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…

  • Alexis B. AvatarAlexis B.

    After not getting any help from my home insurance company, I learned from a colleague about an public adjuster and what they do. I hired Claims Concept and they were a big help and a crucial part in my case. Eventually, I had to hire an attorney and won my case (14 months later). It was a long process and lots of stress but totally worth it. The guys at Claims Concept know what they are doing and I would recommend. - 5/23/2019 

    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 - 10/02/2017 

    ALFRED L. AvatarALFRED L.

    I had direct contact with Eric and Jesse and my experience with both of these professionals was exemplary. I observed a sincere desire on both their parts to assist me in anyway they could to obtain an acceptable settlement from my insurance carrier due to a roof leak resulting in extensive interior damage to one of my rooms as well as to my roof. Whenever I had a question or concern, both Eric and Jesse were there to answer those concerns. I am extremely grateful for their assistance in obtaining the insurance settlement that I received. I recommend Claim Concepts, unequivocally, for anyone in need of Public Adjusters. They are the epitome of professionalism, honesty and integrity. - 10/02/2018 

  • Anthony O. AvatarAnthony O.

    We chose Claim Concepts because of their outstanding credentials and experience, and we were not disappointed. Eric was great to work with, and he demonstrated great knowledge and negotiating ability. We are sure we would have received only a small fraction of the insurance settlement that Eric was able to obtain without him. I hope we never need a public adjuster again, but we now know whom to call if we do. - 12/02/2019 

    Alyssa J. AvatarAlyssa J.

    Absolutely wonderful service. I was very pleased with the outcome and the service I received was above my expectations. I will recommend them to anyone in need. - 1/16/2020 

    Poh W. AvatarPoh W.

    My house caught on fire in late March 2019. Initially I tried to deal with insurance adjuster myself but it quickly became too much work for me to handle. Fortunately, my boss was in a similar situation and highly recommended me to talk to Claim Concepts. I contacted Greg Roover (the owner), we had a great conversation and contracted CC to be my public adjuster. I met with Eric Thomas (one of Greg’s associates, super friendly and professional) the next day to previewed my burnt house and went over logistic. 4 months later not only did I got my insurance claim approved, Eric managed to get the full insured amount as well. Great Job Claim Concepts! I would highly recommend Claim Concepts especially if you find yourself in a fire or hurricane claim situation. - 10/17/2019 

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