 My insurance policy, and probably yours as well, has special policy limits and deductibles for certain coverages. In particular, up to $5,000 for coverage when sewage backs up into your home through the waste lines and originates from the sewer system in the street off your property. This can certainly result in a nasty, smelly mess inside your home and possibly a great deal of damage that is not covered because of this policy limit.
Also, within this coverage there is a special deductible that gets applied which can be anywhere from $500 - $1,000. The coverage in your policy is usually worded like this: For an additional premium, we insure, up to $5k, for direct physical loss not caused by the negligence of any “insured” to property covered under Section I caused by: a. Water which backs up from off the “residence premises” through sewers or drains; or (b) Water which overflows from a sump event it such overflow results from the mechanical breakdown of the sump pump etc. Sometimes clients get confused with this language when they have a broken waste line or drain line which results in the kind of damage to your home caused by the overflow of contaminated water. It is important to know that the above policy language does not refer to damage caused from broken waste lines under your home nor the resulting damage it causes. This damage, unless specifically excluded from your policy or capped by a $10k water damage cap, would be covered and not limited by the $5k back up policy limit and deductible. For any questions regarding your policy and coverage please contact us here.
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We want to wish you all well during this very difficult time and hope you are all staying safe. We take safety precautions very seriously and make it a part of our normal course of business, not just for the Covid-19 virus or Flu season. This is a daily practice for us, both at home and during business.
As Emergency Orders are being issued in every county restricting business from operating, we are still open and running because it has been deemed that Public Adjusters are an essential business that may remain open as we provide services that are necessary to maintaining the safety, sanitation and essential operation of residences and other structures. As Public Adjusters, we routinely enter homes and businesses and are exposed to elements that can affect ones health such as mold, smoke and soot, damp moist conditions from a plumbing leak, sewage issues and even illness. We wash our hands regularly, keep disinfecting wipes and hand sanitizer on us at all times, wear masks and gloves when needed and also change clothes when needed. There are also times when we need to don our very fashionable hazmat suits. There have been many times when we arrived at a meeting to find out someone was sick. Oftentimes, people don't think to tell you because it may be minor to them, but it can be harmful to someone else or their family member. You really never know. It’s important during any time, and more so during this difficult time we are all faced with, to be mindful and think of others. Wash your hands regularly, sneeze into your arm, cough into your shirt and if you are not feeling well, honestly is the best policy to keep everyone healthy and safe. We are all in this together and we are here to help in any way that we can and our business is still open and running. If you have any questions about your insurance policy coverage for your business during mandatory shutdowns or still need assistance with an insurance claim, please contact us here or call us 561-288-6434.  We received a call about a leak in a bathroom and the homeowner asked if she should stop using the shower? We explained that it’s her responsibility under her insurance policy to prevent further damage to her property and she should stop using the shower immediately. Her reply stunned us for a minute when she said that her plumber told her to “go ahead keep using it, the damage is already done”.
An insurance policy is a contract with your insurance company and there are specific conditions that must be complied with or you risk the possibility of getting denied on your claim. Here are a few examples of those conditions:
Try to imagine the look on an insurance adjuster’s face if you told them what the plumber advised you to do. Lack of knowledge is no excuse for not understanding and knowing your responsibilities under your insurance policy. When we met with the homeowner, she said that the plumber did not know where the leak was coming from. After our careful and thorough inspection, we determined the cause was not covered under her policy and all she needed was a new tub and advised her against filing a claim. We previously discussed claims like this in a prior blog Not All Property Damage Is An Insurance Claim.  Mold. That ugly, smelly stuff growing on your walls and furniture. You see it and call your insurance company to report a mold claim. After all, you have coverage in your policy for mold/fungi so you should be covered right?
There are many causes for mold growth, especially living in South Florida where the climate is warm for most of the year. You come home from your 10 day vacation to find mold growing in your home and it is everywhere, including your furniture and clothing. You have no idea how this happened and call your insurance company to file a claim. The adjuster comes out to inspect the damage and boom, the insurance company denies your claim stating there is no covered cause of loss. You pay your insurance premiums so how can this be? Your policy says you are covered for mold, so what gives? What you do not realize is that you are only covered for mold when the mold is caused by a peril/loss that is covered under your insurance policy. What caused the mold? Is it humidity? Is it a plumbing leak that caused water damage to your home and then mold started growing? Did you have storm damage to your home where water entered and damaged the interior of your home and belongings which resulted in mold growth? There could be many reasons why this happened and the burden of proof is always on you to prove your damage and what caused the damage. Humidity, in and of itself, is not a covered loss. Water damage is often a covered loss, as well as any resulting mold growth, as long as it has not been going on for a period of time and the cause of the water has been remedied to protect your property from further damage. Your insurance policy covers damage that is sudden and accidental. However, some insurance companies exclude water damage all together resulting in no mold coverage. We get many calls regarding mold damage that ask “should I file a claim?” You first have to know what is causing the mold and if that cause is covered under your policy. Contract us here and we can help you understand what is and is not covered in your policy with our comprehensive insurance policy review.  isDocumenting the contents of your home and business is very important to do before you have an insurance claim. What are contents? Contents, also described as “personal property” in your insurance policy, or "business personal property" in a commercial policy, is everything that belongs to you that is not attached to the building. For example, if you turned your home or building upside down, everything that would fall out are the contents.
As previously written in our recent blog “Preserving Evidence of Damage Property”, the burden of proof is on you to prove the damage to your property. In this example, we are referring to your personal belongings and business personal property. Let’s say you have a fire or flood that also results in destruction or damage to the contents. Showing the condition of the contents and properly documenting them prior to the damage occurring is key to getting covered for these items. In cases where a fire loss has occurred, the contents may not be recognizable and the burden of proof is on you to prove what you had before the loss, as well as the condition and age of the item. It is never too late to properly document the condition of your property. We specialize in Pre-Loss Property Inspections and can relieve you of this tedious task. |
