Seeking Advice on Overturning a Water Damage Claim Denial
Hi everyone,
I’m reaching out for guidance on how to contest a denial regarding a water damage claim with my homeowners insurance. I live in a condo with a unit above mine, and late last year, I experienced a sudden water leak from a load-bearing wall. Initially, I reported it to the HOA, assuming the problem stemmed from the roof since it was raining at the time, although my upstairs neighbor reported no issues.
After several roof inspections failed to identify the leak source, I decided to check my kitchen ceiling and discovered gallons of water pooled inside, which then poured out. I immediately contacted my insurance company to file a claim, as there was no visible evidence of water entering the ceiling, and the origins of the water were unknown.
The insurance adjuster arranged for a leak detection report, which couldn’t pinpoint the source of the water either. However, it did indicate moisture extending into my upstairs neighbor’s unit, suggesting that water could have been entering through the air ducts during rain. When I inquired about the potential duration of the leak, the adjuster couldn’t provide an answer.
Subsequently, my insurance company called to ask if I wanted to withdraw the claim, citing that it appeared to be a long-term issue. They pointed to fully soaked insulation and a dark stain on my ceiling, interpreting these signs as indicative of wind-driven rain over 14 days. Eventually, I received a denial letter despite the leak detection report highlighting multiple potential entry points and recommending monitoring for water during the next storm.
I’ve been vigilant during periods of high winds and rain, consistently checking for leaks and documenting that none occurred. I relayed this information to the insurance company, but they refused to reopen my claim, stating that I could not prove the leak wasn’t caused by long-term wind-driven rain. They also noted some minor mold growth, which they interpreted as evidence of a prolonged leak despite the absence of other long-term damage such as warping or soaked drywall. The leak detection technician had similarly stated it was impossible to determine how long the leak had existed.
For months, I’ve documented the weather conditions and have never found any water intrusion, yet the insurance company continues to assert that my claim is ineligible due to being classified as “long-term.” I have filed a complaint with the Department of Insurance regarding this situation, but I’m unsure of the best approach to get the insurance provider to reconsider their denial.
I’m facing extensive damages throughout my unit, including structural damage, ruined flooring, and compromised custom cabinets.
If anyone has advice or tips on how to navigate this issue, I would greatly appreciate your input! Thank you!
I’m sorry to hear about your situation—it sounds incredibly frustrating. Here are some steps you can take to help fight the denial of your water damage claim:
Document Everything: Make sure to keep a detailed record of your communications with the insurance company, including dates, times, and the names of the representatives you spoke with. Document your observations during and after rainstorms as well, including photos and timestamps showing the absence of leaks.
Get Expert Opinions: Consider hiring independent experts, such as a water damage restoration professional or a home inspector, to assess the damage and provide a report. They can help establish whether the damage is indeed long-term and provide evidence to counter the insurance company’s claims.
Review Your Policy: Go through your homeowners insurance policy to understand exactly what is covered. Pay attention to any clauses related to water damage, exclusions, and definitions of “long-term” damage. This will help you argue your case more effectively.
Request a Re-evaluation: Formally request that the insurance company re-evaluates your claim, providing any new evidence or expert reports you’ve obtained. Be persistent and assertive in following up on this request.
Engage a Public Adjuster: If you haven’t done so already, hiring a public adjuster can be beneficial. Public adjusters work on behalf of the policyholder and can assist in negotiating with the insurance company. They might be able to present your case in a way that is more favorable than you can on your own.
Stay in Touch with the Department of Insurance: Since you’ve already filed a complaint, maintain communication with them. They can often provide guidance on your next steps and may help facilitate discussions with your insurer.
Consider Legal Advice: If the insurance company continues to refuse to pay your claim, consulting an attorney who specializes in insurance claims may be necessary. They can help you understand your legal rights and may advise on pursuing further action, such as a lawsuit.
Be Persistent: Keep following up with the insurance company regularly. Sometimes, persistence can lead to re-evaluation or settlement offers if they see you’re not backing down.
Connect with Others: Look for online forums or community groups where others have faced similar situations. They may have tips or advice based on their experiences that could prove useful.
Taking these steps may help reinforce your case and improve the chances of having the denial overturned. Good luck, and I hope you find a resolution soon!