By: Brett Carter

In the disaster restoration business, we see this all the time: A homeowner with a damaged home is upset with their insurance company because their policy doesn’t cover something that they think should be covered. “Why do I pay premiums every month if I can’t use my insurance when I need it?” they often say. Nine times out of ten, they’re referring to a roof problem, old damage resulting from neglect, or mechanical system breakdown.

While we agree that insurance should be there for you when you need it, there is a difference between what insurance policies are supposed to cover, and what is simply a maintenance issue that would be covered by something like a home warranty, or else paid for out of pocket by the homeowner who has saved money in preparation for what they should know is the cost of home maintenance.

Most insurance policies specify that in order to be a covered claim, the damage must be the result of a “sudden and catastrophic” incident. Asking your insurance company to replace your twenty-year-old roof because it is leaking is not “sudden and catastrophic;” it’s the inevitable result of what happens when your roof gets old and needs to be replaced.

For instance: If your washing machine malfunctions and overflows during the rinse cycle, that is sudden and catastrophic. The resulting damage likely will be covered by your policy under normal circumstances. However, the repairs to your washing machine (or replacement of it) will not be covered by your insurance. Why? Well, for the same reason a transmission repair isn’t covered by your auto insurance; it’s a maintenance cost resulting from the fact that if something gets old enough, it breaks down.

The good news is that there are warranties to cover those things that homeowner’s insurance doesn’t cover. Good roofers offer warranties. Home warranty companies offer warranties on a home’s mechanical systems and appliances, over and above the existing warranties offered by the manufacturers.

The purpose of insurance is to cover us for damage that is so costly we could not afford to pay for it out of pocket without it ruining us financially. It’s simply to protect our financial security in the event of a disaster – not as a convenience to save us from having to dip into our vacation funds. That’s why deductibles exist. They give us a relatively small financial stake in the claim in order to discourage frivolous claims being filed.

Here’s another example: You have a leak in your shower pan or tub area, and later discover water damage to your floors in the surrounding area. The adjuster notices that the edges around your shower pan or tub area are missing grout or caulking, which is intended to seal the water in and prevent leaks. Your claim is denied

I have seen a few homeowners get very upset about the previous scenario. They argue that they didn’t know there was a leak until they saw the floors buckling or the carpet wet in an adjacent room. What they seem unable to comprehend (or admit) is that they had a responsibility to replace the missing grout or caulk around the shower/tub area in order to prevent a leak. The problem was a direct result of negligence on their part, which resulted in a slow buildup of water under the walls and floors, not a “sudden and catastrophic” flood.

We each have the responsibility to keep our homes reasonably well-maintained in order to prevent damage. That means that if there are tree limbs brushing against the roof, we have them cut back; If our rain gutters are clogged, we clean them out; If we notice a slow leak in an appliance, we disconnect it or discontinue its use until it is repaired so that it will not cause serious damage.

So save that insurance claim for something serious. Maintain your home and pay close attention to anything unusual happening in your house in order to prevent serious damage. And finally, get a warranty to cover your roof and mechanical systems, or start a savings account specifically for home maintenance.