I woke up the other day to find my front wall had collapsed due to the pressure of earth behind it that had build up over 50 years. The claims adjuster said that, as the wall had tilted outwards, which I'd never noticed, it hadn't been satisfactorily maintained and he rejected the claim. Replacing the wall cost $30K. Do the members think it's worth fighting his decision?
Accident Damage
- Thread starter NigelN
- Start date
- 182
Collapse due to earth movement is typically a coverage specific issue (some homeowners policies allow for endorsements for such coverage, but unless the endorsement is specifically added, it is generally specifically excluded.. commercial policies are a different story, but probably not relevant, and since you said you woke up and discovered the damage, I am answering the question with a homeowners or dwelling policy in mind), but when coupled with deferred maintenance, and the fact that based on the information that you provided, this was a long term problem that came to a head (the wall leaning forward over time and eventually collapsing), rather than a sudden and accidental event (which is what insurance is for), you probably will not get very far fighting it.
Check your policy for "earth movement" or "collapse". You can typically find a generic copy of your policy and any endorsements online in .doc or .pdf versions, and simply search for the words to find the sections relevant to your loss.
For example in the HO 00 03 10 00 form (a typical homeowners policy):
SECTION 1 - PERILS INSURANCE AGAINST
a. Coverage A-Dwelling And Coverage B-Other Structures
1. We insure against risk of direct physical loss to property described in coverages A and B
2. We do not insure, however, for loss:
a. Excluded under Section 1-Exclusions
b. Involving Collapse, except as provided in E.8 Collapse under Section 1-Property Coverages; or
When E.8 is referenced, it is referencing additional coverage for collapse, which can generally be purchased for an additional premium. Even in this case, there is an additional exclusion for earth movement, and the covered collapses would be limited to a collapse that renders a building uninhabitable. The only time a retaining wall (if that is what this is.. you were not clear in the OP) or any other structure that is not the actual dwelling would be covered for any type of collapse is if the dwelling itself collapsed and damaged the wall.
I hope this helps.
Check your policy for "earth movement" or "collapse". You can typically find a generic copy of your policy and any endorsements online in .doc or .pdf versions, and simply search for the words to find the sections relevant to your loss.
For example in the HO 00 03 10 00 form (a typical homeowners policy):
SECTION 1 - PERILS INSURANCE AGAINST
a. Coverage A-Dwelling And Coverage B-Other Structures
1. We insure against risk of direct physical loss to property described in coverages A and B
2. We do not insure, however, for loss:
a. Excluded under Section 1-Exclusions
b. Involving Collapse, except as provided in E.8 Collapse under Section 1-Property Coverages; or
When E.8 is referenced, it is referencing additional coverage for collapse, which can generally be purchased for an additional premium. Even in this case, there is an additional exclusion for earth movement, and the covered collapses would be limited to a collapse that renders a building uninhabitable. The only time a retaining wall (if that is what this is.. you were not clear in the OP) or any other structure that is not the actual dwelling would be covered for any type of collapse is if the dwelling itself collapsed and damaged the wall.
I hope this helps.
Last edited:
- 11,995
The above is an excellent answer by a well credentialed adjuster.
To trim it down a touch, usually insurance covers "sudden and accidental", not the result of things that have been developing for years, or in this case, decades.
To trim it down a touch, usually insurance covers "sudden and accidental", not the result of things that have been developing for years, or in this case, decades.
What Accelerated said. He's good about getting down to the facts. Let me argue for you though, just because its Friday night and I want to have some fun.
The earth didn't build up, its been there for 50 years!
or
The wall collapse was sudden and accidental.
or
The wall leaned outwards, but it collapsed inwards
or
The wall being maintained? Show me the recommended service plan!
or
Earth movement??? Earth didn't move, the wall did!
I'm sure you can come up with a few more 'arguments', but, in the end, they come down to the same thing..... it will be a denied claim for the reasons your adjuster (and Accelerated) spelled out. The wall gave out over time, not due to something 'sudden and unexpected'.
Think about it this way. If a water pipe in the ceiling of a new house breaks and water goes everywhere, its usually a covered loss. Not something you would have expected, and it happened suddenly (even if the water ran for hours). If the house was 50 years old and there were water stains on the ceiling for the last 6 months, then the pipe breaks, it probably isn't covered since the pipe wore out due to age, the water stains indicated a problem so it wasn't sudden (or even unexpected).
This, plus the fact that earth movement and/or collapse are separate can of worms, leads you to a claim denial. If you feel otherwise, you can dispute the claim. The letter you get from the carrier will tell you how to do this.
Dan
The earth didn't build up, its been there for 50 years!
or
The wall collapse was sudden and accidental.
or
The wall leaned outwards, but it collapsed inwards
or
The wall being maintained? Show me the recommended service plan!
or
Earth movement??? Earth didn't move, the wall did!
I'm sure you can come up with a few more 'arguments', but, in the end, they come down to the same thing..... it will be a denied claim for the reasons your adjuster (and Accelerated) spelled out. The wall gave out over time, not due to something 'sudden and unexpected'.
Think about it this way. If a water pipe in the ceiling of a new house breaks and water goes everywhere, its usually a covered loss. Not something you would have expected, and it happened suddenly (even if the water ran for hours). If the house was 50 years old and there were water stains on the ceiling for the last 6 months, then the pipe breaks, it probably isn't covered since the pipe wore out due to age, the water stains indicated a problem so it wasn't sudden (or even unexpected).
This, plus the fact that earth movement and/or collapse are separate can of worms, leads you to a claim denial. If you feel otherwise, you can dispute the claim. The letter you get from the carrier will tell you how to do this.
Dan
- 182
I have yet to work with a carrier that "looks for excuses to deny", and our firm works with carriers worldwide. Adjusters look at the policy and determine if it is a covered loss or not. In this case, with the caveat that the OP did not specify the type of policy in place, and that I based my response on the limited info provided (which was spelled out in my earlier post), if I was correct about the policy type, that does not translate into "looking for an excuse not to pay". Put yourself in the shoes of an insurer instead of shamelessly plugging your website with misleading information. If an insurer says "we protect from sudden and accidental loss in these cases", and the insured agrees to the terms, would you pay the insured anyway for an obvious 50 year deferred maintenance issue (as the OP described it), or would you define 50 years of deferred maintenance as a "sudden and accidental occurrence"?
Who is you insurance company?
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