Typical homeowner’s policies usually called an HO3 policy have losses they do not cover or exclusions of coverage in their policy. It’s important to understand what your insurance policy covers before a loss occurs. The last thing someone wants to do is to find out after they had a loss that there is no coverage available to them under their policy language. It is crucial before purchasing an insurance policy that you review what is covered under the policy and what is not covered in the policy and the reason coverage can be denied. A homeowner should make sure their insurance agent reviews each section of the policy with you before you purchase the policy. Every policy can be different for many reasons including the geographic area you live in. For example, it is possible that a Chubb Insurance policy may offer coverage for certain losses or items in one area of the country but exclude this coverage in another area of the county. And there are different insurance companies and each one of their policies can be vastly different.
Also, please keep in mind just because it is written in your policy does not mean for sure that it is valid or complies with state statutes pertaining to 1st party property claims. And if they do have the right to deny or exclude coverage it does not always mean that the reason they use to deny coverage is a valid one. For example, it is common for an insurance company to deny a roof claim for wear and tear when it really was the wind that was the peril that causes the damage. Remember if the insurance company insured the roof and did not inspect the property and specifically exclude it then they most likely covered that item by default. Remember, there is an argument that can be made by both the insured for coverage and by the insurance company for denial of coverage. Insurance companies operate and stay in business by making a profit so they do not always have your best interest in mind when making a decision to cover a claim. In our opinion, there are some carriers that come to your property looking for a reason to deny all claims instead of looking to pay claims fairly.
Every state has different statutes and also case law that changes constantly.
Some of the typical reasons exclusions in a policy or reasons to deny are listed below. It can read that, “we do not insure for damage consisting of or caused directly or indirectly by any of the following, regardless of:
- The cause of the excluded event or damage that; or whether the event of damage occurs, suddenly or gradually, involves isolated or widespread damage, or occurs as a result of any combination of these to; or whether other causes or events act concurrently or in any sequence with the excluded event to produce the loss.
- Freezing of a plumbing, heating, air conditioning or automatic fire protective sprinkler system or of a household appliance, or by discharge, leakage or overflow from within the system or appliance caused by freezing. Thes exclusion does not apply if you have: Maintained heat in the building; or shut off the water supply and drained the system and appliances of water.
- Freezing thawing, pressure or weight or water or ice, whether driven by wind or not, to a:
- Swimming pool, hot tub, or spa, including their filtration and circulation system.
- Fence, pavement, patio
- Foundation, retaining wall or bulkhead
- Pier, wharf or dock