HomeHome InsuranceThe One Word That Could Sink Your Home Insurance Claim

The One Word That Could Sink Your Home Insurance Claim


When Hurricane Ida hit New Jersey in 2021, Maureen Black’s sump pump failed and her basement filled with water. She immediately called her insurer, expecting to use her $5,000 coverage for sump pump failures.

But while Black maintained that the sump pump failed, she noticed the adjuster kept repeating that the basement had flooded.

“I felt like she was trying to trick me,” said Black, a paralegal manager and director of legal operations for People Inc. “I got the sense she was trying to get me to say ‘flood’ so she wouldn’t have to cover it.”

She was right to be cautious. Insurance companies draw sharp lines between different kinds of water damage. If you say the wrong thing, your claim could get denied.

Key Takeaways

  • Reporting that you experienced a flood when filing an insurance claim may lead to a denial.
  • Standard homeowners insurance may cover water damage from broken pipes or, if you have the proper endorsement, sump pump failure, but not from flooding caused by surface water or rising water.
  • If you’re unsure, err on the side of caution and let the insurance company adjuster determine the exact cause of the water damage. 

When a Flood Isn’t a Flood

Most homeowners insurance doesn’t cover floods. You need a separate flood insurance policy to protect your home and belongings from floodwater.

But not all water in your home is a “flood,” at least in an insurance company’s eyes, said Chris Aldrich, a licensed public insurance adjuster and president of Andrew K. Knox and Company in New Jersey. 

“When you say ’flood’ to an insurance company, they automatically think of a National Flood Insurance Program policy, which is a very specific insurance policy,” Aldrich said.

Flood damage is specifically excluded from coverage in a standard homeowners insurance policy. That’s why homeowners need to be specific about the source of the water if they can, said Bob Passmore, consumer lines expert for the American Property Casualty Insurance Association (APCIA), a trade association.

“For example, if the water is coming from a broken pipe, a leaking dishwasher, up from a basement drain, or even from a toilet, those could all be covered losses,” Passmore said. “If it’s coming through the walls or from surface water outside the house, you’d likely need a flood insurance policy.”

But that kind of precision isn’t always possible for homeowners caught in the chaos of a drenched basement. Aldrich recommends a more cautious approach to avoid unintentionally using disqualifying language. 

If you don’t know the source of the water, Aldrich said it’s a safe bet just to say you have “water damage,” and let a professional come out and identify the exact cause.

For Black, not saying “flood” paid off. The insurance company covered almost half of the approximately $10,000 in damage the water caused.

Warning

If you do know the source of the water, don’t lie–in fact, you should never lie to your insurance company. Misrepresenting the cause of damage on an insurance claim can be considered fraud, which is illegal.

What to Say (And Not Say) When Talking to Your Insurer

When your basement is under water, your first instinct might be to say it flooded. But if you don’t have flood insurance, this phrasing could hurt your chance of a successful claim. Here’s how to improve your odds:

Do

  • Say you have “water damage,” especially if you’re unsure where the water came from.
  • Let the adjuster determine the cause. An in-person assessment is a typical part of the claim process, so there’s no need to speculate on whether the water came from a burst pipe or sewer backup. Just describe what you see.
  • Document everything. Take photos, keep receipts, and write down whom you speak to and what was said.
  • Read your policy. Check if you have coverage for sump pump overflow or sewer backups and note the dollar limits.

Don’t

  • Say “flood” unless you’re sure. Floods are explicitly excluded in most homeowners policies.
  • Assume denial is final. If your claim is denied, a public adjuster can often review and appeal your case.

Tip

Claims handled by public adjusters often result in higher insurance settlements, but adjusters typically take a percentage of the payout as their fee.

The Bottom Line

Telling your insurer that your home experienced a flood may result in a denied claim since standard homeowners policies don’t cover flood damage. Experts suggest using broader language, like “water damage,” unless you’re sure about the source. Your policy may cover damage from internal issues like a burst pipe and–if you have a rider–sump pump failure. However, never lie about the cause of damage. That could be considered fraud, which is illegal.



Source link

latest articles

explore more