Supplemental insurance claims: when more damage is found

If you or your contractor find more damage from the same event after the insurer has paid, you can ask the insurer for more money. That request is called a supplemental claim, or reopening the claim if the insurer had closed it. Tell the insurer in writing as soon as you find the damage, because some states and policies set deadlines.

What is a supplemental claim?

It is a request for more money on a claim the insurer has already worked on. The Missouri Department of Commerce and Insurance describes supplements as additional payments from an insurance company beyond the initial settlement amount.

Regulators describe this as a normal part of a claim:

• The NAIC, the association of state insurance regulators, says a claim with substantial damage is not going to be closed with a single payment. It stays open until the insurer has made all the payments you are entitled to under the policy.
• The California Department of Insurance says the first check is often an advance, not a final payment. It adds that under most circumstances, if more damage is discovered later, you can reopen the claim and request additional compensation.

FEMA’s checklist for flood claims names three reasons to ask for an additional payment: you notice more damage, the estimate missed or misidentified an item, or the repair costs more than the adjuster’s estimate.

Is a supplemental claim the same as reopening a claim?

Not always. People use the words loosely, but Florida law defines them separately:

• Reopened claim. A claim the insurer closed and then reopened at your request, for additional costs for loss or damage you had already disclosed.
• Supplemental claim. A claim for additional loss or damage from the same peril that the insurer has already adjusted, or for costs that came up while finishing repairs under an open claim. A peril is the cause of the loss, such as wind or fire.

Neither one is the same as collecting recoverable depreciation. On a replacement cost policy, the insurer may first pay actual cash value, which is the depreciated value, and pay the rest once you repair or replace. The NAIC says the time limit for that payment usually ranges from 6 months to one year, depending on state law and the policy. Missouri’s department says many policies set 12, 18 or 24 months. See actual cash value vs replacement cost.

What should you do when more damage is found?

1. Record it before it is covered up. Take photos and video of what was found and where. How to document property damage has a method.
2. Tell the insurer in writing right away. California’s department says you must notify your insurer immediately when you discover additional damage, as with the first claim. Give the claim number, the date of loss, what was found and the date it was found.
3. Send a supplemental estimate. Missouri’s department says that when a contractor finds additional damage, a supplemental estimate detailing the extra work, materials and costs must be prepared and submitted to the insurer.
4. Let the insurer inspect. Missouri says all supplements must be inspected and approved before repairs are completed, and that this may take more than one inspection.
5. Keep protecting the property. California’s guide says a policy may not cover further damage if you have not taken reasonable steps to prevent it. Keep receipts for what you spend.
6. Keep a log and copies. California’s guide says to log all phone calls and letters and keep copies of everything you send or receive.
7. Ask for the answer in writing. The NAIC says that if the insurer denies any part of a claim, ask for the denial in writing.

Your contractor can write the estimate. Who may deal with the insurer for you is a separate question, covered in contractor or public adjuster.

Why does written notice matter?

Where a deadline applies, what counts is when the insurer was given notice. A letter or an email gives you proof of the date.

• The law is written around notice. Florida’s statute bars a supplemental claim unless notice “was given to the insurer in accordance with the terms of the policy” in time.
• Notice starts the insurer’s clock. In Florida, the insurer must pay or deny an initial, reopened or supplemental claim within 60 days after it receives notice. The claim clock shows insurer deadlines by state.

For letters about deadlines, United Policyholders, a nonprofit, suggests certified mail with a return receipt, and keeping a copy.

Are there deadlines for a supplemental claim?

Yes in some states. Florida’s deadlines count from the date of loss, not from the day you found the new damage.

Florida. The statute sets two notice deadlines for property insurance claims:

The statute’s words are: “A supplemental claim is barred unless notice of the supplemental claim was given to the insurer in accordance with the terms of the policy within 18 months after the date of loss.” For a hurricane, the date of loss is the day it made landfall.

Florida’s consumer guide puts it this way: if the insurer has closed your claim, you have one year to ask it to reopen, and if the claim is still open, you have 18 months from the date of loss to report more damage. Notice given within one year after the date of loss meets both deadlines. See Florida rules.

The deadline to sue. United Policyholders says most policies have a clause giving you one year from the date of loss to file a lawsuit, and that state law may give you more. It also warns that suit limitations can cut off your rights. Examples from state law:

• California’s standard fire policy wording gives 12 months from the start of the loss, or 24 months when the loss is tied to a declared state of emergency.
• Louisiana does not let the kinds of policies listed in its statute cut the time to sue on your own claim below 24 months. See Louisiana rules.
• North Carolina’s standard fire policy terms give three years.

United Policyholders says insurers will usually agree to extend the lawsuit deadline if you ask in writing.

Flood. FEMA’s checklist says you can request an additional payment on a federal flood claim at any time, even if you think the claim has been settled. The same checklist asks for your supporting documents within 60 days of the flood, or within the time your adjuster or insurer gives you. See the flood insurance claim guide.

Deadlines differ by state and policy. See rules by state.

Does cashing the check or signing a release end the claim?

It depends on what the check and the paperwork say. California’s department tells policyholders to understand what a check does and does not cover, and to be wary of first offers presented as full settlements that require a release of further liability. Missouri’s department says additional claim payments are not necessarily full and final. If you are asked to sign a release, one option is to have an attorney read it first.

What if the insurer says no?

Ask for the reasons in writing. United Policyholders takes the position that an insurer has an ongoing duty to consider all information that supports your claim, even after it labels the claim settled.

Your options from there:

• A complaint to your state insurance department. See how to file an insurance complaint.
• Appraisal. If the dispute is only about the amount, your policy’s appraisal clause may apply.
• A public adjuster. In Florida, a public adjuster hired for a reopened or supplemental claim cannot base the fee on earlier payments, and the fee cannot be more than 20% of the new payment. Florida’s other fee caps still apply. The fee calculator shows whether the numbers work, and the contract check lists what the contract must say.

For hidden damage in specific parts of a home, see the roof damage and water damage claim guides.