Water Damage from Rain - Through Hole in the Door

by rseth123 » Mon Mar 26, 2012 09:54 pm

Folks:

I bought this house last may. There were 2 inspections done in the house around that time. One inspection was before the purchase and the other was by insurance company.

Water came in through the door from the bedroom door which opens to the deck. So the way we found it was that last week my wife was sitting downstairs and found a drop of water from the ceiling. We went upstairs, ripped carpet base boards, drywall. Found mold on subfloor, drywall and around it.

My insurance may deny my claim (adjuster is coming tomorrow) that because of my negligence (which i dont believe as we informed then as soon as we found). This was the first set of rains in the house and their guy also inspected the house. So if we missed it then how come their guy missed it too.

Need advice on what to talk to the adjuster and is there any hope of a claim?

House is 2003 constructed and we are the 2nd owners. I also filed a report with builders and they are coming next week.

Total Comments: 8

Posted: Mon Mar 26, 2012 11:00 pm Post Subject:

My insurance may deny my claim (adjuster is coming tomorrow) that because of my negligence


If it's a homeowners policy then it would be denied as it's flood, which is excluded under the homeowners policy.

Posted: Mon Mar 26, 2012 11:04 pm Post Subject: Update

Is it not possible that something got broken because of rains or windstorm which resulted into this one?

Posted: Mon Mar 26, 2012 11:07 pm Post Subject: Addition Update

I read this somewhere "Typical homeowners insurance policies will cover damage by water that occurred before said water comes in contact with the ground. For example, a heavy thunderstorm that leaked through a faulty window and damaged walls and flooring would likely be covered by a homeowners policy." So in my case it is faulty door. I am trying to question you to be better prepared for adjuster. I hope you will understand

Posted: Tue Mar 27, 2012 04:45 pm Post Subject: Quick Question

When the reason of damage is not conclusive. E.g. there is a small hole in the door frame and stucco and adjuster was not confident whether it is because of rain/wind or not. So in this case do they favor homeowner or insurance company?

Posted: Tue Mar 27, 2012 08:24 pm Post Subject:

I don't see where 'Flood" would come in to play with this claim at all so I would not concern myself with that as it does not meet the definition of a flood as per the NFIP. You have a couple of different things going on here.
1. Hole in Stucco: In order for this to be covered you would need to be able to tie it to a wind or some other event that would or could have created this penetration. In the event that it may have just 'created' itself over time this portion of the claim will be difficult to get paid as you do need to have an occurance.
2. Your interior water damage: Now every policy can be a bit different here as some will have exclusions for rain or storms unless they create a breach in the building envelope, however, I do not see that exclusion very often. You will want to read through your policy to see if it has any of that language in it. Another issue that may arise when dealing with the interior water damage is if it was "long term" damage or again was there an occurance.
If there was a slight crack or small hole in the stucco you may not have gotten any water behind it for months or even years until there is a big rain/wind event. In this case the 'event' created water intrusion and in most cases I would feel it should be covered.

My recommendation is to read your policy and ALL endorsements to see what exclusion may apply to your case. If you are not happy with the outcome I would recommend finding a good Public Adjuster in your area to review your claim. Most public adjusters will offer you a free consultation and only get paid if they are able to assist you in recovering money from the insurance company.

Posted: Tue Mar 27, 2012 09:02 pm Post Subject: Sorry Greg my phone died and some reason contacts were not c

Here is the exact wording from my policy and I have been claiming it on wind but insurance guy told me that this seems to be faulty installation

We provide limited coverage for direct physical loss or damage to covered property from direct contact
with water, but only if the water results from:
(1) the build-up of ice on portions of the roof or roof gutters on a building structure;
hail, rain, snow, or sleet entering through an opening in the roof or wall of a building structure
only if the opening is first caused by damage from the direct force from the following;
(2)
i. fire;
ii. lightning;
iii. explosion (other than nuclear explosion);
iv. riot or civil commotion;
v. aircraft or vehicles;
vi. vandalism or malicious mischief;
vii. collapse of a building structure or structural part of the building structure;
viii. falling objects; or
ix. windstorm.

Posted: Tue Mar 27, 2012 09:15 pm Post Subject:

Ok, you do have the language I was speaking of in your policy. At this point I would sit tight and wait to see what they do. If in fact you do get a denial letter please let me know what it says. Did they state that they are planning on sending an engineer to inspect your property?

Posted: Tue Mar 27, 2012 09:19 pm Post Subject: Response

They mentioned that they are planning to send a general contractor (who they believe is an expert in this area) to evaluate the situation and explain them whether this is wind damage or not. They also mentioned that I can hire my own contractor and if my contractor opinion is different than their then they will go with the 3rd one. It seems like hit or miss to me at this point :(

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