Our insured who is a tenant had damage from storm IDA and reported a claim with PHLY on 9/1/2021. The insured said water came from collapsed portion of the roof damaging the insured office contents. On 11/9/2021 PHLY went out and inspected the claim. PHLY is denying the claim for the following reasons.
The adjustor who went out on 11/9/21 sited standing water and clogged roof drain so they referred to Form CP1030 regarding exclusion related to faulty, inadequate or defective maintenance of the roof. The insured argument is that the findings may not have been there at the time of the claim. PHLY is also stating that water coverage does not apply to roof drainage systems, gutters or downspouts under PI-EPE-HS-NY.
My argument is the insured is not responsible for the roof or maintenance of it so why is this being held against them? Is this PHLY way of saying the insured should be going after the landlord for coverage since it is their responsibility? I am looking for some guidance on this situation. Is PHLY correct in denying the claim and forcing the insured to go after the landlord?
New York Subscriber
From the situation you describe, the tenant's property damage is due to the landlord's roof collapse. As such, this would not be covered under the tenant's insurance, but rather should be covered by the landlord.
This is a claim for property damage liability to be submitted to the landlord, which should be covered by their general liability insurance coverage.
For future reference, the type of water damage covered under the tenant's policy would be damage from burst piping, toilets, and appliances inside the tenant's premises.
Likely the landlord would have/should have submitted a claim under their property policy for the roof damage, as the tenant is not liable for such damage.