When Does Citizens Insurance Cover Water Damage Under an HO3 Policy?
Hello! I currently hold an HO3 policy with Citizens in Florida and am seeking clarification on when they cover water damage. Unfortunately, I haven’t received clear answers from the representatives, my insurance agent, or the adjuster. I’ve discovered water damage beneath my flooring, but the field adjuster, water mitigation team, and leak detection experts have not pinpointed the leak’s source. Citizens wants to send out an inspector, which I presume is in their interest.
I want to be prepared in case my claim gets denied, prompting the need for independent specialists to assess the situation. I have vinyl flooring over hardwood, and after noticing a soft spot, I removed part of the vinyl and found rotten wood underneath. Notably, I have never seen any water pooling on top of the flooring.
From my research, it seems that Citizens excludes coverage for gradual leaks and seepage. However, they do have a clause that covers hidden water damage if it is concealed beneath floors, behind walls, or in ceilings. I’m curious about how this applies in real-life scenarios. Since there’s no active leak identified, the damage might stem from a concealed, situational, or accidental spill. I’m struggling to interpret the policy details, as they seem to provide conflicting information. I’ve included some pages from my insurance declaration regarding water damage in the link below:
Could anyone share their insights on whether Citizens would cover scenarios like:
- Moisture accumulation under flooring due to a malfunctioning vapor barrier?
- A gradual AC leak from a pipe failure or improper installation within the walls?
- Sporadic leaks from a poorly installed air handler?
- A cracked condensate line or a sewage pipe leaking beneath the foundation?
- Past water spills that found their way under the floor?
Has anyone successfully had a claim approved for situations like these, or have they been denied on the grounds of maintenance issues? If you received coverage, what type of evidence were you required to present?
I want to ensure I’m prepared for any pushback regarding my claim. It’s been over a month without progress on renovations, as the adjuster has instructed me to keep everything as it is for now. To complicate matters, the adjuster advised me to store the damaged flooring (which has mold) indoors in bags and suggested we vacate our home, downplaying the mold issue based on photo evaluations—despite the water mitigation team indicating that the mold surpassed 10 square feet and recommending we find temporary accommodation until a hygienist could be approved, which hasn’t occurred.
I appreciate any assistance you can provide. Thank you!
I’m sorry to hear about your situation—dealing with water damage and insurance claims can be incredibly frustrating. Here’s a breakdown of the issues you mentioned, particularly in relation to your HO3 policy with Citizens in Florida.
Your understanding is correct that Citizens typically excludes coverage for gradual leaks and seepage. However, the coverage for hidden water damage is a crucial point, as it can sometimes apply if the source of the leak is concealed and resulted from a sudden and accidental occurrence.
Potential Situations:
Spilled water in the past: Coverage here can be tricky; often, insurers will argue that this falls under maintenance unless there’s clear evidence of an unexpected event.
Documentation:
It sounds like you are already aware of the importance of documentation. Keep records of all communications with your adjuster, photographs of the damage, and reports from the water mitigation company and leak detection specialists. If you bring in independent specialists, their findings and reports will also be valuable.
Claims Approval:
If your claim gets denied, you may want to file a formal appeal with Citizens and consider seeking the assistance of a public adjuster or an attorney specializing in insurance claims for further advice.
Immediate Actions:
It’s challenging to navigate insurance claims, and the nuances of each policy can make it even more complicated. Being proactive in gathering evidence and understanding your rights can help improve your chances of a favorable outcome. Best of luck with your claim, and stay vigilant about the health risks posed by mold during this time.