When is a claim covered by homeowners insurance?
Homeowners insurance policies breakdown coverage’s and exclusions and will vary in wording but the general term you want to remember that usually makes or breaks your claims is: Sudden and Accidental.
By definition, sudden and accidental damage means that whatever has happened should not have been the result of damage over time.
So for example, you are getting ready to take your daughter to the movies and then some pizza for dinner. Before heading out little Suzy needs to go to the bathroom and she flushes as she normally does, then you both leave for a fun fill day. Unfortunately, the toilet paper clogged up and the toilet begins to overflow into the bathroom and down the hall into every bedroom. 5 hours later you arrive home to find water damage in half of your home. This example would be considered an accidental and sudden discharge of water and covered under your homeowners insurance.
Now, you would think that a flood would be considered sudden water damage. But, flood insurance is never covered under a standard homeowners insurance and one must buy a separate flood insurance policy to have coverage from a flood.
A common mistake that homeowners make is to find a small leak and ignore it. Then with time a burst pipe floods your kitchen. Now the homeowner calls in a water damage claim to their insurance company and when asked; when did the leak happen? The homeowner states. “I saw a leak about 8 months ago but it seemed harmless at the time”.
Unbeknown to the homeowner that statement just gave the insurance company a reason to deny the claim. Sure enough a week later you receive a letter from your insurance company denying your water claim. Reason: “leaking water over time is not covered.”
Perhaps the burst pipe that caused all the water damage is a totally different pipe that you observed with a small leak 8 months ago. (Gradual water damage is an example of something that is not covered under a homeowner’s insurance policy).
In this same example, lets say 8 months ago when you discovered the small leak you would have hired a handyman or run to the hardware store and repaired the leak (keep receipts) now you have a burst pipe and call in the claim. If the insurance company tries to deny the claim based on a “leaking over time” you can demonstrate that you were responsible and performed the required repairs and maintenance along with receipts.
If you are being denied any claim, make sure that you ask for a full explanation. You have every right to understand exactly what part of the policy wording excludes what you are asking for compensation for.
How to Avoid Having a Claim Denied
- Maintain records of repairs and the professionals you have hired over the years to do maintenance. This may become very important in the event of a loss, and is good practice to keep as a homeowner.
- Make sure you understand all the coverage’s on your policy, and have a good understanding of the exclusions, as well as your responsibilities as a homeowner.
- Do regular maintenance of your home to avoid surprises. Small repairs regularly will avoid large expenses.
- Know what is: Sudden and Accidental vs. Gradual and Over Time.
If you are convinced that your coverage should have applied, or that something is wrong, then you should consider getting a second opinion by a licensed professional. Call Cavalry Public Adjusters, LLC 305-898-7562 for a FREE consultation and policy review. http://www.cavalrypublicadjusters.com