Dolphin Claims

Ch 9 · Special Situations

Module 9.1

Hurricane and Named-Storm Losses

Hurricane deductible math. Wind-vs-flood fight. Anti-concurrent causation. CAT adjuster reality. 1-year deadline.

12 min read

What you'll learn

The 4 things that make hurricane claims different. The deductible math that costs FL homeowners the most. Wind-vs-flood causation fights. The 1-year notice deadline that kills claims.


9.1.1 Why hurricane claims are different

Hurricane claims have unique features:

FeatureWhy it matters
Hurricane deductible (% of Coverage A)Often $10K-$50K+ out of pocket
Named-storm window (NWS watch/warning + 72hr after)Defines which deductible applies
Wind vs flood causationWind covered; flood usually NOT covered (need NFIP)
Surge claim volumeCarriers slow; CAT adjusters often inexperienced
CAT adjuster rotationDifferent person each step
Pre-existing wear argumentsStorm exposes old damage; carrier denies as wear
1-year notice deadlineUnforgiving; many homeowners miss

9.1.2 The hurricane deductible math (recap)

Already covered in Module 2.4. Quick recap:

Coverage A2%5%10%
$400,000$8,000$20,000$40,000
$600,000$12,000$30,000$60,000

Triggers:

  • NWS hurricane watch/warning issued for any part of FL
  • Continues for the watch/warning duration + 72 hours after termination
  • Hurricane-related damage during this window = hurricane deductible
  • Damage outside this window = AOP deductible

9.1.3 The wind-vs-flood fight

Standard FL homeowner policy:

  • Wind damage covered (subject to hurricane deductible)
  • Flood damage NOT covered (need separate NFIP or private flood policy)

The fight: when both wind and flood happen in the same event, carriers argue everything is flood to deny.

Example

Hurricane hits. Wind tears off roof tiles. Storm surge floods first floor.

Damage:

  • Roof: clearly wind
  • First floor: water — but was it surge (flood) or wind-driven rain (wind)?

Carrier position: "all water damage is flood — go to NFIP." Your position: "wind broke the building envelope; the water that came in is wind-driven rain, covered."

How to win this fight

  • Document timing — when did wind hit? When did surge?
  • Photograph the entry path — broken windows, torn roof = wind path
  • Engineer report — separating wind damage from surge damage
  • Weather records — wind speeds + storm path
  • Anti-concurrent causation analysis — if your policy has the clause, work around it

This is expert territory. Get an engineer involved on any meaningful hurricane claim w/ water damage.


9.1.4 Anti-concurrent causation clauses

Most modern FL policies contain anti-concurrent causation clauses:

"We do not insure for loss caused directly or indirectly by any of the following [excluded perils], regardless of any other cause or event contributing concurrently or in any sequence to the loss."

Translation: if any excluded cause contributed (e.g., flood), the entire loss may be excluded — even if covered causes (wind) also contributed.

FL case law has been mixed on these clauses. Some courts uphold; some narrow them. This is litigation territory.

Strategy on anti-concurrent causation:

  1. Causation segregation — argue you can identify wind-only damage separate from flood damage
  2. Sequential causation — wind broke the envelope first; subsequent water damage flowed from wind
  3. Engineering opinion — independent expert distinguishes wind vs flood damage by location, type, and pattern

Get attorney + engineer involved.


9.1.5 The 1-year notice deadline

§ 627.70132 (post-SB 2A) — 1 year from date of loss to file new claim.

For hurricanes:

  • "Date of loss" = generally the date the storm caused damage to your property
  • 1-year clock starts then
  • If you discover damage later (e.g., water intrusion gradually showed up), the discovery rule is narrow

Calendar this immediately after a storm. Many homeowners delay because:

  • Power's out
  • Repairs are slow
  • Family disruption
  • "We'll deal with it next month"

Next month becomes 18 months becomes "you missed your deadline."


9.1.6 The supplemental claim deadline

§ 627.70132 — 18 months from date of loss for supplemental/reopened claims.

Hurricane claims often produce:

  • Initial scope misses (CAT adjusters move fast)
  • Hidden damage discovered during repair
  • Roof issues that emerge in subsequent rain events
  • Code-required upgrades not initially included

File supplements promptly. Don't wait.


9.1.7 The CAT adjuster reality

After a hurricane, carriers deploy thousands of CAT adjusters — often IAs from across the country.

Quality varies wildly:

  • Some are seasoned property professionals
  • Many are inexperienced
  • All are under time pressure
  • Most don't know FL-specific law (matching statute, hurricane deductible, code rules)

How to handle CAT adjusters

  • Be EXTRA prepared. Your file matters more.
  • Provide your own scope + estimate at first inspection. Don't let them guess.
  • Insist on detailed line items — CAT scopes are notorious for "lump" pricing.
  • Photograph everything — including their inspection.
  • Follow up immediately in writing. Today's CAT adjuster won't be tomorrow's adjuster handling your file.
  • Don't sign anything they bring. Releases, settlements, etc. — review with PA/attorney first.

9.1.8 Mitigation in hurricane events

§ 627.70131(5) and standard policy mitigation duty applies. Hurricane-specific challenges:

  • Tarping — emergency immediately; long-term tarping may need permits
  • Water extraction — saturated materials must be removed within 24-48 hours to prevent mold
  • Generator power — for dehumidifier operation
  • Storage — for salvageable contents

Save every receipt. Hurricane mitigation costs often run $5K-$30K. Reimbursable under your policy.


9.1.9 Common hurricane claim disputes + counters

"This roof damage was already there pre-storm."

Counter:

  • NWS wind data showing destructive wind speeds at your address
  • Pre-loss roof inspection / photos (if available)
  • Independent roofer report on damage age + cause
  • Comparable claims from same storm in your neighborhood

"All water damage is flood — go to NFIP."

Counter:

  • Wind broke the building envelope first
  • Wind-driven rain came through the roof breach
  • Engineer report distinguishing wind from flood damage
  • Photos showing water entry pattern (top-down vs ground-up)

"We're applying the hurricane deductible."

Counter (if loss outside window): NWS data showing watch/warning timeline. Loss occurred outside the storm window → AOP applies, not hurricane.

"Code upgrades aren't covered."

Counter: O&L coverage in your policy. Building dept letter on code requirements. Module 2.6.

"We don't pay matching."

Counter: § 626.9744 application. Be aware roof matching has been narrowed by recent reforms — verify current law.


9.1.10 Action steps

  1. The day a hurricane hits: photograph everything. Save weather records. Calendar your 1-year deadline.
  2. Mitigate immediately — tarp, dry, save receipts.
  3. File notice in writing within days — don't wait for power/normalcy.
  4. Get an independent estimate — don't rely solely on the CAT adjuster.
  5. For wind-vs-flood disputes: engineer + attorney immediately.
  6. For anti-concurrent causation issues: attorney before any communication.
  7. Use 18-month supplemental window for hidden damage discovered during repair.

Next: 9.2 Roof Claims Under the New Florida Rules.


Educational. Not legal advice. Hurricane claim deadlines + anti-concurrent causation rules continue to evolve. Verify current Florida Statutes + your specific policy before relying on any approach.

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