Plumbing

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Providing Cost-Effective Legal Help for Plumbing Damages

How To Fight A Denied Plumbing Insurance Claim

When water suddenly appears in your home where it is not supposed to be, a true emergency has occurred. At that point, home life is totally disrupted and removing the water and cleaning up the damage becomes the sole priority. The destruction it causes to personal property, ceilings, walls, and floors can be significant and extensive. In addition, repairing the source of the water leak, such as plumbing behind the walls, can be extremely costly. Fortunately you have a homeowners insurance policy to cover this cost. The problem is your water damage claim has been denied. Below we offer a guide to why things like a bathroom leak insurance claim can be denied and how you can fight a denied plumbing insurance claim.

Why Are Plumbing Claims Denied?

You may think insurance companies pay for any water damage. The reality is very different. Insurance policies have very specific language about what types of water damage claims are paid, and knowing the difference can help the success of your claim.

The core distinction between disallowed insurance claims and allowed insurance claims is whether the plumbing leak was a gradual or long-term leak versus a sudden or accidental leak.

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Why Are Plumbing Claims Denied?

You may think insurance companies pay for any water damage. The reality is very different. Insurance policies have very specific language about what types of water damage claims are paid, and knowing the difference can help the success of your claim.

The core distinction between disallowed insurance claims and allowed insurance claims is whether the plumbing leak was a gradual or long-term leak versus a sudden or accidental leak.

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Gradual or long-term leaks are usually not covered

Because insurance companies believe the homeowner could have prevented those leaks through regular maintenance; an insurance company will not pay a claim that resulted from perceived homeowner negligence. On the other hand, sudden or accidental plumbing leaks should be covered. Sudden or accidental water discharges do not result from homeowner inattentiveness or neglect but rather from some unforeseeable failure or event.

A few examples of sudden or accidental water discharges include:

  • Frozen pipes
  • Failed pipe fittings
  • Failed appliances and
  • Snow and ice accumulation

By and large, these events are not the result of neglect or inattentiveness but rather are unforeseen and unexpected. Accordingly, understanding when and how your plumbing leak arose is critical to a successful plumbing leak insurance claim.

How to Fight a Denied Plumbing Insurance Claim

If your water damage claim is denied for a plumbing leak, you may need to make a stronger case and appeal it to the insurance company. Treat your appeal as a negotiation with the insurance company. Insurance companies are businesses protecting their bottom line, and you need to convince them that they are obligated to pay—their default position is to not pay to protect their profits.

As a first step

Become familiar with your insurance policy and know what types of water damage claims will not be covered. Knowing this will help you understand why the insurance company denied your claim and where specifically in the policy it was justified. After you have a good understanding of the policy, take these next steps:

  • Obtain a written statement from the insurance company stating why the claim was denied and where in the policy the denial is justified.
  • Make notes about every person you spoke with at the insurance company, including their email, phone number, and employee I.D.
  • Take lots of photos of the plumbing leak and damage. Photos can be the most important source of evidence
  • Hire a company that specializes in water damage to do the cleanup, repair, and/or restoration
  • Get a written analysis from the cleanup company as to where, when, and how the leak occurred. This can help categorize the plumbing leak as sudden or accidental rather than gradual or long-standing
  • Save all damaged personal property, flooring, ceiling panels, and drywall as evidence for the insurance company
  • Save all receipts, estimates, analysis, and bills related to the plumbing leak and the damage it caused. Also gather your water bills before and after the leak because they can show when the leak occurred
  • Try to assemble evidence that you were proactive in controlling the leak (e.g., you turned off the water source immediately, removed valuables from the affected area, etc.)

Taking the above steps can help you file a successful appeal with your insurance company and get your plumbing leak covered.

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Lady Law Group Can Help You Get Your Insurance Coverage

Lady Law Group understands the obligations of homeownership and how we all expect the insurance company to hold up its end of the deal for plumbing leaks. With years of dedicated experience in reversing denied water leak insurance claims, we can quickly identify how to best approach the insurance company and help you get the coverage you deserve. Contact us today for a consultation.