Am I Insured for This?

New Mexico Home InsuranceAs an agent I am often asked about policy coverage as it pertains to a specific event.
First I would like to answer the question generally and then give four different examples of how this works in real life. Insurance coverage is intended for a specific unforeseen event that could happen to us but may never happen. Insurance is not intended for instances in which we know for a fact that it will undoubtedly happen. If we know that an event will happen then we should prepare for it in some other way, because it is not an insurable event. On the other hand, if an event happens to some people nearly every day, but you may go your entire life and not have it happen to you; well, that is an insurable event.
For instance: I was driving and ran into a patch of ice on the road and rolled my car, is that covered? This is an example of an event that happens to people every day, but you could go your whole life and never roll your car; therefore, it is an unexpected event. Yes, collision insurance will cover this accident.
In another example: a great big wind and hail storm struck my home and it damaged my roof and now I have a water leak, is that covered? Wind and hail damage is another example of an event that happens all the time, but not necessarily to us. Yes, wind and hail is a covered cause of loss in the standard homeowner’s insurance policy, you will need to pay your deductible and the insurance company should cover the balance of the damage.
A third example: My roof is leaking and has been for the last several months, I now have water stains on the ceiling of my home, and I don’t know when the roof started to leak exactly, is this covered under my policy? This is an example of an event that we know for a fact will happen to every home that was ever built; it will need a new roof. Notice, that there is no “event” here; the person cannot name a specific thing that happened that caused the roof to leak. This is a maintenance issue not an insurance issue. No, routine wear and tear, and maintenance of your home is not covered under your insurance policy. As a matter of fact, these issues are specifically excluded from coverage.
Finally: I came home from vacation and opened the door to my home and water came out, as it turns out the water heater sprung a leak and leaked the entire time that I was on vacation, is this covered? There are actually two different things that happened in this instance. The first loss is the damage to the water heater and the second loss is the damage caused by the leaking water heater. The first loss is an expected event: every water heater will eventually leak; and therefore it is a maintenance issue. Insurance will not cover the water heater. However, the second loss is entirely unexpected and it was caused by an insurable event, therefore it is covered. Your insurance company will pay to repair all of the water damage, but none of the plumbing.
Insurance can be a complicated contract, just remember that it is intended to cover a specific unforeseen event, and that routine maintenance issues are specifically excluded from coverage in the contract.

One Response to “Am I Insured for This?”

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  1. Lisa says:

    It’s very nice presentation. I am impressed; see if filing a claim is really necessary. Hail does damage a roof and will shorten the lifespan, but the damage may not be enough for an adjuster to declare. Roof repairs will be done bitterly currently as a result of new technology has given additional standard facilities like Mobile home Supplies

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