by mtates » Fri May 27, 2011 06:02 am
There was a significant drop in weather temperature causing the water in the pipes to freeze and expand. As a result, the waterline in the attic burst at a T- junction. My mother was away visiting, so her house was vacant at the time that this occurred. The home is well maintained and has a new roof. There are no other issues noted with this waterline.
My adult nephew checks on the home regularly and had gone by there on February 3rd. All appeared to be fine. This flood incident occurred sometime during the Superbowl weekend, February 3-6, 2011. During this time there was an Arctic Blast/Winter Storm causing the temperature to drop below freezing, paralyzing the City with Black Ice. This can be confirmed by a simple check of the City's weather record, which indicates that the temperature was in the range of mid 20 degrees.
My nephew discovered the damage on Monday, February 7th, when he went by to check on the house. He observed that water was pouring down the driveway, as he approached the home. When he entered the house, water was spraying from the attic, the ceilings were fallen in and the home contents were standing in water. He immediately turned off the main waterline and retained a water restoration company to dry the home. They removed the carpet, kitchen flooring and much of the ceiling debris. However, the home remains untenantable, so my mother has had to make other living arrangements until her home is restored.
This is a named peril policy with a $2500 Water Damage endorsement and $2500 is all the money that has been given to my mother. The estimate to restore the home is $20,000. The 3rd party claims adjuster said that the insurance company told him to write the claim as a plumbing failure instead of due to the freeze. He said that if I can get the Agent to tell him to write it the other way then he will do so and all of the damage will be covered. The Agent will not give recognition to there being a freeze. How can we get the damage covered due to the freeze? Additional living expenses are available. Can that amount be issued in advance?
My adult nephew checks on the home regularly and had gone by there on February 3rd. All appeared to be fine. This flood incident occurred sometime during the Superbowl weekend, February 3-6, 2011. During this time there was an Arctic Blast/Winter Storm causing the temperature to drop below freezing, paralyzing the City with Black Ice. This can be confirmed by a simple check of the City's weather record, which indicates that the temperature was in the range of mid 20 degrees.
My nephew discovered the damage on Monday, February 7th, when he went by to check on the house. He observed that water was pouring down the driveway, as he approached the home. When he entered the house, water was spraying from the attic, the ceilings were fallen in and the home contents were standing in water. He immediately turned off the main waterline and retained a water restoration company to dry the home. They removed the carpet, kitchen flooring and much of the ceiling debris. However, the home remains untenantable, so my mother has had to make other living arrangements until her home is restored.
This is a named peril policy with a $2500 Water Damage endorsement and $2500 is all the money that has been given to my mother. The estimate to restore the home is $20,000. The 3rd party claims adjuster said that the insurance company told him to write the claim as a plumbing failure instead of due to the freeze. He said that if I can get the Agent to tell him to write it the other way then he will do so and all of the damage will be covered. The Agent will not give recognition to there being a freeze. How can we get the damage covered due to the freeze? Additional living expenses are available. Can that amount be issued in advance?
Posted: Fri May 27, 2011 01:37 pm Post Subject:
Is this a difference between deductible amounts (water damage deductible vs the normal deductible)?
Go to wunderground.com and use the history feature to print up the temps for that day. Who was the first repair person to show up? Will that person give an opinion as to why the damage occurred?
Is the insurance company paying for the leaking pipe? What are they saying caused that pipe to fail if not freezing water? Age? If it's age then they should not be paying for the pipe. If it's age, does the same section of undamaged pipe show the same wear and tear? Or does it look perfectly sound?
Posted: Sat May 28, 2011 04:39 am Post Subject:
We do not know why, but the deductible never came into play on the claim. My mom received a Water Endorsement check (which she has not yet cashed) for $2500 and the insurance company said that the claim was closed. We have asked the agent to file for the additional living expenses. but this has not yet been done.
Each repair person has stated that the pipe was failed due to the freeze. Do I need to get them to say so in writing? The insurance company has stated that since this is a named peril policy, freeze weather would have to be named in the policy to be covered and it is not named. However, it seems that if "freeze weather cuasing a pipe to freeze and burst" is not excluded form the policy, then it must be included in the policy. Is this so? Do we need to file a complaint to get cooperation? If so, then where must we file?
Posted: Tue May 31, 2011 09:08 pm Post Subject:
Policies are either "named peril" or "all risk". A named peril policy ONLY pays claims for perils listed as covered in the contract. An all risk policy covers all losses EXCEPT those excluded by name. Which form of policy is it?
If a named peril policy, with no discussion of freezing water in pipes, there probably is no coverage. That would be the reason for the water endorsement -- to add coverage specifically excluded. If a claim has been paid, the contract has been fulfilled.
The coverage may have been improper. If so, then you may have a claim against the agent for negligence in not recommending or placing the proper coverage. That will be a difficult claim to win, but he will have Errors & Omissions coverage to pay up to $1,000,000 or more.
You can always file a complaint with your state's Dept of Insurance if you believe either the insurance company or agent, or both, have acted improperly.
Posted: Fri Jun 03, 2011 03:26 pm Post Subject: Frozen water pipe damage
Thank you for your advice. This sounds very much like what has actually happened in this claim. I am not opposed to filing a complaint, if I really have grounds for one. The policy is a "named peril" policy. My mom's home is in Texas in the Gulf of Mexico region. Many Insurance Companies will no longer provide home coverage in this area. My mom's previous insurance company refused to pay enough money to cover her roof following Hurricane Ike damage and paid nothing for the damage to the inside of the house. FEMA was a total "no show" to the disaster. Nevertheless, Mom sprung for the additional expenses to at least take care of the roof.
A year ago, I sent my mother to the current agent so that she could get better home coverage. I did not oversee that process, since I trusted the Agent as a long time friend of my parents, for which they and other family members have had other policies (Auto, Life...) for many years. I recently learned that the current Agent merely "rolled over what Mom already had from the previous company's policy"...which I knew was much of nothing. About 2 months ago I had the Agent to go do some research to find a better policy, since we were approaching renewal date. The new policy cost about $300 more, but is a much stronger policy. So, I think Mom is set for the future.
Now...back to the current claim discussion. The Agent originally thought Mom had $5000 in Water Damage Endorsement, but then later simply stated that she only had $2500, but could claim $7500 in Additional Living Expenses. The home is no longer habitable, so my mom has had to move to another city to live with my brother. Sometimes she stays with me also. How do we account for and collect the $7500 Additional Living Expenses and can that be done up front and in advance of starting the work on the home? We need the seed money to get started. Does it appear that there is enough omission and error to have grounds for a complaint?
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