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Claiming Home Insurance For Natural Gas And Water Leaks In Japan
When you are suddenly hit with water damage to your home or business, it can feel like everything is working against you. After faithfully paying your insurance premiums every month for years, you expect your provider to hold their end of the bargain and help cover the cost of repairs.
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Unfortunately, not all water damage incidents are covered by homeowner’s insurance policies and insurance companies often cite the fine print as a reason to deny your claim. If your water claim is denied, you may wonder if and how your insurance company will pay for water damage.
At Avner Gat Inc., our team of civil adjusters has worked on hundreds of homeowner’s insurance claims and helped our clients negotiate with their providers for fair payment. In our experience, families find it difficult to understand how their provider makes coverage decisions, especially regarding water damage insurance claims.
Insurance policies are complex legal documents full of contingencies and fine print designed to protect the interests of the insurance company. Although most of us have no choice but to accept the terms presented by our suppliers, we often do not fully understand how all the complexities of these contracts can complicate the compensation process.
Every situation is a little different, but more often than not, I see insurance companies denying claims based on a homeowner’s insurance policy that doesn’t specifically cover damage caused by rot and repeated leaks. Basically, what that means is that if the accident that led to the water damage is not ‘sudden and accidental’ such as bursting of pressurized clean water pipes, then it will not be considered a covered loss.
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Claiming that the water damage caused to your property was accidental and accidental is one of the most common reasons that water damage claims are denied. If your provider denies your water damage claim, it’s important to ask your insurance adjuster questions about why and under what conditions of your policy they did so.
Usually, the leakage occurs gradually. Damage accumulates over time. Insurance companies feel that it is the homeowner’s responsibility to stay on top of maintenance and water problems in their homes. That means they expect you to identify the problem and take action, sooner rather than later.
If you put off dealing with repairs, this is considered negligence on your part and can be used by your insurance provider as a valid reason to reject your claim. Under their terms, you didn’t support your bond so, they don’t have to support theirs; to cover the cost of repairing water damage.
Not all leaks will be obvious and noticeable. In fact, I’ve talked to many homeowners who didn’t reveal the leak until the damage was done. When that happens, these homeowners call me and say the insurance company denied the claim because of a small leak inside the wall or under the flooring.
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These families are in a very difficult situation. They explained that they didn’t see the leak and ignored it, they just didn’t know what was going on inside the walls. When the effects of a leak aren’t immediately apparent, families struggle to understand why their insurance provider won’t pay for water damage repairs.
Yes, these homeowners have a good point! They were not careless and avoided routine maintenance. In their opinion, the damage happened suddenly. However, insurance companies see the situation differently, which is why they avoid providing coverage for leaks and water leaks.
When I talk to homeowners about these exclusions, I find that it helps to explain using health insurance as an example. Your health insurance may look very different from other policies. For example, if you are an elite athlete, you may take a specific policy on your arms and legs. On the other hand, if you work as a model, you may need insurance for certain facial features.
Before issuing a quote for payment, insurance companies take your unique risks and needs into consideration. They know that no one wants to go to the doctor, but they may look at some of the riders and services you’ve requested and conclude that you’ve invested too much in maintaining your health. This may lower your premium in the end.
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In the same way, when a homeowner’s insurance company issues a policy, it must first calculate its risk. Insurance providers want to provide coverage for events when they know they are working with the homeowner, and both parties are equally invested in preventing damage.
From the point of view of insurance companies, they cannot insure risks such as leaks and water leaks, because the company will not know about hidden leaks. They don’t want to take responsibility because they can’t calculate their risk. Insurers only want to cover events where they know homeowners will act quickly. In fact, some companies may even limit the time you have to respond to a claim – counting from when the accident occurred until you take action.
What kind of immediate action should I take to get the insurance company to pay for the repairs?
Taking action does not mean applying! If you notice a small leak in the kitchen sink, it will often be more beneficial to pay for the repair yourself. It may make more sense to call a plumber yourself rather than apply and pay the deductible. If you are not sure where the leak is, you may need to contact a leak detection company.
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In such cases, you need to keep receipts and records so that you can prove that you actually did something. Whether you hire a professional or do the work yourself, save receipts to show your insurance company that you’ve been busy. This way you can prove to your provider with documents that you have indeed fulfilled your responsibilities.
In some cases, it may be tempting for homeowners to complain when damage occurs if it looks like their claim will be denied. Please note that insurance companies have ways of determining how long ago the water damage occurred. For example, they may look for an unusual water or gas bill. If they can prove that the damage was ongoing and left unattended, they will not cover it.
More importantly, they may take additional action against you if they believe the deception qualifies as fraud. It is always better to represent yourself and your situation accurately because the risk of lying to the insurance company is often greater than the reward. Their business revolves around protecting their investment and they have developed fraud detection tools over decades of dealing with fraudulent claims.
As civil adjusters, we have decades of experience interpreting the complexities of insurance policies and identifying the many ways providers call themselves to protect themselves. Just as you might have a lawyer review a contract for an important business activity, we can use your policy and inform you of any clauses you may not have known or understood.
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Based on your individual goals, we will then ask you questions about the timeline of the water damage incident that will directly affect the validity of your claim. The more information and documentation you can provide us with, the better we will be able to fully understand your specific situation and find ways to work for you. Armed with your side of the story, we will negotiate with your insurance adjuster to pursue fair compensation for your water damage insurance claim.
Avner Gat, Inc. has 17+ years of experience as a community adjuster in Southern California. We protect homeowners from the games and underwriting that insurance companies are known for.
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