Insurance policies can be separated into two categories: residential policies and business/commercial policies. The overview in this article applies to both. Additional business concerns are also addressed below.

Which Policies Do I Have?

Residential polices are often called "homeowners" policies. If you reside in a high-risk (coastal) location, you might have more than one homeowners policy.

Your residential policy might cover standard risks, including fires, but might exclude coverage of hurricane losses.

Your windstorm policy would provide coverage against risks related to the winds that come with hurricanes, but exclude damages caused by floods (storm surges associated with hurricanes are usually included).

A flood policy would provide coverage against risks connected to flooding. All primary flood policies would include storm surges, also known as the "overflow of tidal waters."

Policies for homes in non-coastal or other low-risk areas commonly include coverage for wind and fire losses.

Flood vs. Wind: Private insurers (such as Allstate and State Farm) generally write wind coverage. Any disagreements concerning these polices are governed by Louisiana law. These private insurers will also handle primary flood coverage. All polices are the same. Disputes involving polices fall under federal law.

FEMA administers the National Flood Insurance Program (NFIP) with the assistance of private insurers. If you have flood coverage that goes beyond the $250,000 federal limit, then state law will usually govern disputes under those coverages.

It is very important to find or get copies of polices and highlight the flood definition that is not included under your windstorm or homeowners policy.

Some definitions are wider than other definitions and might cover surge-related losses that won't be covered by similar policies. Insurers, however, generally have taken extreme care in not including coverage for any damage resulting from rising waters of any kind so that related losses can only be covered under "federal" flood polices.

Other properties can be covered under separate polices. One example of this is if your car sustained damages during a storm. You might be able to claim your loss through your motor vehicle insurance policy.

An insurance policy is an agreement—a contract—between the insurer and you. When you enter into an insurance contract, you are agreeing to pay premiums. You are also agreeing to take certain steps, such as mitigating any home damages and notifying the insurer in the event that you experience a loss. As part of your agreement, your insurer would have agreed to act fairly when assessing the value and cause of your loss and pay you based on this determination. If either of you fails to follow the terms of your agreement, this would be a breach of contract.

Reading Your Residential Insurance Policy

You need to understand how an insurance policy is structured to read one intelligently. Insurance policies usually include a number of sections, such as:

• A declarations page that lists each coverage's policy limits
• A section explaining policy definitions
• Theinsuring agreement
• The coverage sections (which sets out what is covered by your policy)
• A section establishing what is excluded (known as exclusions) from the policy
• A section known as the general conditions section

Declarations Page. Also called the "decs" page, this page explains what coverage you have and should also explain the limits of any potential recovery under each type of coverage. The usual coverages shown on this page typically might include contents coverage (which covers personal items), coverage for your physical structure (the actual building that is your residence), the coverage of other structures (might apply to a pool house or a toolshed), loss of use coverage, additional living costs coverage (would cover hotel costs and lost rent), and any other coverages, such as costs that come with complying with new codes to rebuild your residence, fence coverage, and other special considerations.

This page should also identify all the "forms" that are part of your policy. These forms usually will have a strange number attached to them, such as HO-334-9. You should find each form noted on your decs page as a corresponding section or page in your policy. Your decs page should therefore serve as a table of contents for you. You can use the decs page to check off each form mentioned on the page and see whether your policy is complete. You should also look at your files for any riders or endorsements that might have been sent to you after you got your original policy. Your deductible can be found on your decs page.

Definitions. You must become familiar with this part of your policy. Insurers can be very specific when it comes to applying the technical definitions of policy terms (that usually show up in italic or bold script in other areas of your policy). For example—and this is a hypothetical example—"flood" is a term that can be defined as "a tidal surge or water rising from anywhere" or "the falling or rising of waters in estuaries, including rivers."

Your right to receive benefits can depend on the definitions that are used in your policy. Mark the definitions section because you will refer to it frequently when looking over your policy.

Insuring Agreement. This part of the policy will explicitly explain what dangers are covered. The language here is usually written in a broad manner but limited by the exclusions that come next. There may be a separate insuring agreement for each coverage section.

Coverage Sections. These sections usually provide detailed coverage of what your policy covers. For example, a homeowners policy might say that your dwelling structure is "Coverage A," your other structures are "Coverage B," and your contents fall under "Coverage C." Insurer's liability limits for each kind of coverage will usually be outlined here.

Exclusions. In this area, the insurer takes away a lot of what it appears to provide under the insuring agreement and coverage sections. While the insuring agreement and the coverage sections basically state: "Everything is covered except what is in the exclusions section," the exclusions section eliminates specific coverages. You might find language that tries to take away coverage for ordinance or law, flood, power failure, etc.

Conditions. This section explains the routine aspects of claim handing and coverage. For example, it will explain to you how to file a claim, what your responsibilities are to minimize damage to an insured property, the way your insurer will adjust your loss, and what must occur if there is a dispute between you and the insurer.

Reading the Policy. To read your policy, we recommend that you:

1. Search the decs page for general information and make sure that you have the whole policy with you. Remember to look through your files for riders and endorsements to your policy.
2. Become familiar with the definitions section of your policy.
3. Look through the insuring agreement and coverages section and note what perils are insured again and what losses are covered.
4. Look through the exclusions page to find out which coverages have been taken away or are limited.
5. Make note of exactly which conditions you consented to in regards to minimizing damages, letting the insurer know, etc.

Business Coverages

Commercial policies usually include similar coverages to those that exist for residential policies (such as coverage for contents and the structure). Often, however, these policies will also include coverages that are specific to businesses, including:

Business Interruption. Covers lost income for a certain time period if caused by a covered loss.

Accounts Receivable. Covers losses garnered by your inability to collect accounts receivable due to a covered loss.

Civil Authority Coverage. This provides compensation to businesses for losses caused by forced evacuations or similar declarations made by civil authorities.

Contingent Business Income. Covers income loss caused by damages sustained by others, such as your primary customers that are no longer able to do business with you or a supplier that has lost its ability to send goods to your area (or ship goods anywhere).

Extra Expense Coverage. Covers operating costs that could not have been incurred any other way but through the devastating event. Costs can include having to contract out your work and relocating temporarily.

Utility Services Coverage. Protects you if you lose business because your local utilities have failed.

Other similar coverages that exist often overlap with one another. They are frequently subject to "sublimits" that cap your total recovery. Business policies are usually more complex than residential policies and tend to vary from one another.

Making a Claim.

It is easy to report a claim. Call your agent or find your insurer online. Insurers frequently advertise on TV and on the radio after a major disaster. They will usually provide a 1-800 number so you can report your loss after a catastrophe.

Document, document, document! The most important action that you can take after sustaining a loss is to document your damages (by shooting video, taking pictures, or with handwritten itemizations). You should also document any calls or correspondence with your insurer. Keep a record of every interaction that you have with your insurer, and write down the name of the person you spoke with, the date the communication took place, and details regarding the exchange. Make a note of any information that you were given regarding the reasons for your loss or coverages. Keep records of all written correspondence, especially letters or e-mails sent to and received from your insurer.

Put together rough estimates regarding your property's replacement value. You might want to assess the loss of a fence, your housing structure, your tool shed, and/or your personal contents. Contents losses can be especially difficult to itemize after a traumatic loss. A good way to catalogue your contents losses is to go to a local department store or look through a shopping catalog. Look for items that you owned and write down everything you see (from a $5 dish to a $500 appliance to a $5,000 piece of furniture).

The Insurance Information Institute offers the following advice:

Give an insurance representative or the insurance agent an accurate description of the damage. The agent will report the loss to an adjuster or to the insurance company. The adjuster will get a hold of you and schedule a damage inspection.

Take pictures of the damage. This can help you present a solid claim. It will also help the adjuster do his or her job.

Create a detailed inventory of any destroyed or damaged personal property. Make two copies of this list. Keep one for yourself and give one to the adjuster. This list should include a list of the items destroyed, a description of the items, how much they cost when you purchased them, and how much it could cost to replace them. If you have any invoices, cancelled checks, or receipts, give them to the adjuster.

If you can, make temporary repairs. Cover broken windows, damaged walls, and roofs so that no further damage can occur. Keep receipts for any materials or supplies that you purchase. Your insurance company should pay you for reasonable expenses related to temporary repairs.

Get a detailed estimate for how much it will cost to make permanent repairs to your residence. Make sure that you are speaking to a reliable contractor. Give a copy of the estimate to your adjuster. Include the proposed repairs, replacement prices, and repair costs.

Insurance adjusters and agents tend to prioritize the most serious hardship and losses cases.

For answers to any of your questions about insurance claims, contact The Berniard Law Firm at (504) 527-6225 or contact us online.

Contacting a Specific Insurer

Here a several online resources that provide toll-free phone numbers for nearly every casualty and property insurer:

http://www.disasterinformation.org/findins.htm
http://communitydispatch.com/artman/publish/article_1783.shtml
http://www.insurancejournal.com/news/national/2005/08/29/58894.htm

State Insurance Contacts

Alabama Department of Insurance: (800) 433-3966
Louisiana Department of Insurance: (800) 259-5300
Mississippi Department of Insurance: (800) 562-2957

Call (800) 427-4661 for questions about NFIP (flood) insurance.