Making Home Insurance Companies Pay for Damages

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zemus

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Hey guys, was hoping someone has tips for how to make a home insurance company pay for damages.

Long story short, I have a rental home which has been rented out to a tenant for the past 2 years. They recently moved out and when inspecting the home I found a few areas in the ceiling that have a little water damage that was not there originally.

The sheet rock in the ceiling will need to be cut and replaced (not a big deal), but I suspect the roof also needs to be replaced as it is about 12 years old. I guess it's possible the damage could also be caused from a leaking pipe, i'm not 100% sure.

Anyone know the best way to file a claim and make this happen? I don't know the root cause of it, but my policy doesn't cover basic 'wear and tear' type repairs. Not sure if this actually is from wear and tear, but I'm sure the insurance company will claim that so they don't have to pay anything.

Thanks,
 
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KDow

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Hey guys, was hoping someone has tips for how to make a home insurance company pay for damages.

Long story short, I have a rental home which has been rented out to a tenant for the past 2 years. They recently moved out and when inspecting the home I found a few areas in the ceiling that have a little water damage that was not there originally.

The sheet rock in the ceiling will need to be cut and replaced (not a big deal), but I suspect the roof also needs to be replaced as it is about 12 years old. I guess it's possible the damage could also be caused from a leaking pipe, i'm not 100% sure.

Anyone know the best way to file a claim and make this happen? I don't know the root cause of it, but my policy doesn't cover basic 'wear and tear' type repairs. Not sure if this actually is from wear and tear, but I'm sure the insurance company will claim that so they don't have to pay anything.

Thanks,


You have it pretty much right. If you can find a burst or leaking pipe you might have a shot but unless there was a specific event that caused the roof to leak they tend to chalk it up to deferred maintenance / wear and tear and will deny.

Still worth giving it a shot though.
 

zemus

Trakanon Raider
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That's what I figured. The thing is though, it could have been caused by a storm or the winter freeze, and the tenant just never told me about it. It happened sometime within the past 2 years, they just never told me when.
 

Captain Suave

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Filing a claim like this is highly likely to result in your insurance policy getting more expensive. You should do the math out on self-funding the repair vs paying escalated rates. (Also, find a tenant who will keep you notified of maintenance problems.)
 
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Gravel

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Filing a claim like this is highly likely to result in your insurance policy getting more expensive. You should do the math out on self-funding the repair vs paying escalated rates. (Also, find a tenant who will keep you notified of maintenance problems.)
Home insurance is a scam in my opinion. Because no matter what you claim, your premium will go up to make it cost prohibitive to not just pay out of pocket. Essentially making it only useful for catastrophic damage.

We were talking with our real estate agent and apparently the thing here in Florida is a roof replacement policy; essentially that you have to replace the roof on the insurer's timeline, regardless of whether your roof needs replacement. So a 30 year roof typically becomes a 20 year roof that you have to replace or they'll cancel your policy.
 
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Captain Suave

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Essentially making it only useful for catastrophic damage.
Honestly, catastrophic protection is what insurance SHOULD be for, of all kinds. The whole point is to spread costs over a group that would otherwise bankrupt an individual. The idea that insurance pays for your routine dental checkups (or in this case regular roof maintenance) is just stupid. There's no value to you in hedging against outcomes that are guaranteed to happen over reasonable timeframes. At that point you're outsourcing your cash flow management to the insurance company at a premium. This is why HDHP policies are categorically cheaper than the alternatives with comparable benefits; you're (partially) taking back that responsibility.
 
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Khane

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Ugh, tenants who dont report major issues like this to you. I'm getting PTSD thinking about it. If it's just a minor roof leak and there's no black mold it's likely coming from a worn chimney flashing or attic vent boot and the repairs wont be expensive. Both of those things are relatively cheap to fix. This literally just happened to me at my rental property during Ida. $175 to fix the vent boot and then just a simple sheetrock job to fix the water damage in the ceiling in that one small spot.

I'd recommend calling a few more roof contractors before deciding its definitely a full roof replacement. And no insurance company will cover that unless you can prove it was faulty material and/or workmanship. And even then its unlikely.

Not even cheap asphalt shingles should fail after 12 years. If you know what type of shingles they are you should check manufacturers warranty
 

Dr.Retarded

<Silver Donator>
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Hey guys, was hoping someone has tips for how to make a home insurance company pay for damages.

Long story short, I have a rental home which has been rented out to a tenant for the past 2 years. They recently moved out and when inspecting the home I found a few areas in the ceiling that have a little water damage that was not there originally.

The sheet rock in the ceiling will need to be cut and replaced (not a big deal), but I suspect the roof also needs to be replaced as it is about 12 years old. I guess it's possible the damage could also be caused from a leaking pipe, i'm not 100% sure.

Anyone know the best way to file a claim and make this happen? I don't know the root cause of it, but my policy doesn't cover basic 'wear and tear' type repairs. Not sure if this actually is from wear and tear, but I'm sure the insurance company will claim that so they don't have to pay anything.

Thanks,

First thing you need to do is try to figure out exactly what happened. Probably wouldn't hurt to have a roofing contractor come out and do an inspection on the roof which should be free. If they're worth their salt they'll also inspect for storm damage while they're up there.

I don't know where you live but if there was any storm related events at the time over the past couple of years it could be the cause of the problem. If there's evidence of that type of loss, contingent on your policy, you might be able to get the roof replaced with just having the front your deductible.

If it was a burst pipe from a freeze, you'd still be having water come in. Possible it's a small trip somewhere from a fitting coming loose, but you'd really know if it was a pipe issue.

If I had to hazard a guess, it might be an air handler that's in the attic space. Sometimes when units aren't serviced the condensate lines will get clogged and will overflow into the drip pan. This happens all the time during the summer when the units being run constantly. It's important to always get your unit serviced at least once a year to have things like condensate lines blown and coils cleaned. Otherwise you're just reducing the life expectancy of that unit.

If it really is the roof and it's not a weather related issue, but just normal wear and tear, the carrier isn't going to cover it. Poor installation of flashing, boot on a plumbing stack, or vent being screwed up also won't be covered.

Just get somebody to come out and do an inspection. And if you got to crawl into the attic and just start looking around. If there is an above ceiling handler check it out and see whether or not the pan looks like it's had water or if it's bone dry.

You can always file a claim and have the adjuster come out to help determine what might be the issue. You can always withdraw the claim if it looks like they're not going to pay for enough of the repairs or if you're going to be upside down on your deductible.

Your insurance might go up but if there was a weather-related event chances are your insurance is going up anyways because of other people filing claims within your area. I think they call that pooling where basically the insurance carrier increases everybody's premiums to offset their loss across a certain market.

If you have insurance use it there's no reason to carry it otherwise.

Hope that helps.
 

BrotherWu

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Just popping in to say that you should consider having a mold remediation company come out and take a look. If any mold has started, you want to nip that shit in the bud. Usually they will also come out and assess the root cause and the damage for you.
 
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Dr.Retarded

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Just popping in to say that you should consider having a mold remediation company come out and take a look. If any mold has started, you want to nip that shit in the bud. Usually they will also come out and assess the root cause and the damage for you.
Very good point.

You're probably going to have to pay for it out of pocket though. Most policies have a mold exclusion written into them, meaning the carrier isn't going to cover it.
 

BrotherWu

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Very good point.

You're probably going to have to pay for it out of pocket though. Most policies have a mold exclusion written into them, meaning the carrier isn't going to cover it.

Yeah it would be really rare if they paid for mold (they did for my neighbors after they just purchased the home). However, if there is a chance that this is a coverable event, their diagnosis might help OP with the insurance coverage. They're pretty comfortable working with reputable restoration companies.
 
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Dr.Retarded

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Yeah it would be really rare if they paid for mold (they did for my neighbors after they just purchased the home). However, if there is a chance that this is a coverable event, their diagnosis might help OP with the insurance coverage. They're pretty comfortable working with reputable restoration companies.
Exactly.

It's all about what's covered in the policy. That's why it's important to at least try to figure out what the problem is via reputable contractor, and then get the insurance company out there to assess the loss.

It's always a roll of the dice when I comes to you and adjuster. They're all across the board with competency level or field experience in relation to construction. I've dealt with guys that say just send me a reasonable estimate.

Then you meet people where you're essentially having to explain to them "how things are put back together", or they treat the project like they're having to spend their own money, and things become a nightmare. At that point you end up pulling in a public adjuster because as contractor you don't have the legal authority to attempt to make the carrier do the right thing based on policy.

Really just comes down to there are people good at their profession and there are other people who aren't, and sometimes you have to deal with the people who suck.

If you're not ever happy with the judgment from the carrier don't give up and you can always pursue reinspections or things like hiring a PA.

Just be willing to fight your insurance company if you're dissatisfied, because of the vast majority of people don't, and that's where carriers make a ton of money. All of those claims say no they can get away without paying because the insured doesn't have the fortitude to stick it out and get what they paid for.
 
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BrotherWu

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We recently had some significant damage at our house as a result of a storm and power outage: A toilet started backing up and before I got the lift station back on a generator, the toilet water had contacted all of the walls in the bathroom. All drywall in the bathroom pulled out (up to 2 feet), flooring pulled out, vanities pulled out, etc. Additionally, some drywall and carpet in adjacent rooms. Nightmare. They do not fuck around with that type of backup. You just basically assume everything is contaminated and pull it out.

In 25 years of home ownership, this is the first claim I've ever had to make and it has been a pain in the dick. The first problem is getting a contractor to even come out and look at it. Between the labor shortage and the housing shortage, they're all stupid busy.

Next problem is the faggot adjuster won't even come and look. He just looked at photos and drawings and pulled an estimate out of his ass (in reality I know they have a program they use but it is still bullshit). I have two quotes from contractors. One is double his estimate and the other is significantly higher. Faggot never answers his phone and doesn't respond unless I call my agent and crawl up his ass.

He sent me a check for the lower amount but I am refusing to cash it until he answers on the two quotes I have. The best part is that the fuckers have already sent me a bill for my increased premium. It's an asshole business.
 
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Khane

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We recently had some significant damage at our house as a result of a storm and power outage: A toilet started backing up and before I got the lift station back on a generator, the toilet water had contacted all of the walls in the bathroom. All drywall in the bathroom pulled out (up to 2 feet), flooring pulled out, vanities pulled out, etc. Additionally, some drywall and carpet in adjacent rooms. Nightmare. They do not fuck around with that type of backup. You just basically assume everything is contaminated and pull it out.

In 25 years of home ownership, this is the first claim I've ever had to make and it has been a pain in the dick. The first problem is getting a contractor to even come out and look at it. Between the labor shortage and the housing shortage, they're all stupid busy.

Next problem is the faggot adjuster won't even come and look. He just looked at photos and drawings and pulled an estimate out of his ass (in reality I know they have a program they use but it is still bullshit). I have two quotes from contractors. One is double his estimate and the other is significantly higher. Faggot never answers his phone and doesn't respond unless I call my agent and crawl up his ass.

He sent me a check for the lower amount but I am refusing to cash it until he answers on the two quotes I have. The best part is that the fuckers have already sent me a bill for my increased premium. It's an asshole business.

Is this an experience other people have had? Because it doesn't sound reasonable to me at all. How much water are we talking about here?

Not trying to say you were at fault by any means, and please tell me if I'm way off base, but people's toilets get clogged and overflow all the time. Toilets with literal shit in them leak out before they can get the plunger in to counteract it. If its cleaned up fast enough Bleach will kill anything.

I mean, here in America we literally wipe our asses with thin pieces of paper and then just use hand soap to clean our hands. People leave their toilet seats up after taking a dump and flush it with their toothbrushes sitting 5 feet away on a countertop.

I can see them doing this if there was a significant amount of water and it wasn't cleaned up and dried out fast enough, but because of black mold worries, not toilet water contamination. Most bathrooms are absolutely disgusting 80% of the time so this kind of seems like some shady contractor taking advantage of you.
 

Dr.Retarded

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We recently had some significant damage at our house as a result of a storm and power outage: A toilet started backing up and before I got the lift station back on a generator, the toilet water had contacted all of the walls in the bathroom. All drywall in the bathroom pulled out (up to 2 feet), flooring pulled out, vanities pulled out, etc. Additionally, some drywall and carpet in adjacent rooms. Nightmare. They do not fuck around with that type of backup. You just basically assume everything is contaminated and pull it out.

In 25 years of home ownership, this is the first claim I've ever had to make and it has been a pain in the dick. The first problem is getting a contractor to even come out and look at it. Between the labor shortage and the housing shortage, they're all stupid busy.

Next problem is the faggot adjuster won't even come and look. He just looked at photos and drawings and pulled an estimate out of his ass (in reality I know they have a program they use but it is still bullshit). I have two quotes from contractors. One is double his estimate and the other is significantly higher. Faggot never answers his phone and doesn't respond unless I call my agent and crawl up his ass.

He sent me a check for the lower amount but I am refusing to cash it until he answers on the two quotes I have. The best part is that the fuckers have already sent me a bill for my increased premium. It's an asshole business.
Sorry to hear about your situation. Insurance is basically gambling and The House always wins.

You should really think about threatening him with hiring a public adjuster. Sometimes that'll make them pay attention, and the other option is to figure out who his supervisor is and deal directly with him. Just escalate the situation as far as you've got to to get somebody to do the right thing. It's good you've got your agent helping you out.

The problem with claims right now is that they take so long the process by the time the estimates are blessed by the carrier, material and labor prices have gone up again, so you have to go back and supplement for those additional cost.

Xactimate, the industry standard pricing engine, I believe only updates their pricing once a month, and even then it doesn't seem to catch up with the market.

You should be able to just submit the estimates given to you by your contractor and submit that for a supplement. But that will probably require you going over the current desk adjusters head. They're just a real pain in the ass to deal with the times.

Wish you the best of luck with it though.
 
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BrotherWu

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Is this an experience other people have had? Because it doesn't sound reasonable to me at all. How much water are we talking about here?

Not trying to say you were at fault by any means, and please tell me if I'm way off base, but people's toilets get clogged and overflow all the time. Toilets with literal shit in them leak out before they can get the plunger in to counteract it. If its cleaned up fast enough Bleach will kill anything.

I mean, here in America we literally wipe our asses with thin pieces of paper and then just use hand soap to clean our hands. People leave their toilet seats up after taking a dump and flush it with their toothbrushes sitting 5 feet away on a countertop.

I can see them doing this if there was a significant amount of water and it wasn't cleaned up and dried out fast enough, but because of black mold worries, not toilet water contamination. Most bathrooms are absolutely disgusting 80% of the time so this kind of seems like some shady contractor taking advantage of you.

The problem was that we had a freak storm that dumped 8 inches rain in about an hour and it also knocked out the power (for three days). My system has a lift station that pushes the septic out to the drain field. All of that ground water ingressed into the system created a shitload (har har) of back pressure and no pump to keep it going in the right direction (due to power outage) it started coming in through a toilet and it was coming in pretty fucking fast. It was coming in as fast as I could bail it out the window next to the toilet. I didn't have a generator on hand and had to borrow one, which wasn't easy to do in the middle of the night.

Anyway, by the time I got power restored and the backup stopped, the floor had been wet for a while. It looked just like clean water but it smelled terrible. The water contacts the drywall, trim, wood, etc. and wicks. It is full of bacteria, can create massive problems, and they absolutely do not fuck around with it. The resto companies can walk around with a meter that senses moisture content below the floor covering, behind the baseboard, etc. Anything that has moisture gets pulled and then there is an anti-microbial and drying protocol with a bunch of blower and dehumidifiers.

Bottom line is that water does way more damage than most people realize. The adjuster didn't bat an eye at the scope of the damage- he was just off on the pricing of replacement.
 
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BrotherWu

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By the way, I have learned my lesson and I am planning to install a whole-house NG generator. Also looking into setting up a duplex pump system so I have redundancy in case one fails. So far, I haven't found anyone who seems to know anything about them.
 
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Khane

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The problem was that we had a freak storm that dumped 8 inches rain in about an hour and it also knocked out the power (for three days). My system has a lift station that pushes the septic out to the drain field. All of that ground water ingressed into the system created a shitload (har har) of back pressure and no pump to keep it going in the right direction (due to power outage) it started coming in through a toilet and it was coming in pretty fucking fast. It was coming in as fast as I could bail it out the window next to the toilet. I didn't have a generator on hand and had to borrow one, which wasn't easy to do in the middle of the night.

Anyway, by the time I got power restored and the backup stopped, the floor had been wet for a while. It looked just like clean water but it smelled terrible. The water contacts the drywall, trim, wood, etc. and wicks. It is full of bacteria, can create massive problems, and they absolutely do not fuck around with it. The resto companies can walk around with a meter that senses moisture content below the floor covering, behind the baseboard, etc. Anything that has moisture gets pulled and then there is an anti-microbial and drying protocol with a bunch of blower and dehumidifiers.

Bottom line is that water does way more damage than most people realize. The adjuster didn't bat an eye at the scope of the damage- he was just off on the pricing of replacement.

Oof, that is god awful
 

Lanx

Oye Ve
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The problem was that we had a freak storm that dumped 8 inches rain in about an hour and it also knocked out the power (for three days). My system has a lift station that pushes the septic out to the drain field. All of that ground water ingressed into the system created a shitload (har har) of back pressure and no pump to keep it going in the right direction (due to power outage) it started coming in through a toilet and it was coming in pretty fucking fast. It was coming in as fast as I could bail it out the window next to the toilet. I didn't have a generator on hand and had to borrow one, which wasn't easy to do in the middle of the night.

Anyway, by the time I got power restored and the backup stopped, the floor had been wet for a while. It looked just like clean water but it smelled terrible. The water contacts the drywall, trim, wood, etc. and wicks. It is full of bacteria, can create massive problems, and they absolutely do not fuck around with it. The resto companies can walk around with a meter that senses moisture content below the floor covering, behind the baseboard, etc. Anything that has moisture gets pulled and then there is an anti-microbial and drying protocol with a bunch of blower and dehumidifiers.

Bottom line is that water does way more damage than most people realize. The adjuster didn't bat an eye at the scope of the damage- he was just off on the pricing of replacement.
was it only the toilet? shouldn't it come back up from all the drains so like you'd have horror movie shit coming up from the bathtub?
 

BrotherWu

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was it only the toilet? shouldn't it come back up from all the drains so like you'd have horror movie shit coming up from the bathtub?
It was just the first point it reached and I was nearby when it started and began bailing. A little came up into the nearby shower but not much.