Client: Confidential
Type of Claim: Water Damage with Disputed Coverage Period
Location: Residential Property, New Jersey
Result: Full Claim Payment Secured from Prior Insurance Carrier
Background
At Funari Public Adjusters, we specialize in handling complex property damage claims, often stepping in when policyholders are overwhelmed by insurer denials or delays. One of the most challenging cases we’ve faced involved a residential water damage claim that required proving the timing of the loss across two separate insurance policies. The dispute centered not on whether damage had occurred, but when.
The insured had recently changed homeowners insurance providers. Soon after the new policy went into effect, she discovered significant water damage on her property. When she filed a claim, her new carrier denied it outright, asserting that the loss had taken place prior to the effective start date of their policy. This put the burden on the homeowner to prove the damages had occurred during her previous carrier’s coverage period, something she had no technical way to demonstrate on her own.
That’s when she called us.
The Challenge
This claim posed multiple layers of complexity:
- Overlap in Coverage Periods: The damage appeared to fall in a gray area, too early for the new insurer to accept responsibility, but not definitively within the timeline of the previous carrier either.
- Lack of Visual Proof: Water damage had progressed subtly, with no clear catastrophic event to timestamp the incident.
- Carrier Denials: Both insurers were hesitant to take responsibility, a common scenario in transition-period claims.
- Technical Evidence Needed: Proving the date and progression of a water leak required an advanced, scientific approach.
Most policyholders would have hit a dead end here. But our team thrives on solving what seems unsolvable.
Our Approach
Funari Public Adjusters knew that establishing the timing of the water damage was the key to unlocking the claim. Here’s how we tackled it:
1. Engaging an Engineer to Analyze Water Flow
We brought in a licensed engineer with expertise in fluid mechanics to conduct a forensic review. The goal was to reconstruct the water usage timeline using three critical data points:
- The home’s historical water bill data
- The diameter and flow rate of the main water pipe
- The volume of water damage discovered within the property
By calculating how much water had passed through the system over time and how much would have been necessary to cause the damage observed, we were able to pinpoint the leak’s origin date, squarely within the previous carrier’s coverage period.
2. Detailed Documentation and Reporting
Our adjusters compiled an exhaustive report that integrated:
- Photographic evidence of damage
- The engineer’s technical report with flow calculations
- Policy documents from both insurance companies
- A timeline of events, including the policy transition and discovery of the damage
We used this documentation to construct a comprehensive narrative that not only presented facts but made a compelling argument for the prior carrier’s liability.
3. Persistence in Negotiations
Armed with technical evidence and policy expertise, we engaged directly with the prior insurance company’s claims department. As expected, they pushed back initially. However, our detailed engineering analysis made it impossible to deny the logical conclusion: the water damage occurred during their policy period.
Our ability to back up our argument with professional data turned the tide.
The Outcome
Thanks to our rigorous approach and refusal to accept “no” for an answer, we successfully secured full payment for our client from her previous insurance carrier.
This was a major victory. Not only had the new carrier denied the claim, but the homeowner initially had no idea how to pursue recovery from the old provider. Our involvement bridged that gap, turning a denied claim into a substantial payout.
Key Takeaways
- Technical Expertise Makes a Difference: By incorporating engineering analysis, we transformed a vague situation into a provable claim.
- Understanding Policy Overlap Is Critical: Many policyholders are unaware of how dangerous the gap between old and new coverage can be. We navigate this gray area with precision.
- Persistence Pays Off: Insurers may initially deny responsibility, but with the right evidence and advocacy, that decision can be reversed.
Final Thoughts
At Funari Public Adjusters, we don’t back down from complex or disputed claims. This case exemplifies how our deep industry knowledge, professional network, and attention to detail deliver real results for policyholders. Whether it’s a structural collapse or a contested water damage claim, our mission is the same: to make sure our clients get what they’re owed, no matter how hard the fight.