“It’s NOT covered”

There really are no worse words a homeowner who carries insurance can hear. Let’s be honest. The first thing you think is “well why do I have insurance in the first place?” As an insurance agent my heart breaks because even though we review coverage’s etc. when you purchase a policy… in the time of a claim it’s almost as if it all goes out the window.

There are not a ton of instances where a homeowner’s claim wouldn’t be covered, however the big one in which I am going to cover today is Home Maintenance/Wear and Tear.

Scenario 1:

Joe has been a long time customer of Insurance Carrier A. They are hit by the Arizona monsoons and notice a leak coming in down their wall and head in further to investigate. Once they move closer they feel wet carpet and have no idea how long it has been there. After filing a claim with their independent insurance agent, the claims adjuster notices that Joe’s roof is missing a lot of shingles, is 28 years old, and hasn’t been maintained. The claims adjuster agrees to pay the damage caused by the leaky roof however will not cover the cost to repair/replace the roof.

So why is the damage covered but not the roof?

In this specific situation this insurance carrier was generous with covering the damage caused by the loss. However, not all insurance carriers do this. You will want to check on your policy specifically with your agent to make sure your policy covers this type of damage.

Part of the wording in an insurance document explains that in laments terms.. “you hold up your end of the bargain and we will hold up ours”. If you knowingly do not maintain your roof, maintenance it when needed, or do what is necessary then we cannot provide coverage for negligence.

Ways you can prevent this from happening to you:

–  Inspect your roof once or twice a year depending on the roof’s visibility

–  Climates and weather conditions cause different types of wear and tear on a roof. Understand what your area recommends for inspection and do it.

–  Flat Roofs require more maintenance. You will want to make sure you are inspecting flat roofs a few times of year and also their coating.

–  Make sure you are keeping trees and other shrubbery off the roof of your home, by doing this you are helping prevent a loss. The best thing you can do… prevent.

–  Contact a local roofer to make sure your roof doesn’t need additional maintenance.

Scenario 2:

Mary has been a client of Insurance Carrier B for years and has had a water loss in her master bathroom. After filing a claim with her independent insurance agent they discover that Mary has polybutylene piping and that is the main cause of the water damage. Pipe Burst. Mary, has a wonderful insurance policy and they will also cover the majority of the damage to the home caused by the pipe burst. However, the insurance company explained to Mary that they would not pay to re-plumb her home.

Why didn’t the insurance company pay to plumb her home and remove the poly pipe?

As a homeowner home improvements would be made by the homeowner. The key here is preventing negligence. If you know you are having problems with your poly piping, it is your responsibility to fix and alleviate the problem.

As a side note you need to make sure that your policy would cover damage caused by pipe burst. Some insurance policies are very specific and can exclude polybutylene piping. Check with your agent as soon as possible to make sure you are covered.

Scenario 3:

Kevin just purchased a brand new refrigerator and it is working wonderfully. 3 weeks after having it the ice machine stops working. Come to find out the manufacturer has gone out of business and he isn’t able to get a new refrigerator. Kevin calls his insurance agent hoping to find out his insurance will cover the cost of the new fridge. His agent informs him it will not be covered by his insurance policy.

Why?

– What Kevin is looking for is a type of “home warranty” policy.

– Mechanical breakdown and maintenance of appliances are not items covered on a homeowner’s policy.

– If you are looking for home warranty policies, your best bet would be to hop online and search for a plan in your area. Here are two that many clients of mine have had success with.

American Home Shield

Select Home Warranty

These are just a few samples of some circumstances that can leave you feeling vulnerable during a claim scenario. Here are a few things to remember if you are faced with a “loss” and need some advice or help.

Use your insurance agent

That is why we are here. This is OUR JOB! Call us, ask questions, and we will also help you start the claims process if need be.

Find a reputable restoration company

I cannot explain how important this is. The restoration company is crucial in helping you become whole again after a loss. They also play a vital role in making sure things are covered on your homeowner’s insurance policy by working closely with a claims adjuster. If you need a good referral call your insurance agent immediately.

Most insurance companies offer a “Preferred Provider” list that can help point you in the direction of a good restoration company that they have had experience with.

Report claims in a timely manner

What I mean by this is if you notice an issue… report it. If you have water in your home and you notice it 3 months ago but do nothing to fix it, that doesn’t help the insurance agent go to bat to provide you coverage for Mold (side note Mold is typically excluded from homeowners insurance, be sure to check with your agent). You are being a negligent homeowner by doing nothing to fix it.


Be a responsible homeowner

You purchased a home knowing that there would be times that you had to pay out of pocket to fix some items or maintain them. Do it.

As a homeowner myself I know that there are times where you wish you could snap your finger and something would be fixed. However, just like an insurance policy wouldn’t cover the cost of you painting your shutters… it won’t cover items that should also be maintained by the homeowner.

If you have questions or concerns about anything on your home policy I would encourage you to reach out to your independent insurance agent, or our agency.

We would love to help you through life’s unplanned grey areas.