Why Florida Water Damage Claims Are Denied

Many people think that water damage to their homes caused by burst pipes, leaks, storms or sewer backup is automatically covered by their insurance policies. When their insurance claims are denied, they are then very upset and disappointed.

Given the prevalence of water damage claims in Florida, it is probably worthwhile to examine the reasons why many of these claims get denied.  After all, knowledge is power, and you’ll be much better prepared to navigate the claims process and obtain fair payment for damage that should be covered if you understand your policy better.

Florida Homeowners Policies Do Not Cover Flood Damage

Standard insurance policies exclude water damage caused by flooding, defined as water that has been on the ground before entering a building. This includes flood water caused by storms, overflowing bodies of water, runoff of surface water, mudflow waves, tidal water, and spray from flooded areas or bodies of water, even when caused by the wind.

Coverage for flood damage requires a separate flood insurance policy. If you live in a high-risk area in Florida, you are required to have flood insurance. People who live in other parts of Florida should also consider flood insurance because of the significant damage floods from hurricanes and other storms can cause to buildings in areas traditionally considered moderate and low risk.

Gradual Water Damage Is Usually Not Covered

Insurance policies usually cover water damage caused by a sudden, accidental event, such as overflow of water or steam from a part of the plumbing, heating, air conditioning, or fire protection sprinkler, a burst pipe inside the building, or a malfunctioning appliance. However, typically, policies exclude the appliance itself or damage caused by water that enters your home through sewers, drains, or sump pumps.

Policies also typically exclude damage that happened over a period of more than 14 days.  For example, damage that occurred because of seepage from a leak in your roof would probably not be covered because the property owner is supposed to fix issues such as leaky roofs in a timely manner. A more ambiguous situation occurs, however, when an appliance or pipe leaks but the property owner doesn’t discover the leak until damage is noticeable. If your insurance company thinks the damage occurred over more than 14 days, they could deny your claim.

Common causes of gradual water damage include faucets, plumbing, or pipes, or parts of a roof deteriorating over time. Good maintenance of a home, appliances, and systems can help you avoid this, but even a careful homeowner can be caught by surprise with water damage that has gone undetected, either because it was hidden or because you were away from the home for a while.

Sewer and Sump Pump Backups

Water that backs up into your home from sewers or drains can be very unpleasant, unhealthy and damaging. However, the damage is excluded from most homeowners’ policies.

Many homeowners are also surprised to discover that damage from overflowing sump pumps or any system designed to remove subsurface water from a building’s foundation area is not covered, nor is damage from water below the surface of the ground. Since overflowing sump pumps and sewer and drain backup can cause thousands of dollars in damage, many homeowners opt to add special coverage to their policies.

Handling a Water Damage Claim

You can help to avoid water damage to your property with careful home maintenance. However, even the most careful homeowner can be caught off guard by sudden or hidden leaks, breaks and storms. If this happens, you need to file a water damage claim.

It’s a good idea to make sure a water damage claim is as complete as possible, with pictures of the damage, receipts for damaged property, and maintenance records, if possible. It’s also a good idea to be informed about how to handle the situation if your water damage claim is denied.

If your claim is denied, you should ask for an explanation. Since several different insurance company people can work on your claim, it’s important to understand who made the decision to deny payment and the basis upon which that decision was made.  If you are not satisfied with this explanation, you can always ask for a second opinion.

If you believe you should have been covered for the damage and your insurance company is standing firmly behind their denial, a Florida insurance claim dispute attorney can help. An experienced insurance dispute attorney has the knowledge, skills and experience you need to negotiate and win a fair payment for your water damage claim.

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