Overturning a Wrongful Denial to Win a Full Settlement

Project Type: Residential Denied Claim (Roof Leak)
Location: Orlando, FL
Challenge: Insurance company wrongfully denied a valid claim, blaming “wear and tear” and “long-term neglect.”

The Situation: A Frustrating Mystery

The Miller family in Orlando noticed a growing water stain on their ceiling after a series of heavy rainstorms. They soon discovered a slow but persistent leak originating from their roof. They filed a claim with their homeowners’ insurance, expecting the support they had been paying for.

The Ultimate Setback: “CLAIM DENIED”

The insurance company dispatched their adjuster, who concluded the leak was not caused by a specific, covered event like storm damage. Instead, they blamed the issue on “improper maintenance” and the “age of the roof.” A week later, the Millers received a formal denial letter in the mail. Their claim was worth $0.

They were now facing a $20,000+ bill for a new roof and interior repairs, all while continuing to pay their insurance premiums. They felt betrayed and were on the verge of taking out a loan to pay for the repairs themselves. As a last resort, they called us.

Our Solution: A Fight for Justice

A denied claim is not the end of the road; for us, it’s the beginning of the fight. We immediately launched a multi-pronged counter-attack.

Step 1: Re-opening the Claim & Invoking the Appraisal Clause
We formally notified the insurance company that we were representing the Millers and were re-opening the claim. We immediately invoked the Appraisal Clause in their policy—a powerful tool that allows for a third-party resolution when there’s a dispute.

Step 2: Engaging an Independent Expert
The insurer’s “expert” served their interests. We brought in ours. We hired a licensed, independent structural engineer to perform a forensic analysis of the roof. This was the critical move.

Step 3: Uncovering the Truth
The engineer’s report became our “smoking gun.” It proved, with photographic evidence and professional analysis, that the leak was not from general wear. It was a direct result of wind-lift damage from a recent, documented storm that had creased shingles and broken their seals, allowing water to slowly seep in over time.

Step 4: Building an Unassailable Case
We combined the engineer’s report with meteorological data, a detailed line-item estimate for a full roof replacement from a reputable contractor, and a formal letter outlining how the initial denial violated the terms of their own policy. Our case was no longer a homeowner’s plea; it was a professional, evidence-based demand.

The Result: From $0 to a Full Payout

Our strategic and evidence-based approach completely reversed the insurance company’s decision. They could not argue with the findings of an independent engineer.

• Initial Insurance Decision: $0 (Claim Denied)

• Final Settlement Secured by Our Team: $32,000

We didn’t just get the claim approved; we secured a settlement that covered a full roof replacement to meet Florida Building Code, all the interior water damage repairs, and the cost of our expert engineer. The Miller family was made whole without spending a dime out of pocket beyond their deductible.

Client Testimonial:

“We were about to give up after our claim was denied. The insurance company made us feel like it was our fault. We made one last call to Propert Damage Claims Experts, and it changed everything. They immediately took over, hired their own engineer who found the real cause of the damage, and went to war for us. They turned a complete denial into a $32,000 check for a new roof. It was incredible. Don’t take ‘no’ for an answer until you’ve spoken to them.”

– The Miller Family, Orlando, FL