The most important -- and often toughest -- part of an adjuster's job is determining coverage. Each month, Claims publishes a coverage question asked by an insurance professional, along with an answer provided by the dedicated editorial staff of FC&S Online (which, like Claims, is a division of the National Underwriter Company). With winter upon us, let's take a look at coverage question concerning snow buildup.

QUESTION: We have a policyholder with water damage under a Form 3. Considerable snow built up on his roof and he pulled it down with a rake and it piled up against his wall. Water melted from the snow pile and came in through his siding, damaging a side wall and the floor sheathing. The company raises questions of the water possibly being surface water and there is more than one incident of melting, with each day having a thawing and freezing cycle. It is thought that possibly snow that came off the roof would add to the stack, leaving the possibility of several occurrences. They also raised the possibility of lack of coverage by neglect in not removing the snow against the house, realizing that damage might occur. What are your thoughts?

ANSWER: The benefit of the doubt must go to the insured and provide coverage for the loss. For a start, surface water is usually defined as water from rain or melting snow that meanders over the ground in no set pattern. But here, the water from the melting snow did not meander; rather, it entered the insured's dwelling from a pile of snow that melted, froze, and melted again. It would have been similar to the snow remaining on the roof and melting and being forced up under shingles and into the dwelling.

As for "additional occurrences," it appears that all loss was attributable to one pile of snow; unless the insurer can prove which exact day of melting caused which exact damage, this argument is shaky.

The exclusion for neglect links this to "at the time of loss" and failure to protect against further damage. Until the damage from the melting snow became visible, the insured did not know there was a loss and so cannot be accused of neglect. Obviously, once the damage became visible, the insured took the proper steps to mitigate the damage.

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Special Reports /

Questions of Coverage: Snow Buildup

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