Covered or Not?

[cottonland]

Here is the scenario..... Dwelling with Special Cause of Loss form. The "boot" around the vent pipe cracked and resulted in water entering the dwelling causing water damage to the ceiling during a recent rain/windstorm.

I realize that there is no coverage to replace the boot, but contend that the resulting water damage is covered as a result of the special from not requiring visible damage to the exterior of the dwelling.

Thoughts??

 

[iiinycboi]

i would think special cause covers everything except those 8 little exclusions.

 

[cottonland]

My sentiments exactly. Issue has more to do with the adjuster not being able to READ and understand the policy in the first place. Had to go up two levels to get someone that actually understands the coverage form. OIEVAY...

 

[Guest]

That would probally fall under lack of maintance.....claim declined.

 

[cottonland]

The boot is clearly not covered due to the lack of maintenance. The resulting interior water damage...... covered.

 

[Josh]

The boot is clearly not covered due to the lack of maintenance. The resulting interior water damage...... covered.

I don't know the answer to this, but wouldn't the lack of maintenance be considered negligence and give them grounds to legitimately dismiss the claim?

 

[cottonland]

I don't know the answer to this, but wouldn't the lack of maintenance be considered negligence and give them grounds to legitimately dismiss the claim?

Interesting stance..... I have always interpreted the "Negligence" exclusion to apply to a situation after a loss is known, due to the "save and preserve property" language. For example, a tree limb puntures the roof and the homeowner does no type of temporary repairs to further prevent loss.

"7.​

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​

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Neglect​

Neglect, meaning neglect of the "insured" to
use all reasonable means to save and
preserve property at and after the time of a​

loss."

I think it would be stretching it in this situation given the fact that the homeowner was unaware that the "boot" around the vent pipe was cracked. There had been previous rains prior to the damage and there were no signs of water leakage.

It boiled down to the adjuster trying to impose the requirement of visible signs of damage to the roof for water damage to be covered. This is true if the dwelling was written on a "Basic" form as opposed to special. The special form has the exact same requirement however it states that it does not apply to coverage A or B, so they covered it.

"3.​

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COVERED CAUSES OF LOSS - SPECIAL​

Subject to D. above, when Special is shown
in the Declarations, Covered Causes of Loss
means Risks of Direct Physical Loss unless
the loss is excluded in the following
paragraphs or in Section E. EXCLUSIONS.
a. We will not pay for loss or damage​

caused by or resulting from:

4) Rain, snow, sleet, sand or dust,
whether driven by wind or not, to the
interior of any building or structure or
the property inside a building or
structure, unless the building or
structure first sustains wind or hail
damage to its roof or walls through
which the rain, snow, sleet, sand or
dust enters. This does not apply to
Coverage A - Dwellings or Coverage​

B - Other Private Structures."

 

[Guest]

The boot is clearly not covered due to the lack of maintenance. The resulting interior water damage...... covered.

if the boot has lack of maintance, and that was the cause of the water damage, then there would be NO COVERAGE at all.

PERIOD end of story

 

[moonlightandmargaritas]

if the boot has lack of maintance, and that was the cause of the water damage, then there would be NO COVERAGE at all.

What about lack of maintenance?

(C'mon man, they even put a squiggly red line under it if you spell like a third...no second...grader.)

 

[Guest]

What about lack of maintenance?

(C'mon man, they even put a squiggly red line under it if you spell like a third...no second...grader.)

I am in a forum, I DONT CARE ABOUT SPELLING you ***, I am sick of you trolling me