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Ocean Point Claims Company
Ocean Point Claims:causation disputes denial
Denial Playbook

Causation Disputes

Causation is the factual dispute at the heart of many Florida denials. Whether damage came from a covered peril or an excluded one often turns on specific forensic evidence.

Common causation disputes

  • Storm vs. wear-and-tear
  • Sudden plumbing failure vs. gradual seepage
  • Wind damage vs. flood
  • Fire damage vs. firefighting-water damage
  • Collapse vs. earth movement

Florida causation rules

Efficient proximate cause

  • The "predominating" cause controls
  • Even when multiple causes contribute
  • Analysis can favor policyholder when covered peril predominates

Concurrent causation

  • Multiple causes; apportionment possible
  • Anti-concurrent-causation clauses modify this
  • Florida enforces ACC clauses with limits

Ensuing loss

  • Damage resulting from excluded cause may be covered
  • Broad policy language supports
  • Florida case law develops this

Ocean Point Claims:denial using engineering reports

Establishing causation

Physical evidence

  • Damage pattern analysis
  • Photographic documentation
  • Preserved samples
  • Moisture / chemistry analysis

Expert reports

  • Forensic engineers
  • Industrial hygienists (water/mold)
  • Fire investigators
  • Plumbers for water-source

Event correlation

  • Weather data
  • Time-of-event documentation
  • Witness statements
  • Prior-loss absence

Related

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