Mario L. Enriquez, Esq.
First Party Property Insurance Coverage
It is common for people to pay for insurance to protect their homes, cars, health and livelihood. It is also quite common that people do not understand all the fine print contained within their insurance policies. As such, this month I am honored to feature Mario Enriquez, an attorney with a practice focused on representing policyholders whose insurance claims have been denied or underpaid for our SPOTLIGHT INTERVIEW.
Q: Thanks for taking the time to sit with us, Mario. First off, please tell our readers about yourself. What sort of cases do you handle in your practice?
A: My pleasure, Elina. Thank you for having me. My firm represents the owners of commercial buildings and homes that have made a claim on an insurance policy. My experience is that policyholders that have been dutifully paying premiums for years are often times treated unfairly by their insurance company when they make a claim. People pay premiums with the expectation that their insurance company will come to the rescue after their home or business has been damaged by fire, water, wind, theft or vandalism. A lot of times, however, they are confronted by unwarranted skepticism and unnecessarily burdensome requests for information. My job is to keep the insurance company honest, make sure they own up to their obligations and make sure they treat my clients and their customers with the respect deserved.
Q: What is your favorite part of your work?
A: I’m the youngest of three brothers, so my natural instinct is to fight hard against bullies. In battles between David and Goliath, I have always wanted to fight for the little guy. Being a lawyer, there a plenty of ways to make a living executing legal process upon those that are unable to defend themselves. That type of work never interested me. I am motivated by the prospect of really benefitting people’s lives. In my line of work, I know that insurance companies have more money and greater resources than my clients will ever have. I know that they can write the policies without any input from my clients on a take it or leave it basis. I know that many times my cases will be an uphill battle. I also know that owning a home or business is a major investment and a big part of the American dream. I get tremendous personal and professional satisfaction from helping my clients in protecting that part of their dream.
Q: How do I know if my homeowner’s insurance policy provides sufficient coverage?
A: Determining whether your insurance contract protects you adequately can be intimidating. Many times during the insurance application process, you will not be provided a full copy of the policy and will only get a declaration sheet with an outline of coverage. Ask your insurance agent for a full copy of the policy that they are proposing so you can review the coverages. Make sure to check the deductible amounts. Deductibles are the amount of money you will have to pay out of pocket before you can recover on a claim. Review whether there are arbitrary caps on water damage. According to an article in the Sun Sentinel, 79% of South Florida property insurance claims are for water damage. As such, many insurance companies attempt to limit water damage and leave you without the most important coverage. Also, be wary of insurance policies that provide an option to repair clause. Many times, these policies prevent you from choosing a contractor that performs repairs on your property and require you to pay out of pocket deductibles before they perform any work on your property. Also, there are some option to repair policies that limit your right to challenge the extent of repairs necessary. Those policies can force you to allow the insurance company to perform repairs that don’t adequately restore your property to pre-loss condition. Be wary of surplus lines insurers. Surplus lines insurer are much less regulated by the State of Florida’s Office of Insurance Regulation and often write policies that contain substantially less coverage than their regulated counterparts. Ask your agent if insurance policy he recommends is issued by surplus lines insurer.
Q: If you already have adequate insurance, what are some steps you can take to protect your property?
A: If you have adequate insurance and your house is in good shape, that’s great. There are still things that you can do to protect your property in case you suffer a loss. It is always a good idea to document the condition of your property. Insurers will often hire “experts” to say that water damage is the result of constant and repeated seepage or long term exposure to water. If you have photos showing that damage was not present before the loss, you can affirmatively demonstrate that the damage is covered. If your insurance company asks to perform an inspection before agreeing to insure you or as a condition of continuing to offer insurance, ask for a copy of the report. That report will demonstrate that your house was not suffering long term damage, was free of wear and tear and was otherwise in an insurable condition.
Q: What should I do if I have a claim?
A: It is very important to remember that the insurance company has representatives working on its behalf from day one to gather facts that justify them denying their customer’s case. It is, therefore, imperative for an insured to get their representatives working on their behalf as early in the claims process as possible. I highly suggest hiring an attorney or a public adjuster to represent an insured’s interest at the outset of the claim. The insurance contract has been written to be a minefield for an unrepresented insured. Insurance companies will argue that an otherwise valid claim should be forfeited for failure to comply with a long list of post loss obligations and other inane formalities. It is also important to note that an insured has the right for their counsel or a representative to be present for any examinations under oath, recorded statements, and inspections. I suggest that policyholders exercise the right to counsel and have an attorney present at those important meetings protecting their interests.
Q: How can our subscribers reach you for a consultation?
A: Subscribers can contact me anytime to discuss a potential or pending insurance claim. There is no charge for a consultation. In my field, there is a law that makes insurance companies liable for my attorney’s fees and costs incurred if a claim is underpaid or denied. This allows my firm to represent our clients without charge until the insurance company issues payment. If the claim is paid in litigation, the insurance company will almost always pay my firm’s attorney’s fees and costs separate from any amount paid for my client’s claim. Should you need to get a hold of me, you can call my office at (305) 631-2528 or my cellular phone (786)282-5996. You can also email me at email@example.com or visit my website, www.trujillovargas.com.
Thank you, Mario, for sharing your knowledge with our subscribers. This is Elina signing off until next month’s spotlight interview. Have a great month!