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It seems that every week, we receive a call from a client about whether or not to file a homeowner’s claim. This is a bit complicated because you have insurance for a reason but please remember that your homeowner’s policy is in place to cover catastrophic events and is not a maintenance agreement. That is why we recommend a minimum deductible of $1,000 and are pushing more clients towards a $2,500 deductible.

It’s also a complicated question because one needs to weigh their deductible against how much more premium we anticipate will be paid out due to filing a claim.

You see, the insurance company isn’t raising your rate simply to punish you for filing a claim. Over the years, they have discovered that once your home has a certain type of problem such as a water leak, it is expected that there will be more of the same kind of problem leading to more claims in the future.Man in suit showing sign saying "Are you covered"?

A lot of these calls can be avoided if the homeowner knew which types of perils are typically excluded in a homeowner’s policy.

Of the many types of homeowner’s insurance policies, the HO5 comprehensive form covers more perils than other types of policies.

 

 The following is a list of perils usually NOT covered under the HO5 policy

 Earth movement

We know all about this in California. These include earthquakes, mudslides, and landslides. You need to have an earthquake insurance policy to cover these risks (we offer this)

 Floods

While some water damage is certainly covered, rising water due to a flood is not covered. To be covered for this, you would need to purchase flood insurance (we offer this too).

 Damage from birds, vermin, rodents and insects

This type of damage is usually not covered though it is worth filing a claim to be sure. It’s important to keep your eyes peeled for signs of termites or other such perils to your home.

 Neglect, deterioration, and general wear and tear

This is the one we get the most questions about and which cause the most frustration. Homes age just like we do. As they age, they slowly deteriorate. Most claims need to be sudden and accidental. A good example of this is a burst pipe which destroys a wall and damages flooring. A slow leak can be even more destructive and can lead to mold but this is a maintenance problem. The insurance company takes the stance that if the leak was stopped and the home was properly maintained, then the damage would not have occurred. Remember that sudden and accidental is the key phrase.

 Settling, shrinking, bulging, or expanding of your home’s foundation 

Again, this is not sudden and accidental but rather it occurs over a long period of time. Fortunately, this kind of claim is more common in cold weather areas and is much less likely to occur in California.

 Pets and other animals

As much as we treasure our pets, we cannot replace them through a homeowner’s policy. If your pet bit somebody, that is a covered peril through your liability coverage but other than that, coverage is very limited.

 Mold, fungus, and rot

This is another type of peril which takes time to develop and does not cover our sudden and accidental criteria.

 Intentional loss 

It’s a horrible idea to damage your own home with the thought that the insurance company will fix it up better than new. This is not covered and can lead to a conviction of insurance fraud.

 War, government action, and nuclear hazard

These are very catastrophic in nature and are beyond a homeowner’s policy to cover. When I once asked why these events were not covered, a wise man told me that it’s because they are explicitly listed on the “not covered” list. Good enough.

 Smog, rust, and corrosion

These are not covered for the same reasons that many other risks are not covered. These are not sudden and accidental type claims and occurred over a long period of time meaning that it’s an issue of lack of maintenance and neglect.

Important – Some of these events may still be covered if they happen suddenly and accidentally so it’s important to call us or your insurance carrier about your particular circumstances after a loss.

--Ken May

Posted 2:00 PM

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