Coverage vs. scope: why the difference matters
- Scope disputes: appraisal-eligible; amount question
- Coverage disputes: courts and CRN only; whether covered at all
How to challenge a coverage denial
Written challenge
- Specific policy language citation
- Facts supporting coverage
- Florida case law when applicable
- Request reconsideration
Expert support
- When technical question drives coverage
- Causation analysis
- Policy language interpretation
Escalation
- CRN for pretextual denials
- Litigation for genuinely disputed coverage
Common coverage disputes
- Cause of loss (storm vs. wear-and-tear)
- Exclusion application (flood vs. wind)
- Endorsement application (mold sublimit vs. water full)
- Policy condition (late notice, proof of loss)
Florida interpretation rules
- Policy language construed narrowly (exclusions)
- Ambiguity resolved for insured
- Reasonable interpretation doctrine
- Ensuing-loss analysis
When to retain counsel
- Written coverage denial without factual support
- Complex policy language interpretation
- Bad-faith coverage handling pattern
- Significant claim value