Coverage Triggers and Thresholds

Policy-language triggers

Occurrence

• Sudden, unexpected event
• Definitional language varies
• Time period defined

Direct physical loss

• Structural impact required
• Not just economic loss
• Florida interpretation

Covered peril

• Named or all-risk
• Specific peril must apply

Factual triggers

Cause of loss

• Specific event identified
• Event must be covered peril
• Policy terms tested against facts

Damage threshold

• Sometimes deductible-based
• Sometimes sublimit-triggered
• Sometimes excluded below threshold

Statutory triggers

Notice deadlines (627.70132)

• 1 year from loss (new claim)
• 18 months (supplemental)
• Reopening within 1 year

Response deadlines (627.70131)

How triggers interact

• Policy trigger + factual satisfaction = coverage activation
• Statutory timing + policy compliance = ongoing coverage
• Missed statutory timing + weak compliance = coverage risk

Practical implications

• Document the trigger event precisely
• Notify promptly (statutory windows)
• Comply with policy conditions
• Preserve rights at each stage