Understanding Citizens’ Coverage for Water Damage Under HO3 Policy
Hello everyone,
I have an HO3 policy with Citizens in Florida and I’m trying to get clarity on their coverage for water damage, as I’ve faced some challenges in getting accurate information from representatives, my insurance agent, and the adjuster. Currently, I’m dealing with water damage under my flooring, but despite having a field adjuster, a water mitigation company, and a leak detection specialist involved, no one has been able to pinpoint the source of the leak. Citizens wants to send out their own inspector, which seems to favor their interests, and I’m preparing for the possibility of a claim denial.
I installed vinyl flooring over hardwood and discovered a soft spot; upon investigating, I found rotting wood underneath. Notably, I haven’t observed any water on the surface of the flooring.
From my understanding, Citizens excludes coverage for gradual leaks and seepage. However, they do have a provision for hidden water damage that was unknown and concealed beneath floors, behind walls, or in ceilings. I’m curious how this works in practice, particularly since there’s no identifiable active leak. Could the source be something accidental or situational instead? The fine print seems to have conflicting details, so I’ve included a few pages from my insurance declaration related to water damage in the link below:
Here are some specific scenarios I’m wondering if Citizens would cover:
- Moisture accumulation under flooring due to a failed vapor or moisture barrier?
- An AC leak within the walls from a pipe failure or improper installation over time?
- Sporadic leaks from a poorly installed air handler?
- A cracked condensate line or sewage pipe leaking beneath the slab?
- Water that may have spilled in the past and made its way under the floor?
Has anyone successfully had Citizens approve a claim for similar situations, or have they denied claims based on maintenance issues? If you were covered, what type of evidence did you provide?
I’m eager to be prepared for any pushback on my claim. It’s been over a month now, and I can’t proceed with renovations since the adjuster wants everything left as is for the time being. They’ve instructed me to store the damaged flooring (which has mold) indoors and suggested we vacate the house. This was despite the water mitigation company’s recommendation for a temporary stay due to concerns about mold, especially with a young child in the home.
Any insights or experiences shared would be greatly appreciated. Thank you!
I’m sorry to hear about the challenges you’re facing with your claim. Water damage claims can be quite complex, especially with the nuances of HO3 policies. Here are some insights that might help clarify how Citizens may approach your situation:
Understanding Coverage: As you mentioned, HO3 policies typically cover sudden and accidental water damage, as opposed to gradual leaks or maintenance issues. The key phrase in your policy is “hidden water damage,” which can sometimes cover damage that is not immediately visible and is caused by an unexpected event.
Common Situations for Coverage:
Past Spills: If you can demonstrate that a one-time spill led to ongoing damage, there may be room for a claim; however, this can often be harder to substantiate.
Evidence and Documentation: As you prepare for the inspector and any potential disputes, gather as much documentation as possible:
Any correspondence with your insurance adjuster.
Independent Assessment: If the inspector does not provide a satisfactory assessment, having an independent inspector or contractor provide a written evaluation could help. If they can confirm that there was an undetected leak or defect leading to the damage, this may support your claim.
Staying Proactive: Given your concerns about mold and your child, it’s important to prioritize safety. If health risks are at stake, consider bringing this issue up with the adjuster directly, emphasizing the urgency from the mitigation company.
Dealing with Claims Pushback: If you receive a denial or unfavorable assessment, you can appeal the decision. Be prepared to present all gathered evidence and possibly bring in additional testimony from qualified professionals.
Community Input: It can also be helpful to connect with others who’ve had similar experiences with Citizens in Florida. They might offer insight into what worked for them or how to navigate disputes.
Remember that insurance claims can be a lengthy process, so patience and thorough documentation are key. Best of luck, and I hope you find a resolution soon!