if you must proceed.
7. Contact a public adjuster for a free inspection. Otero Property Adjusting & Appraisals offers a free initial inspection in Florida.

How mitigation and emergency repairs affect your claim

You must act to limit further damage. Insurance policies require you to try to reduce loss. You can cover small emergency repairs yourself and ask the insurer to reimburse you. You must keep all receipts and document the need for repairs. You must avoid doing major permanent repairs before the insurer inspects, unless the insurer gives permission.

Sample list of documents the insurer will want

You must prepare these items to speed up your claim.

• Police or fire report, if applicable.
• Photos and videos of damage.
• Inventory of damaged personal property.
• Receipts for purchases and repairs.
• Contractor or contractor estimates.
• Building permits and code upgrade costs.
• Proof of ownership or age of items, if available.
• Hotel or living expense receipts for ALE.

A simple table of damage types and proof

Type of Damage	Example	Usually Covered?	Proof Needed	Florida Notes
Structural	Roof ripped off	Often	Photos, roof report, estimate	Hurricane deductible may apply
Personal property	Sofa soaked	Often	Receipts, photos, inventory	Contents limits may apply
Flood	Rising water from outside	Rare on home policy	Flood policy, photos	Buy NFIP or private flood policy
Water from pipe	Burst pipe	Often if sudden	Photos, plumber report	Excludes long-term leaks
Wind and hail	Shingles missing	Often	Photos, damage report	High frequency in storms
Fire and smoke	Kitchen fire	Often	Fire report, photos	Keep fire department report
Mold	Mold after leak	Sometimes	Remediation report	Coverage depends on cause
Sinkhole	Ground collapse	Sometimes	Geotechnical report	Florida has specific rules
ALE	Hotel costs	Often	Receipts	Coverage limits apply
Debris removal	Fallen trees, broken materials	Often	Photos, removal invoice	Tree removal may have limits

How insurers value your contents in Florida

You must know how your contents will be valued. The insurer may use ACV or RCV. The insurer will list the method on your policy. If your policy gives RCV, you may need to replace the item before you get full payment. You must show receipts for replacement.

What if the insurer denies the claim?

You may get a denial for many reasons. You may have a policy exclusion. You may have missed a deadline. You may lack proof. You must read the denial letter. You must gather more evidence if you can. You should call a public adjuster. You can file an appeal with the insurer. You can hire an attorney if needed. A public adjuster can help you decide the next steps.

Negotiation tips you can use

You can present your claim clearly. You can give the insurer facts, photos, and receipts. You can ask for itemized estimates. You can ask for the adjuster’s report. You can challenge low estimates with second opinions. You can ask for building code upgrade costs if your policy covers them.

How a public adjuster helps in negotiation

The public adjuster writes a detailed estimate. The adjuster notes hidden damage, like mold or structural harm. The adjuster points out policy language that supports your claim. The adjuster negotiates with the insurer to increase your payout. The adjuster can manage communication so you avoid confusion.

Fees and payment for a public adjuster

Public adjusters typically charge a percentage of the claim settlement. You must check the contract for the fee. You must confirm the fee before hiring. Otero Property Adjusting & Appraisals follows a contingency fee model. Otero only gets paid if you get paid.

Why you should choose Otero Property Adjusting & Appraisals

You may want a local Florida firm with public adjuster experience. Otero serves homeowners across Florida. Otero’s team knows Florida weather and policy issues. Otero offers a free initial inspection with no obligation. Otero documents damage and helps you get a fair settlement. Otero works only for you, the policyholder.

Contact Otero:

• Otero Property Adjusting & Appraisals
• 3105 W Michigan Ave, Pensacola, FL 32526
• Phone: (850) 285-0405
• Website: https://oteroadjusting.com/

What to expect during Otero’s free inspection

You call Otero or you fill a form. Otero inspects your property at no cost. Otero documents the damage with photos and notes. Otero lists repair costs and the scope of loss. Otero explains your policy coverages in plain words. Otero shows how it will help you negotiate with the insurer.

Common misunderstandings you should avoid

You might think all water is flood. You must know the difference. Flood is water from outside. Water from a burst pipe is usually not flood. You might think mold is always covered. You must read your policy. You might think the insurer will pay everything without help. A public adjuster can help you find all valid items in your claim.

Examples you can relate to

You live in a Florida house. A storm hits and the roof leaks. Rain soaks the ceiling and your couch. You take photos. You call the insurer. The insurer sends an adjuster with a short report. You believe the insurer missed hidden damage. You call Otero. Otero inspects and finds rot behind the ceiling. Otero documents the cost to remove and replace the drywall and insulation. Otero negotiates and the insurer increases the payment. You get enough to fix the roof and replace the couch.

You have a pipe burst while you are away. Water floods the hallway and soaks the wood floor. You return and see the pool of water. You shut off the main water. You take photos of the flooded floor. You call the insurer. You save receipts for a plumber and a hotel. You hire Otero. Otero prepares a full inventory of damaged items and obtains contractor estimates. Otero gets you a larger settlement that covers floor replacement and living costs.

A simple script to call your insurer

You will want to be clear and calm. You can use this short script to report your claim.

1. State your name and policy number.
2. State the date and time of the loss.
3. State the cause of the loss (storm, fire, burst pipe).
4. State the damage you see (roof, walls, personal items).
5. Ask how to file receipts and photos.
6. Ask about the next steps and the timeline.

Write down the claim number and the adjuster’s name. Keep that information safe.

Common mistakes that lower your payout

You might delay filing a claim. Insurance companies may deny for late notice. You might forget to take photos before cleanup. You might throw away damaged items that the adjuster needs to see. You might accept the first low offer without review. You might skip hiring a public adjuster for major losses.

How long does a claim take?

Small claims can resolve in days to weeks. Large claims may take months. The timeline depends on the damage and the insurer. You must keep records of calls and documents while the claim proceeds. A public adjuster can speed up the process by preparing a clear and complete claim.

When to hire an attorney

You may need an attorney if the insurer acts in bad faith. You may need legal help if the insurer denies a valid claim with no reason. You may seek an attorney if the insurer refuses to pay the policy limits. A public adjuster can work with your attorney if needed.

Checklist: What you should do now

• Ensure safety for all people in your home.
• Photograph and video all damage.
• Save receipts for all emergency and mitigation costs.
• Do a room-by-room inventory of damaged items.
• Call your insurer to open a claim.
• Keep a log of all calls and the names of people you speak with.
• Contact a public adjuster for a free inspection.
• Do not throw away key damaged items until the insurer inspects.

How to spot hidden damage

You should look for signs that go beyond the obvious. Dark stains on the ceiling may mean roof rot. A musty smell may mean mold. Warped floorboards may mean water under the floor. You should document these signs with photos. You should hire a professional to confirm hidden damage if you suspect it.

Repair vs replace: what the insurer may pay

Insurers may pay to repair or to replace. For structural items, the insurer may pay to repair to pre-loss condition. For personal property, the insurer may pay to replace with similar items. The insurer may apply depreciation for older items.

Why documentation is the best tool

You win claims with clear proof. Photos and receipts show what happened. Expert reports show why the damage needs repair. A detailed inventory shows the full value of your loss. The insurer reads documents and numbers. Good documents help the insurer say yes.

Final note about your rights

You have the right to a fair settlement under your policy. You have the right to question the insurer’s decision. You have the right to hire a public adjuster. You may accept help from Otero to protect your rights. Otero will work for you to recover what your policy allows.

How Otero helps Florida homeowners

Otero Property Adjusting & Appraisals helps homeowners across Florida. Otero inspects homes for free. Otero documents damage and prepares claims. Otero negotiates with insurers on your behalf. Otero only gets paid if you get paid. You can call Otero at (850) 285-0405 or visit https://oteroadjusting.com/ to schedule your free inspection.

Quick recap

• Damages mean harm to your house or things.
• Your policy defines covered damages and limits.
• You must gather photos, receipts, and reports.
• Flood may need separate flood insurance.
• A public adjuster can help you get full value.
• Otero offers free inspections and Florida expertise.

If you want help, you can call Otero Property Adjusting & Appraisals at (850) 285-0405 or visit https://oteroadjusting.com/. Otero will inspect your property for free and explain how to claim your damages.