Filed Under:Agent Broker, Coverage Issues

Here’s why some water damage claims aren't covered

The origin of a water leak is frequently a determining factor in whether or not the resulting damage will be covered by a standard homeowners policy. (Photo: Shutterstock)
The origin of a water leak is frequently a determining factor in whether or not the resulting damage will be covered by a standard homeowners policy. (Photo: Shutterstock)

Home water damage comes from many different sources, is classified in different ways, and falls under different areas of coverage.

For instance, natural flooding is considered to be very different from standard water damage and is covered under separate policies. When you’re confronted with a claim, here are some of the things you need to look for to judge the matter correctly according to the policy.

Gradual vs. sudden damage


This is by far the most important distinction. Homeowners insurance is meant to cover sudden unexpected damage to a home. The trouble with water damage is that it can hide for quite a long time before it becomes apparent. This leads to conflicts about whether or not the original cause of the damage was gradual or sudden.

For instance, discovering a crack in a foundation might be a cause for a claim. But if the crack wasn’t found and water seeps into the basement and causes damage that might not be covered because it was gradual. Another example is a slow faucet leak under a sink. If the cabinet floor underneath the sink gets damaged, that’s gradual.

Examples of sudden damage include a pipe breaking in a freeze that leads to a huge flood, or a tree poking a hole into the roof of a home after falling and letting storm water in. But these can also lead to secondary damage that doesn’t show up till much later, which can create conflicts with policyholders.

If the smashed roof was repaired, but soaked insulation wasn’t remedied, mold could develop and lead to another claim. A common example is a sudden failure of an appliance. A washer in a dishwasher might gradually fail, but once it does the damage can be sudden.

Policy will be the guide


The policy will be the guide about whether or not this secondary damage can be covered or not. For instance, some states require insurance companies to cover secondary mold damage due to a legitimate water damage claim. It's up to adjusters to know the exceptions and to understand exactly what the policy covers.

flooded kitchen

Adjusters have to get a clear idea of where the water came from and why before adjusting a claim.  (Photo: Shutterstock)

Water damage vs. flooding


Most homeowners policies will cover sudden water damage except in one major case, flooding. Flooding is not covered by most homeowner’s policies. It requires separate flood insurance. So, how is flooding defined?

In the most general sense, once water from a natural source (e.g., a river or the sky) touches the ground, it is then considered flood water. Your insurance company may put in other restrictions, but this is the core difference. This is why storm water falling in from a hole in the roof is covered by some policies, but a swollen river washing away a porch is not.

However, most homeowners are not conversant with this difference. It is common to say that a room is flooded when there is water all over the floor, and this can set off alarm bells for insurance adjusters. Adjusters have to get a clear idea of where the water came from and why before adjusting a claim. Too many simply hear the word flood and automatically deny it.

How to make a judgment


Deciding which category a claim falls into is tricky, but acquiring evidence is the same as any other claim. Ask for home maintenance records, photos, and descriptions of what the homeowner did before and after the incident.

Interview any professionals including water damage professionals who worked on the situation prior to your examination. Ask if any cleanup work was done and what preventative measures the policyholder took to prevent further damage. From there, it’s just a matter of using your expertise and the wording of the policy to know whether or not the claim is covered.

Michael Jacobs is the head of the public relations department at ServiceProsLocal.com, with a primary focus on customer satisfaction. He focuses on water damage restoration, environmental friendly house building and plant cultivation. Contact him at michael@serviceproslocal.com.

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