Many types of damage from winter storms and frigid temperatures are covered by standard homeowners’ insurance policies. If you sustained property damage related to winter weather, here is what you need to know to successfully submit your claim and receive the coverage that you are entitled to under the terms of your policy.
What Policies Typically Cover
Read your homeowners’ policy carefully to understand your coverages and limits. Standard homeowners’ policies generally cover the home and its contents from losses caused by a broad range of winter-related perils, including snow, ice, hail, wind, frozen pipes or heating systems, and falling objects. For instance, if your roof collapses due to the weight of snow or ice, your insurer will generally cover the cost to replace or repair the roof. If a pipe bursts due to extreme temperatures, the policy will likely cover the cost to repair any resulting damage to floors, walls and furniture, as well as remediating any mold that built up due to the covered event. If a windstorm causes a tree to fall on your house, your policy will likely cover the cost to repair the damage.
What Policies Don’t Cover
All insurance policies have exclusions, and it’s important to understand your policy’s limitations and some of the common reasons insurers give for denying claims. Policies generally don’t cover losses caused by natural flooding, including floods induced by rapid snowmelt. Damage caused by excessive wear and tear to the home is also typically not covered. Insurers routinely deny or challenge claims when poor maintenance or preexisting damage causes or contributes to the losses. Notably, if a pipe bursts due to the homeowner’s failure to adequately heat the home or to turn off and drain the water in a vacant, unheated property, the insurer will likely use this as a reason to deny the claim. If your roof is damaged in a covered storm, but if it is 25 years old and/or had preexisting damage due to inadequate maintenance or pest damage, the insurer may deny your claim based on the excessive wear and tear exclusion or by claiming your negligence led to the losses.
Actual Cash Value vs. Replacement Cost
Many homeowners’ policies provide “replacement cost” coverage for the structure and “actual cash value” coverage for contents. Replacement cost coverage means that the insurance company is required to cover the cost to repair or replace destroyed property with property of similar kind and quality at today’s prices. Actual cash value coverage factors depreciation and normal wear and tear into the property value. For example, if you need to replace a 10-year-old appliance damaged by a covered event, the insurer will not pay for a brand new appliance of like kind, but will reduce the payout to reflect 10 years of depreciation.
Filing a Claim
Contact your insurance agent or the insurance company’s claims department as soon as possible to notify them that you will be filing a claim. Ask the insurance company representative to walk you through their requirements for filing a claim. Insurance companies generally have short deadlines for providing notice of claim following an event, as well as for submitting follow-up information. It is important to meet all of their requirements in a timely manner.
The insurance company will send a claims adjuster to the property and prepare an initial assessment of the damage. If the adjuster says something is excluded or subject to certain conditions, ask the adjuster to point to the policy provision that refers to this exclusion or limitation.
Document the damage yourself by taking photos or video of the outside of the home or impacted rooms inside. Do not discard any damaged items until the adjuster has finished the assessment. Create an itemized list of damaged items and their value, and gather receipts and other evidence where possible to support your claim. Save receipts for any out-of-pocket expenses you incur as a result of the damage.
If Your Claim Is Denied or Limited
If your claim is covered, your insurer will provide you with a settlement offer. If, however, your claim is denied, the insurer will notify you in writing and provide a reason for the denial.
If the settlement offer is lower than your own calculations, or if you believe the insurer’s reason for denial is without merit, you may appeal directly to the insurance company. Review your policy and carefully craft a response to the insurance company that provides a compelling, thorough argument of why you are entitled to coverage or a higher settlement. Include any additional evidence that will help support your claim. When confronted with new evidence, an insurance company has a good faith obligation to reopen a claim and reconsider its decision.
If your insurance company has denied or is challenging your property insurance claim, contact Schwartz Conroy & Hack. We have the expertise, experience and tenacity to make insurance companies keep their promises to you.
