When Is Damage Covered? Perils, Exclusions and the Burden of Proof

In Part 4 of the Master Your Insurance Policy series, Attorney Edward Jimenez explains the question at the center of every claim: when is your damage actually covered? The answer depends on how your policy is written and who carries the burden of proof. This builds directly on Part 3, where we covered your ABCs of coverage.

All-Risk vs. Named-Peril Coverage

Most Florida homeowners policies are all-risk (also called open-peril) for the dwelling, meaning damage is covered unless the policy specifically excludes it. Personal property is often named-peril, meaning it is only covered if the cause appears on a listed set of perils. Knowing which type applies to each part of your policy tells you what you have to prove.

Who Has the Burden of Proof

Under an all-risk policy, you prove that a direct physical loss occurred, and the insurer then bears the burden of proving that an exclusion applies. This distinction is powerful. Many denials fail because the insurer never properly establishes that an exclusion actually defeats coverage.

Common Exclusions to Watch

Standard exclusions include flood, wear and tear, neglect, and faulty workmanship. Flood is the big one in Florida: it is never covered by a standard homeowners policy and requires a separate flood policy. Wind-driven rain and storm surge are frequently confused with flood, and that confusion is often used to deny legitimate hurricane claims.

Ensuing Loss and Concurrent Causation

Even when one cause is excluded, resulting (ensuing) damage may still be covered, and Florida recognizes the concurrent cause doctrine when a covered and an excluded cause combine to produce a loss. We dig deeper into using these doctrines in Part 6 on unlocking coverage.

Talk to a Florida Property Damage Attorney

If your insurer denied your claim by pointing to an exclusion, that denial may be wrong. Attorney Edward G. Jimenez handles property damage claims across Florida and knows how to hold insurers to their burden of proof. Review our case results, then call (321) 465-3425 or book a free consultation. Next: Part 5: The Little-Known Additional Coverages.