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Ely, Counselor at Law
Category: Legal
Satisfied Customers: 101381
Experience:  Private practice with focus on family, criminal, PI, consumer protection, and business consultation.
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Had a water leak in my kitchen. Mercury now says it was from

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Had a water leak in my kitchen. Mercury now says it was from wear and tear and won't cover it. My wood floors were 2 years old and they are giving me a small amount to replace the floor (which won't cover cost of new wood flooring). So now I have been without a kitchen for almost a month. Half of the cabinets and counters are gone, floor is completely gone. All I want is to have cabinets replaced that were damaged (have all cabinets sanded and painted). Plus they will not be able to match existng tile and I am not asking for granite, just new tile. My kitchen is very small. We have always kept up our home and the house was built in 1986. Can I appeal this claim?
Hello friend. My name is XXXXX XXXXX welcome to JustAnswer. Please note: (1) this is general information only, not legal advice, and, (2) there may be a slight delay between your follow ups and my replies.

I am sorry for your situation. Can you please tell me:

1) Who is Mercury - an insurance company? Do you rent or own?
2) What do they cover, exactly (i.e. damage, accidents, etc)?
3) How did the water leak come about?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. Thank you in advance.
Customer: replied 3 years ago.

Mercury Insurance (homeowners) they cover damage, accidents etc. Pipe leaked and they said it was from wear and tear. How do they know this? Have been paying for this insurance for almost 20 years and have never filed a claim. Same with our auto insurance with them. We own the home

Thank you, B.

Can I appeal this claim?

Yes, of course. Understand that the claim may be appealed through litigation.

When you have insurance, you and them have entered into a contract that they would cover certain things. In a claim, you ask "hey cover this." They can either fulfill their end of the contract, or they can deny it.

If they deny it, you could potentially sue them to force coverage.

How do they know this?

They do not. However, they claim this is so because under contract, wear and tear is not covered, and they hope that you simply give up and walk away.

However, if they refuse to cover a proper claim, one can appeal the matter in court and have the court decide if the policy contract covers this or not.

Often, the threat of filing suit can have them reconsider the coverage and offer a certain amount to cover the damage. Why? Because they know that you'll at least get that in Court, if you file suit.

An attorney usually cuts through this malarkey since the adjuster knows counsel does not put up with this and WILL file suit if needed (whereas here, they do not see you as much of a threat without an attorney since you filing or winning a suit without counsel is unlikely). Then a settlement is usually reached. The attorney should take this on a contingency basis, meaning they do not get paid unless you do. Usual set up is their take is 33% settlement, 40% win at trial, 45% at appeal; plus some office costs. Everything is negotiable.

May I recommend the CA Bar referral program - here. The attorneys are vetted and qualified. You should be able to find an attorney you are confident with and whom you can trust, and who is available ASAP.

I hope this helps and clarifies. Good luck.

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