Most days we receive calls for help with insurance claims. That is what we do and we do it well. Our clients expect us to work miracles and we often do. But, we cannot produce coverage where coverage does not exist.
We recently inspected a home with water damage to the ceilings, walls and floors which were continuous throughout their home. There were also some damaged personal belongings in two adjacent rooms. The homeowners said that during a few days of heavy rains, their roof began leaking and the ceiling in one of the rooms had fallen down. They called their insurance company to file a claim and a company representative told them they were not covered for a roof leak and asked them if they still wanted to file the claim.
Unsure of what to do, they decided to hold off and contacted us for assistance. We reviewed their policy and this tricky language was as clear as day to us, “Windstorm or Hail. This peril does not include loss to the property contained in a building caused by rain, snow, sleet, sand or dust unless the direct force of wind or hail damages the building causing an opening in a roof or wall and the rain, snow, sleet sand or dust enters through this opening”.
However, in this particular policy, the language was not referring to the actual building damage caused by a roof leak, but was listed under the Personal Property section and referred to the damages to their personal belongings which were not covered due to this excluded language.
Luckily for this family, they are covered for the building damage. However, many insurance policies today do not cover water intrusion from a roof leak and use the same language above to exclude building damage from their policies.
Thought for the day … It is important to know what is in your insurance policy and what is not. We have extensive knowledge of insurance policies and offer comprehensive insurance policy reviews which is invaluable if you have ever had an insurance claim and found yourself with no coverage.
If you ever have an insurance claim and are expecting your insurance company to cover damage to your home or business, it is important to preserve the evidence. You need proof that the damage you are claiming actually happened, because the insurance company needs to see it in order for them to properly document the damage and pay the claim.
We as property and business owners, have several conditions noted in our insurance policies that we must comply with, for example, “Your Duties After Loss”. This section requires that you “make reasonable and necessary repairs to protect the property”, and also “As often as we reasonably require: Show the damaged property”.
Many times, when an emergency arises (like a broken pipe that floods your property) you are understandably in a panic and trying to salvage your property. If you call a mitigation company to dry out the property in order to protect it from further damage, they may have to remove damaged building materials. Protecting your property from further damage is a requirement in your policy.
Will your insurance company penalize you for doing this before they inspect the damage? Not necessarily if the damage is properly documented. When this is not done, it becomes a he said, she said, and the insurance battle begins.
Some policies also state “Except for emergency measures, there is no coverage for repairs that begin before the earlier of (a) 72 hours after we are notified of the loss, (b) the time of loss inspection by us, or (c) the time of other approval by us”.
The burden of proof is always on you, so make sure the evidence of the damage is preserved and not discarded and that you understand what you are required to do under your insurance policy.
After a long day at work, you come home to find water all over your beautiful floors and the water has traveled into many rooms of your home. The panic sets in and you grab every towel you own in an attempt to soak up the water but to no avail and have to call a professional company to remove the water and dry your property. You realize you have extensive damage to your floors, walls, baseboards, kitchen cabinets and furniture.
Of course, you trust that your insurance policy will cover the cost of the damages and the dry out bill. Why wouldn’t they? After all you pay your insurance premiums every year! Then the insurance adjuster arrives at your home to inspect the damages and you quickly find out that you have a $10,000.00 water damage limit in your policy.
In recent years, insurance companies have been placing these water damage limits in their policies to limit their payout on a water damage claim caused by a plumbing leak, air conditioning leak or broken pipe. Unfortunately, this limit also includes the cost to dry out your property.
In a situation like this, it is truly a catch 22 because you are required to protect your property from further damage as per your insurance policy, yet it could add up to be costly and eat away at the $10k limit, leaving you with limited funds toward repairing your property. This same scenario above happened to a prior client of ours. The cost to replace the pipe itself is never covered, but the cost for a plumber to access the pipe is covered, and also falls under this limit.
If your home was built in the 50’s or 60’s and has cast iron pipes, your insurance company may require that you replace all the pipes with PVC before they will continue to insure your property. They may place a $10k water damage limit in your policy or they may exclude water damage coverage all together.
It is important to understand and know what is in your insurance policy. That is why one of our comprehensive policy reviews is so valuable. When you know and understand what is actually in the policy you pay for, it gives you the opportunity to shop for a better policy before disaster strikes and you are left to pay for expensive damages that are not covered.
Those of us who live in communities with homeowners associations are familiar with the dreaded letter informing us that our tile roof and/or driveway needs to be pressure cleaned within 30 days. In some cases, this helpful information comes with threats of fines, ouster from the community pool or other horrible social banishment.
At least every week or so in my community, I see a person on a roof with a large circular sidewalk wand moving it over the tiles, washing away the discoloration and restoring the appearance of the roof to its former brilliance. What goes unobserved are the cracked and broken tiles left behind. Sidewalk wands are named that because they are meant to be used on sidewalks and driveways, not on tile roofs!
Another thing that can cause damage during roof cleaning is the person walking on the roof. An inexperienced or careless worker can cause a great deal of destruction. Broken and cracked tiles occur by stepping on the curved portion of barrel tiles instead of the flat parts. I have inspected many roofs with damage like this where there has been no storm activity and the only people to have accessed the roof is the pressure cleaning company.
So, what do you do? There are roof cleaning companies that do not use destructive methods. Several use a chemical process that is environmentally safe, to wash away the dirt and grime. Do your research. Ask questions. If possible, hire someone that a friend or someone you trust has used and is pleased with. Don’t hire just anyone that knocks on the door and gives you a low bid. It may cost you big time down the road.