Posted: 04 Jul 2012 05:45 Post Subject:
People who write ONE PARAGRAPH stories need to reconsider what they wrote, and how difficult it is to follow and respond. Having said that:
Mistakes #1 & #2: called the plumber. He discovered the broken shower arm, put in new one, and said we should file a claim and save the broken pieces to show the adjustor. He called a drying company to come out
Although he may have seen similar insurance claim situations, the plumber is not a licensed agent, and has no business giving insurance advice. He may have done the right thing to call a drying service, but that doesn't mean an insurance company will pay for it.
Mistake #3: the agent's assistant said a sudden loss was covered and gave me a claim and said go ahead and set up the fans etc and pay our deductible to the drying company
Probably not a licensed person and one who does not have any authority to make such negligent statements. But she may have exposed her employer to an ERROR & OMISSIONS claim that could pay for your loss.
Mistake #4: This all sounded like a covered claim to me and to the drying techs and plumber.
But who among all of you actually spent any time reading your insurance contract to see what is or is not covered? There is a difference between was "sounds like" and actually is a covered loss.
Mistake #5: The drying tech gave a referral for asbestos testing
Probably a good thing, but it needed to be done by the insurance company's adjuster if your loss was covered, not a "drying tech". What coverage does your policy provide for this?
Mistake #6: the drywall was found to contain asbestos (house built 1976).
Drywall is made from gypsum, not asbestos. Any asbestos would have been in the insulation, if any, inside the wall. Does your policy provide any coverage for asbestos?
Mistake #7: mold and mildew in the shower track, and misplaced tiles (above the shower stall) stall, indicated we've had an ongoing leak. The shower stall and tiles are not part of the claim
It doesn't matter that you are not making a claim for the shower stall and tile, it is someone's opinion that mold and mildew are evidence of a maintenance issue. Your policy does not cover those kinds of losses.
You stated: Our shower arm broke off behind the wall most likely while my young daughter was showering and Next morning my husband showered and noticed low water pressure, he thought maybe the sprinklers having been reset affected the pressure
I don't believe these are accurate statements. If the shower arm (I assume you mean the cheap pipe that sticks out of the wall and has a shower head on the end of it) "broke off", water would have been shooting out of the opening in the wall and your husband would have had a much different impression of the matter.
Your next statement One day the shower worked normally, the next day the arm broke right behind the wall, allowing most of the water to flow backward. is further evidence of a maintenance issue, not a catastrophic failure. This cheap piece of pipe does not bear weight, is not pressurized, and only breaks due to unusual weight (like a child hanging on it, or a husband grabbing and pulling on it) or from corrosion-induced fatigue. These chrome-plated pieces of metal are not typically made of corrosion resistant copper or stainless steel. They cost about $3 at Home Depot to purchase a replacement.
Instead, it sounds to me as though the shower arm -- was it as old as your 36 year old home? [probably] -- was corroded and suffered from corrosion-induced fatigue that ultimately resulted in material failure, not a "sudden bursting" under pressure. Water only flows through that piece of pipe when someone is showering, unlike the other constantly pressurized portions of your household plumbing, which could be subject to catastrophic failure.
Mistake #8: Mildew in the shower is not part of the claim. She claims our closet baseboard has mildew per the field adjustor photos, but it is just accumulated dust and dirt along the top of the baseboard.
I haven't seen the photos, so I don't know if this is your mistake or the insurance company's. But someone is mistaken. Again, mildew in the shower doesn't have to be part of the claim to be evidence of other issues. If there is mold and mildew on baseboards, that is evidence of accumulated and continuing moisture. [But I must say that I doubt that a photograph of "dust and dirt" would come close to resembling "mildew".]
Mistake #9: My guess is they are denying the claim because replacing part of the drywall will involve additional cost of asbestos abatement.
Insurance companies normally deny claims because the loss is not covered. Again, have you even read your insurance contract to know what is or is not covered? What does your policy say about asbestos? That also may not be a covered claim.
There is also lead in the vinyl floor under the tile, according to the asbestos tester
Could be true. About 5% of older residential vinyl flooring (sheet and tile) may contain some amount of lead. But your insurance is probably not responsible for the cost of its abatement.
I said I never felt any dampness in the carpet and she said "you would nor necessarily feel it" so apparently unfelt dampness that she is sure of can be a factor in the denial
It has nothing to do with what one may or may not "feel", it has everything to do with "catastrophic failure". None of us are expected to go around tearing out walls to see if something is leaking. And the insurance company is not going to pay for things that have been leaking for a long time either. There may or may not be visual or other physical clues to a long-term leak, but that still doesn't make it the insurance company's problem when you finally notice the problem. You have a contract that tells you what is and is not covered.
Mistake #11: I said water flowed behind the wall during the showering immediately soaking our carpet in the adjoining closet (yards away-the water first traveled under a tub). It was not a slow build up of dampness. It was not a leak but a flow. She said that the arm could have been leaking for months before it broke. I said if any breakage could simply be assumed to always be preceded by a leak that causes no noticeable dampness, then no water damage claim could ever be valid.
Now your emotions are running too high. And your insurance vocabulary is incorrect (not your fault, most folks don't have a good insurance vocabulary either). A "flow" is not the same as the policy language which probably states something like "sudden and unexpected discharge".
While your husband was showering under the misbelief that "low water pressure" must have resulted from a change in the sprinkler timer, water was "flowing" at the rate of 2-5 gallons PER MINUTE. A 20 minute shower could have meant that 20 gallons of water came out of the shower head and 80 gallons of water flowed inside the walls.
But if the piece of pipe has had a corrosion leak for several years, the water would have "flowed" out every time you, your husband, and your young daughter took a shower -- anywhere from a few ounces initially, to several gallons each time, before you finally realized there was a problem due to the 80 gallons of water in your carpet that "bubbled up around your feet" on that one day. That "flow" you speak of is a long-term "leak" in the insurance dictionary. Leaks are commonly excluded. Sudden bursting is covered.
Question #1: Will there be future mold damage if we don't replace drywall as recommended by the drying company?
Undoubtedly, the answer to this question is YES. And it could be TOXIC MOLD, which is probably excluded as a loss in your insurance policy, too. So, my advice is to replace all of the damaged drywall immediately. You also need to have the water-damaged lumber properly dried and treated to prevent rot, or replaced. This could very likely include any subfloor material that was saturated with water. Unless exposed and properly dried, it will rot. And that is definitely not going to be covered in the future either.
Mistake #12: I am actually more annoyed that the adjustor calls water damage a "matter of opinion" (in which she automatically wins) than about our loss.
If you believe the claims person's/adjuster's "opinion" is wrong, you can always ask for a second adjuster to reevaluate your claim. And you could hire a "public adjuster" to argue your claim with the insurance company on your behalf. You will pay that person about 10% of whatever recovery they obtain on your behalf.
Understand, however, that insurance companies don't just pay claims because you hire a public adjuster. They only pay claims which are proved to be covered by the contract they issued to you.
Now, having said all of this, most of which is not in your favor as far as your homeowner's insurance policy is concerned, the statement by your agent's "assistant" that a "sudden loss" is covered could result in coverage -- not under your homeowner's insurance policy, but under your agent's Errors and Omissions ("professional liability") insurance.
Mistake #13 would be not filing a claim against the agent's E&O policy. He has coverage for the negligent advice given by his employees. Don't make Mistake #13. Call the agent and ask for the name of his E&O insurer. File a claim with them and see what happens. You could recover up to 100% of your damages in that manner.
Posted: 11 Jul 2012 04:01 Post Subject: Broken Shower arm
I would hire a Public Adjuster, They fight the insurance company for the largest ammt possible.
I don't know what state you live in, but I'm licensed in Pa. & Md. If you live elsewhere call me I help you out the best way I can over the phone!
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