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Four years after Hurricane Wilma, some South Florida homeowners still dealing with claims

By Julie Patel
Sun-Sentinel

Sunday, September 20, 2009

Marta Ayala’s colorful artwork is showcased throughout her immaculate Parkland home. Every room also features vivid reminders of 2005’s Hurricane Wilma: cracking paint and yellow water drip marks, some as long as 10 feet.

Weeks after the storm, Ayala and her husband, Carlos, got $12,700 from their insurer, The Hartford, to repair their roof. In 2006 and 2007, they paid for more repairs. Still, they needed buckets to catch dripping water during heavy rains.

Earlier this month, the Ayalas broke ranks with the thousands of Floridians waiting for Wilma insurance settlements. The Hartford agreed to pay $39,000 for a new roof.

"It has been a battle," said Carlos Ayala.

More than 2,000 homeowners are trying to get payments from their insurers to repair damage from the Oct. 23, 2005, hurricane. An exact count of outstanding claims is hard to get because the state doesn’t track such cases and some insurers will not tell.

Insurers say most of the 400,000 claims from Wilma have been settled.

Reasons for the unsettled claims vary. Some homeowners, like the Ayalas, learn years later how extensive the damage was and that they can ask their insurer for more money, in a process called reopening a claim.

Homeowners have five years after a hurricane to file an insurance claim or lawsuit. With more than a year until the Wilma deadline, lawyers and independent adjusters, also called public adjusters, are advertising that they can help homeowners pursue claims against their insurers.

Some claims remain unsettled because the homeowners aren’t happy with their insurers’ offers. These homeowners have been in negotiation, mediation or arbitration for months or years. Some have hired appraisers, lawyers or both in efforts to win settlements.

Insurers say they need time to deal with lingering claims. Some claims are for damage that policies don’t cover, such as wear and tear. Others are fraudulent, insurers say, and must be investigated. Industry critics say some insurers fight, delay or underpay claims.

"If you delay, some people will just go away and you don’t have to pay," said J.D. Howard, who worked for insurance companies for 15 years. He is now an independent adjuster and executive director of the Insurance Consumer Advocate Network.

Homeowners with insurance problems can complain to the state Department of Financial Services hotline. Financial Services workers can report signs of wrongdoing by insurers to the Office of Insurance Regulation. Critics say the state should do more.

"People are fighting three, almost four years now, just to get a roof over their head. Why that’s something the state should tolerate is beyond me," said Paul Berger, a lawyer who founded Claims Solvers, a Coral Springs-based public adjusting firm that the Ayalas hired.

Berger cites a provision of Florida law that seldom is followed: Insurers are required to pay interest if the insurer pays more than 90 days after the claim is filed. He said he is seeking interest for the Ayalas and another client, the Ulrichs of Davie.

Unlike some states, Florida does not require insurers to provide a policyholder with all documents related to an insurance company’s estimate.

Sean Shaw, state insurance consumer advocate, has assembled a panel to recommend better ways to handle claims. So far, the ideas include making sure that insurers use licensed adjusters and clearly telling policyholders about their right to reopen claims.

The Ayalas learned they could reopen their claim from a neighbor and hired Berger’s firm in late 2008. Nine months later — after an appraisal, a claim denial and a call from a Sun Sentinel reporter — The Hartford settled.

All that’s left is getting written proof of the settlement. Then the Ayalas will hire someone to replace the roof.

"I feel very comforted," said Carlos Ayala. "No more stress caused by seeing the leaks and damage."