Interesting Claim Denial: Condensation

We were recently hired by a very nice couple in Boca Raton that had some water damage to their property and their claim was denied.   I know from working on both sides of the claim process that many times there is a good reason for denying the claim but in this case I wanted to take a look for myself.  From what I was told the Air Conditioning system had leaked damaging the walls, ceiling and some baseboards.  I proceeded to read and reread the policy and was stuck on the part where they state the covered perils, one statingBoca Raton Claim denied for condensation.  As Florida Public Adjusters we helped to get the claim paid the following:

“Accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or from within a household appliance”

It seemed pretty clear to me that this claim should in fact be paid and I took on the challenge to get the insured what they deserved.  It turned out that their reason for the denial was stating that the water damage was caused by condensation on the outside of the system and therefore it was not ‘within’ the system.  The only question I repeatedly asked was “what other water is in a A/C system other than condensation?”

Results:

Insured was paid within 30 days of our Florida Public Adjusters began fighting the case.  I have seen the insurance companies reach far for a reason not to pay but in my opinion this one was a bit further than most.  I am thrilled that we were able to help and the insured finally got what they deserved.

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What our clients say…

  • Michael M. AvatarMichael M.

    Great effort by Greg and Eric . Really did a fine job for us by collecting the amount needed to repair house. - 6/09/2019 

    Steve L. AvatarSteve L.

    I was very impressed with the level of service I received from Claims Concept. Greg, Jesse, and Eric were very professional and took the time to explain and handle the entire process. I highly recommend Claims Concept! - 1/19/2021 

    Patsy B. AvatarPatsy B.

    Greg was super professional and helped me do battle with a very reluctant insurer (Peoples). Our damage claim was fair to both sides, and was very happy Peoples finally saw it that way. Greg was on time for appointments and kept in excellent communication. I would not hesitate for a moment to recommend him to family and friends and use in future-- God forbid--if I had insurance problems or damage to my home - 10/02/2019 

  • Duane M. AvatarDuane M.

    I highly recommend claim concepts. Greg was extremely pleasant to deal with, yet firm and persistent in getting us the results necessary. I highly recommend them. You won't be disappointed. - 10/02/2017 

    Marilyn P. AvatarMarilyn P.

    We had a water leak in our house. We called insurance and they send an appraisal guy to determine the damaged. What a bad experience when he gave me instructions of what to do taking pictures forward to him etc. When the insurance final the case they send us a check for much less to cover all the damage.We found Greg Hoover, He response immediately and guides us in what to to do. He fought for us with the insurance company and we get exactly He told us in his appraisal. Highly recommended him. Very professional - 10/23/2017 

    Shanda N. AvatarShanda N.

    Excellent professional service! I received everything I needed in a timely fashion.. highly recommended - 6/23/2017 

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