What’s covered in a water damage claim and how to maximize it

Business News | 28 Jun |

One of the most common causes of home insurance claims is water damage. According to a report by the International Organization for Standardization (ISO), water claim damages are the second largest and most frequent insurance claim after wind and hail damage. The numbers of water damage claims have also been increasing, whereas other causes of damage remained fairly consistent or decreased. It’s hardly any surprise then for people to become naturally curious about water damage, what’s included in their homeowner’s insurance, and why “gradual damage” claims are not included.

TYPES OF WATER DAMAGE

There are several types of water damage claim that may be included or excluded in a homeowners policy. For example:

• Overflow

• Flood

• Sudden or Accidental Discharge

• Sewer or water backup

• Storm-related damage covered by insurance

WHAT KIND OF WATER DAMAGE DOES A HOME INSURANCE COVER?

As a homeowner, you might be wondering what your home or renter insurance covers for water damage.  You might want to know whether:

• Water leak is covered by home insurance

• Leaking toilet is covered by insurance

• Water damage claim from a leaking roof covered by insurance

The answer to these questions depends largely on the kind of policy you have, source of damage, and whether or not the water claim is sudden or gradual.

It should be noted that gradual water damage is usually not included in most home insurance coverage, so even though your policy cover water damage, if the reason for the damage is not accidental or sudden, it might not be covered.

GRADUAL DAMAGE: WHAT IS IT?

Gradual damage is described as damage to property that that happens slowly over time. A good example of a gradual damage is like paint chipping off the wall. It starts small, but eventually grows bigger until the entire wall’s paint is undone. Gradual water damage is a common problem plaguing home insurance claims.

WATER DAMAGE AND GRADUAL DAMAGE AT HOME

Without proper maintenance, key areas in our homes deteriorate and fall apart. Anything could go wrong under the surface, and you would never know it until the damage becomes very obvious. When this happens, we try and make a claim.

If the damage is caused by a long-standing problem that you were unable to detect, you will have some problem making a claim or worse, your claim might get denied.

EXAMPLES OF GRADUAL DAMAGE

Some examples of gradual damage are:

• Mold, rot and/or corrosion

• Deteriorating electrical wires

• Plumbing, faucets and/or pipes leaking over time, damaging the walls, floors and ceilings as a result

• Flashing, tiles, shingles or damaged parts on the roof that showed signs of needed repair

• Water damage from seepage coming from cracks in the foundation, or at the exterior of the house letting water into your home

• Poor or lack of home repairs

It’s not always easy to understand why a water claim gets denied. However one of the most popular reasons as to why this happens is when you try to make a claim for something that you think suddenly appeared, but is actually the result of something that has been going on for years.

Generally, insurance is meant to cover accidental and/or sudden damages. By definition, this refers to damages that are not the result of damage over time.

WHEN DO INSURANCE COMPANIES COVER GRADUAL DAMAGE?

It’s easy to figure out what an insurance company includes and will not cover based on the wordings on the contract or policy. If you have any questions regarding the coverage, it would be wise to consult with your insurance advisor, agent or broker. You might want to review the exclusions of the policy as well as the types of coverage you’re entitled to.

WHY WAS YOUR WATER DAMAGE CLAIM DENIED AND WHAT CAN YOU DO ABOUT IT?

First things first: if your insurance company denies any of your claims, be sure to ask for a full, comprehensive explanation. You have every right to understand exactly what part of the contract or policy excludes you from compensation for your claims.

It’s important to note that there are several people representing the insurance company during a claim. Therefore it would be wise for you to understand where the decision is coming from. Was it a contractor, insurance adjuster or your agent who told you? Each of them plays a different role. Don’t be afraid to ask for clarifications to avoid miscommunication. Normally, you would receive a letter advising you of the official decision in case a claim is denied.

If you still understand the reason why something is not covered, and you feel that there’s a chance for the company to review your situation, don’t be afraid to speak to your agent or representative and request for a review or a second opinion. Claims can be stressful, so it’s completely understandable why some things are not expressed clearly on either side. There’s nothing wrong with wanting to make sure you understand everything completely.

WHY WERE YOU DENIED COVERAGE?

If you believe your coverage should have been approved, or that something is wrong with the decision, consider getting a second opinion from a licensed professional or organization that specializes in consumer advocacy

Your insurance company may also have an ombudsman who can assist you in reviewing your claim. Another option is by contacting your state insurance commissioner for guidance or for filing a complaint.

HOW TO AVOID GETTING YOUR WATER CLAIM DAMAGE DENIED

• Keep records of repairs and professionals you’ve employed to do maintenance over the years. Not only is this important in case of a loss, it’s also a good practice as a homeowner.

• Have a good understanding on what your policy covers and excludes, as well as your duties as a homeowner

• Conduct regular maintenance on your home every spring and fall. You can avoid unnecessary large expenses in the future with regular small repairs. 

• Purchase the best insurance for your needs; ask about extra coverage you can add.

MAXIMIZING YOUR WATER DAMAGE CLAIM

It’s extremely important to know how you can maximize water damage claim. You’ll thank yourself for getting homeowner’s insurance once your plumbing starts leaking or your ceiling starts dripping. You’ll be covered for all damages when you make a water claim—right?

This is partly true. Although most homeowners do get this coverage, insurance companies are bent on keeping your claim amount low. Don’t worry. Follow the tips below to maximize your water claim and get the coverage you’re owed.

1. CONTROL THE DAMAGE

Once you find out that you have water damage, take all the necessary steps to limit or control it. If not, your insurance company will rightfully decline any or your entire claim, for the reason that you didn’t intervene.

The actions you cantake depend largely on the kind of water damage you have. If you experienced a windstorm that broke your windows and let water in, board your windows up. If you are experiencing a plumbing leak, turn off the water to the house. For roof leaks, put up a tarp to block rain temporarily.

Remember to avail the services of professionals (plumbers, restoration specialists, roofers, etc.) as soon as possible. They might have an idea of actions you can take to control the damage, and they can get started on repairs too. But, it might not be a good idea to sign off on major repairs unless your claim has gone through, since there’s an off-chance your insurance company might not approve the full-repair amount. If you opt to wait, get an estimate you can show the water claim adjuster.

It’s also important that you don’t throw any of the damaged items out yet. Keep water-damaged items (and debris) in plastic bags or containers so you can present physical proof to the water claim adjuster.

2. KEEP EVIDENCE

In order to assess your water claim, your insurance company will require you to present evidence. Fortunately, it’s easy to document evidence with our smartphones. Take photos of all the damage thoroughly. Include anything and everything you think could have been the cause of the damage.

If you can, do take videos to support the photo evidences too. It might not be easy to be as thorough with videos as with photos, but videos are more convincing and provide a better look on the damage that photos aren’t able to capture. In case you have to take your water claim to court, videos would be pretty useful and not to mention illustrative. Pro tip: describe what you’re seeing while you’re recording.

Besides photo and video evidence, written evidence is also important. Create a list of what was or were damaged, including each item’s value and projected replacement costs. If you’re unsure about the pricing, your restoration experts can provide you with valuable insight on the value of a piece of furniture or items.

Have the professionals you’re working with assist you with creating quotes and reports explaining what happened and how much it will cost to fix the damage. Professional plumbers and roofers should be familiar with this procedure. Don’t forget to keep your receipts if you opt to pay up-front for any quick repairs.

3. REPORT IT

For this step, all you have to do is to contact your insurance company. Don’t put off doing this, or you’ll risk your claim. Even if you’re okay with making the repairs yourself, calling your insurance company will save you a ton of headache later on. If you’re unsure whether water damage claim is covered by your policy, still try to make a claim. The insurance company will inform you if you’re not covered, and there’s no fine or penalty for asking.

You’ll probably be asked about your policy number, so pull it out before you make the call. You’ll be instructed to fill up a “proof of loss form.” Make sure you ask them to send you a copy (preferably by email) or ask them where the form can be found online so you can print it out.

If you feel like the entire process is too complicated for you, or you don’t have time for it, your restoration specialists can do it for you. They have lots of experience handling claims of all types.

4. WHAT KIND OF DAMAGE IS IT? FLOOD OR WATER?

Flood damage and water damage are two completely different things to an insurance company. Floods are caused by nature and affect more than one home (with exceptions for large rural properties). Water damage, on the other hand, involves everything else from leaking HVAC equipment and broken pipes.

Although majority of homeowner’s insurance policies cover water damage, NOT ALL cover flood damage. Be sure to check with your insurance company the type of damage your home has experienced so they can enlighten you on the process, guide you to the right forms and provide you with the right coverage.

5. HIRE A PUBLIC WATER CLAIM ADJUSTER

Water claim insurance process can be slow and time-consuming. Your insurance company only has 15 days to send a water claim adjuster, who will evaluate the extent of the water damage. It’s actually a lot better to hire a public water claim adjuster if you can, especially if you have a large claim. Why? Because public adjusters aren’t tied to the insurance company, so they’re unbiased and focused only on finding the truth , rather than minimizing the insurance company’s payout.

6. AVOID USING INSURANCE COMPANY VENDORS

After assessing the water claim, your insurance company is given another 15 days to decide whether your claim is legit or not. If they approve some or the entire claim, they have another five days to transfer the payment to you.

Within this period, the insurance company may try to convince you to use their vendors. Your insurance company will have their own team of roofers, plumbers and restoration experts. However, these people get their work through the company, so it would be hard to get an unbiased assessment from them. When making a claim, you’d want to have someone on your side, so choose professionals you trust to make the repairs.

If you’re worried about maximizing your water claim alone, you can always ask the assistance of professional water claim adjusters. They’ll be able to handle your claim in your behalf, from beginning to end.

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