June 17, 2015
Sharon Abbott
4700 Saint Andrews Arc
Leesburg Fl 34748
RE: American Integrity Claim Number: ACH124224
American Integrity Policy Number: AGH199657
Date of Loss: 02/12/2014
Cause of Loss: Wind and hail
Insured Location: 4700 Saint Andrews Arc Leesburg Fl 34748
Dear Ms. Abbott:
On April 28, 2015 you reported damage to your roofand interiorfrom windwhich you state occurred on February 12, 2014; 15 months.
Among other things, American Integrity Insurance Company retained an engineer to conduct an investigation and analysis with regard to the cause and extent of the damage.The investigation revealed there was no wind or hail damage at the property. Specifically, the engineer noted the following:
1-It was our opinion that the shingle roofing system did not evidence hail stone damagewhereby the serviceability of the shingles had been compromised. Furthermore, if hailstones had impacted the shingle roofing system the stones were not sizable enough todamage the asphalt shingles or cause points of impact with mat fracture or bruising. Itwas also our opinion that the roof did not evidence damage from a wind storm wherebyshingles would be missing, torn or creased.
2-The shingles did not evidence points of impact or bruising with mat fractures aswould be expected if hail stones large enough to inflict such damages to asphaltshingles had impacted the roof system.The sheet metal off-ridge vents did not evidence dents or ‘dimpling’ as would be
anticipated if hail stones large enough to damage asphalt shingles had impactedthe rooftop. It should be noted that these vents were located such that there weremultiple vent surfaces which faced generally in each direction (north, south, east,and west).The shingles evidenced granule voids which evidenced depleted asphalt to thepoint that the fibers within the asphalt were exposed. These fibers were not foundto be fractured or evidenced indentations consistent with impact. This conditionwas found consistent with manufacturing defects in the shingle aggravated byweathering.
3-The shingles evidenced approximately 55 localized irregular granular voids withdepleted asphalt to the point that the fibers within the asphalt were exposed. Thiscondition was found consistent with manufacturing defects aggravated byweathering; Several areas were marked by the roofer as wind damage, however upon furtherinspection the shingles were only found to be delaminated and did not evidencecreasing or tears;
4-Despite some sporadic debonding of the corners of the shingle strips, the shingles did not evidence damage from a wind storm event. Specifically, missing, torn or creased shingles were not observed. The roof evidenced sporadic exposed nail heads throughout the slopes. While
these exposed fasteners were not related to hail damage, they may be a source for possible water infiltration.
5-Despite the sporadic exposed nail heads, the roof system was in good serviceable condition and capable of performing as intended for several more years despite minor and localized surface granule voids, manufacturing defects, and other various gouges and cuts typical for asphalt shingles of this age. None of these minor conditions were considered to be problematic or contributive to loss of function of the roof system.
Based upon the information obtained through its entire investigation, including but not limited to, our inspection of your property, and our expert investigation, American Integrity Insurance Company concludes that there was no wind or hail damage to your roof. The condition of the property inspected was due to a combination of wear and tear, faulty workmanship, not protecting property, deterioration, faulty maintenance, faulty manufacturing, marring, weather conditions, acts or decisions. We regret that we must therefore deny coverage for your claim. Specifically, the following policy provisions set forth the contractual basis for our conclusion that there is no coverage under the policy for the claimed damage:
Please refer to your HO 03 04 91 policy, as amended by AIIC 02 HO3 SP 10 12 SPECIAL PROVISIONS FOR FLORIDA – HO 00 03, which states:
SECTION I – PERILS INSURED AGAINST
COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES
We insure for sudden and accidental direct loss to property described in Coverages A and B only if that loss is a physical loss to covered property.
We do not insure, however, for loss:
2. Caused by:
e. Any of the following:
(1)Wear and tear, marring, deterioration;
(2)Inherent vice, latent defect, defect or mechanical breakdown;
.
3.Excluded under Section I – Exclusions.
Under items 1. And 2., any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered.
SECTION I – EXCLUSIONS
1. We do not insure for loss caused directly or indirectlyby any of the following. Such loss is excludedregardless of any other cause or eventcontributing concurrently or in any sequence to theloss.
2.We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered.
a. Weather conditions. However, this exclusiononly applies if weather conditions contribute inany way with a cause or event excluded inparagraph 1. above to produce the loss;
b. Acts or decisions, including the failure to actor decide, of any person, group, organization or governmental body;
c. Faulty, inadequate or defective:
(2) Design, specifications, workmanship, repair,construction, renovation, remodeling,grading, compaction;
(3) Materials used in repair, construction, renovationor remodeling; or
(4) Maintenance
of part or all of any property whether on or off the "residence premises."
Your policy requires that you undertake certain duties following a loss, including reporting the damage promptly and protecting the property from further damage. Please refer to your policy, as amended above, which states under:
SECTION I – CONDITIONS
2. Duties After Loss
In case of loss to a covered property, you must see that all of the following are done:
- Give prompt notice to us or our agent;
d.Protect the property from further damage. If repairs to the property are required, you must:
(1) Make reasonable and necessary repairs to protect the property; and
(2) Keep an accurate record of repair expenses;
f.As often as we reasonably require:
(1) Show the damaged property;
SECTIONS I AND II – CONDITIONS
1. Policy Period. This policy applies only to loss in Section I or "bodily injury" or "property damage" in Section II, which occurs during the policy period.
We will therefore be unable to honor your claim. We expressly reserve our right to assert all other rights or defenses that we may have to this claim even though not enumerated above. We do not waive or relinquish any of our rights under the policy of insurance.
This denial has occurred after a good faith evaluation of the total circumstances involved. If you know of any reason why our evaluation of the facts is not correct, please advise us in writing to the address below or by email to .
Sincerely,
Tracey Cassaway
Claim Adjuster
American Integrity Claims Services
Tele: 813.880.7000
Proof of Mail
CC:Westgate-Jones Ins. Agency, Inc.
26200 US Hwy 27
Leesburg, FL34748
Noland’s Roofing Inc.
1295 W. Hwy 50
Clermont FL 34711
If this document contains an excerpt from your Insurance Policy (“the Policy”) it is provided here for informational purposes only. This excerpt is not the official version of the Policy. The official version of the Policy is the policy issued to the insured on the policy effective date. In the event there is inconsistency between this document and the Policy, the Policy shall serve as the official version.
Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. F.S. 817.234