by hummingbird » Sat Mar 01, 2008 03:35 am
My in-laws paid insurance premiums for years .Enough to add an addiction on to their house with the money. The had some damage to the floor of their kitchen which happened to be close to a water heater. When the agent looked at it he said it was from a water heater leak.They told him no, it had never leaked. So then he claims it was from water damage from water running under the house.he said it came under flood damage and they could not pay cause they had no flood insurance.So they had top fix the floor themselves.They ask the agent for flood insurance and he told them they could not get that because they did not live in a flood zone.I won't mention the name of the insurance company.My in-laws are the type of people who believe in turning the other cheek and will not fight or go to court for anything. My father in-law in gone now.
Posted: Sat Mar 01, 2008 06:19 am Post Subject:
It seems that the adjuster himself is not sure how to deny the claim. Please ask your in-laws to re-read their policy document carefully, especially the exclusion portion. It has the reasons documented under which the insurer can axe the benefits. The incidents of wrongful denial of claims by the insurers are not rare now-a-days.
Posted: Sat Mar 01, 2008 06:47 am Post Subject: How mean!
They ask the agent for flood insurance and he told them they could not get that because they did not live in a flood zone.
Sorry, I thought this is a problem while you're applying for a policy rather than while you're claiming for an approved benefit. These companies should be taught a lesson. Thanks, GeoffMorgan
Posted: Sat Mar 01, 2008 06:52 am Post Subject:
The standard homeowners insurance doesn't cover damages caused by seepage of water. Normally, they attribute it to the maintenance issue and blame the homeowner for negligence. And flood is also not normally covered under the homeowners insurance. I think the reason of the damage needs to get ascertain by an independent adjuster as the adjuster sounds to be uncertain with the actual cause.
Posted: Sat Mar 01, 2008 07:00 am Post Subject:
My in-laws are the type of people who believe in turning the other cheek and will not fight or go to court for anything.
While we apply for an insurance, we must make sure that we may need to run miles to achieve our benefits. Otherwise its not worth paying the premiums!
he said it came under flood damage and they could not pay cause they had no flood insurance.
I feel you should get the money either way in this case. If the home is not in the flood zone then how can he say that it was damaged by flood ? And if it is in the flood zone then you are entitled to get reimbursed.
Martha
Posted: Sat Mar 01, 2008 12:17 pm Post Subject:
If you don't live in a flood zone and it obviously was not caused by a flood,then my thoughts are that it should be covered, you said the hot water tank was not leaking right? Where do they think the water came from? What do they think caused the damage?
Posted: Sat Mar 01, 2008 03:47 pm Post Subject:
Your inlaws were told correctly. Most ho policys will maintain that the damage must be 'sudden and accidental' now if the water heater burst suddenly and spewed all over, likely would've been coverage, the policies will further exclude, 'gradual seepage, or deterioration'...such as a water heater, slowly leaking pipe etc.
Re: actual flood, again ho policys do not cover flood and will exclude that peril in the policy most include an exclusion re: underground water as well.
You inlaws can contact the government agency re: flood insurance, however, they may not be able to purchase it as the agent said because they aren't in a flood plain, and if they could, hold your hat, if you think the standard ho policy premiums are high wait till you see the flood policy premiums..
It's unfortunate when any claim has to be denied, however the perils are clearly laid out in the policys and they are not after all a 'catch all' or maintence policy. I understand this is hard to understand, and Joe Public has the opinion that 'by golly I paid this much in premium therefore if I turn in a claim no matter what the claim is, it should be paid'....I get that, however as I said, the policys are not 'catch alls'...so sorry, I know that isn't what you wanted to hear.
Couple of questions, was this an 'agent' or an 'adjuster' that inspected this. Secondly, there should've been a formal denial IN WRITING stating exactly why the claim was denied. Was the sourse of the water 100% found? If not it needs to be on many points, not the least of which is to make sure they don't suffer anymore damage.
Posted: Sat Mar 01, 2008 04:14 pm Post Subject:
OK, this is basically all the information I had. Like I said before my father in-law has since passed away but the coverage is still intact.To my knowledge the damage was cause by underground water coming up under the house and rotted out the floor and it fell in.Something that was not detected untill it was to late as it was unde the house. That past of the house was the original part of the house.The house was added onto 2 times.The other day the original part was removed.I don't think a lot of people bother reading thier policies.One thing they seems not to be written in layman's terms.I have not even read ours as the last time I read a policy it seem to be written in the all to familiar "run around term"...lol my pet name for jargon that the layman can't understand...lol I do think it was an adjuster that came may not have been. I was just wanting to tell about this as seems like a lot of people have that happen to them not always the insurances dault sometimes just a matter of not reading or understanding their policy.
Posted: Sat Mar 01, 2008 04:32 pm Post Subject:
You are correct in that policys are difficult to read, when a new adjuster starts most training programs have days devoted to just learning to read the policy. Many time, it give the coverage here then takes it away there. That's why places like this forum, and even your question are important, so people can gain some understanding of their policys...thanks
Posted: Tue Mar 04, 2008 12:38 pm Post Subject:
We recently tore down the original part of the house where the damage was.We are now in the process of repairing from that.I also noticed some water stains on the ceiling.No one is living there at this time.One stain in on the living room ceiling and the other there are 2 on the bathroom ceiling. Will the insurance pay for that? I heard that insurance won't pay if no one lives in the house. If that is the case what is the benifit of having it?
Posted: Tue Mar 04, 2008 12:45 pm Post Subject:
In truth they more than likely would've canceled the policy if no one lived there...perhaps wrote a dwelling policy only (which would be cheaper so you might want to look into it but no personal property coverage)...depends on what caused the leak....more than likely the roof, if it has hail or wind damage you might have a shot...need to have someone look at it and find the origination of the leak.
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