This is the denial letter itself. Not a summary, not a quotation of one: the document the insurance company sent, filed as an exhibit to a lawsuit and therefore public. It survives because the policyholders sued and their lawyer attached it to the complaint.
Sent on March 10, 2021 from Western World Insurance Company, 300 Kimball Drive, Suite 500, Parsippany, NJ 07054. Every quote and figure below is read off that document. The street address, policy number and claim number are removed; the party names are the public case caption.
| Who wrote it | Western World Insurance Company |
|---|---|
| Who signed it | Rich Teglia, Property Claims Specialist, Western World. An independent field adjuster assigned by Western World did the inspection. |
| Who received it | Ana Bracho, the named plaintiff in the public case caption. The letter went by email to her public adjuster. |
| Who was on the policyholder side | Santos Public Adjusters represented the homeowner on the claim; she later retained counsel and sued. |
| What it is | A partial denial that pays. Western World accepted the water damage to the master bedroom as covered, then refused the tile floors on the ground that the tile was improperly installed. |
| What the carrier calls the form | HO 00 03 05 11 Homeowners 3 Special Form |
| Where | Miami, Miami-Dade County, Florida |
| When the loss happened | May 25, 2020. Reported May 28, 2020, three days later. |
| When the letter was sent | March 10, 2021, about nine and a half months after the loss. The tile expert inspected on February 22, 2021. |
| Why, in the letter’s own reasoning | The letter relies on the faulty workmanship exclusion at Section I Exclusions B.3.b of the HO 00 03 form, covering design, specifications, workmanship, repair, construction, renovation, remodeling, grading and compaction, plus maintenance at B.3.d. |
| Replacement cost of the covered dwelling damage | $3,053.38 |
|---|---|
| Less recoverable depreciation | $0.00 |
| Actual cash value | $3,053.38 |
| Less deductible | $2,500.00 |
| Net claim payable | $553.38 |
| The tile floors | Excluded entirely, and not priced anywhere in the letter |
This section is our reading of the document above, not the letter's words.
What it does for the insurance company
This is the partial denial done carefully. Conceding the master bedroom costs $553.38 and makes the letter look like an adjustment rather than a refusal. The tile, which is the expensive part, leaves through a workmanship exclusion supported by a retained tile expert, and the anti-concurrent-causation wording means the water cannot bring it back. The letter then adds two levers most policyholders miss: no supplemental work without prior approval, and a thirty-day window that sounds generous but is not a deadline the policy imposes.
What it means for the homeowner
A $2,500 deductible against $3,053.38 of accepted damage leaves $553.38. The number that decides this claim is the one that never appears: what the tile floors cost. Nine and a half months passed between the loss and this letter, and the tile expert who supplied the reason inspected two weeks before it was written.
- 1 When a letter pays something, read the payment table first. Replacement cost, minus depreciation, minus deductible tells you what was actually conceded, and here it is one room.
- 2 The excluded item is never priced. Get your own estimate for the tile so the real size of the dispute is on paper.
- 3 A workmanship exclusion rests on an expert opinion about how the tile was installed. Ask for that report, the inspector's credentials and the photographs. This letter says the report is attached; make sure you receive it.
- 4 Note the instruction that unapproved changes will not be covered. Confirm in writing what the carrier is actually requiring before you start repairs, because a supplemental claim is a policy right, not a favour.
- 5 The thirty-day window to submit more information is the carrier's own timetable, not a legal deadline, and it does not shorten or extend anything in the policy or the statute.
The letter names the tile expert and his firm, gives the inspection date, and says the report is attached. That is more disclosure than most denial letters offer, and it is what makes the workmanship finding testable rather than a bare assertion.
Bracho v. Western World Insurance Company, No. 1:21-cv-22199-BB (S.D. Fla.), Doc. 1-1, Exhibit B at 71 to 74 of 74. Removed from the 11th Judicial Circuit, Miami-Dade County. Read the filed document ↗
A complaint states one side's allegations and the case is pending; nothing here has been decided by a court. Not legal advice; consult an attorney about your specific claim.
The third letter in the archive held as a document, and the clearest example of a partial denial that pays something. The check is real. So is the exclusion that removed most of the claim.
Bracho v. Western World Insurance Company, No. 1:21-cv-22199-BB (S.D. Fla.), Doc. 1-1, Exhibit B at 71 to 74 of 74. Removed from the 11th Judicial Circuit, Miami-Dade County. · public record ↗
Quotes are verbatim from the cited public record. Case status and statute summaries drafted August 2026; verify against the current docket and statute. Not legal advice; consult an attorney about your specific claim.
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