Disagreement with insurance company about the definition of "in the building"
I hate to agree with evil corporate overlord but I think stoops are outside, even the underneath part. Your house starts where the heat starts and where the finished walls and floors start. I agree it’s annoying but common sense says the stoop is outside. Often there is even a little grated opening without glass under a stoop to allow for ventilation. Clearly you would never have a window to your house proper without glass or screen.
slopegirl
in Insurance 13 years and 7 months ago
5
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5 replies
brokedown | 13 years and 7 months ago
We’re making our first claim on our homeowner’s policy, and we’re frustrated by an illogical decision that the carrier made, so we’re trying to decide what recourse to take. We’ve just started the debate with them and hope to avoid getting into a legal battle or hiring a public claims adjuster, but we’ll do those things if we can’t resolve this ourselves. Maybe you can help…?
The key question is: Is the french drain that we have under our stoop– enclosed by brownstone on top, bottom, and 3 sides, with a locked gate on the 4th side– legally “in the building”? They’re saying that it is outside, so the damages that came from it aren’t covered under the part of our policy that pertains to drains. We disagree. Any thoughts?
RunJoe | 13 years and 7 months ago
The french drain you describe is outside the foundation walls. My insurace (Everest) has the following exemption when it comes to water backup and sump overflow.. Water under the ground surface pressing on, or flowing or seeping through: a. Foundations, walls, floors or paved surfaces; b. Basements whether paved or not; or c. Doors, windows or other openings.
brokedown | 13 years and 7 months ago
Thanks, run-joe…
But- we have our locked door outside of the entry way under the stoop, not inside it, so the sewage only came through an interior door, not an exterior one. More generally, it seems like a narrow interpretation of those exclusions would exclude pretty much every possible way that a sewage back-up would damage your house. I mean, when the pipe backs up, where can the sewage go except up through the basement, and in the house through “other openings”? (And I’m not saying that based on my own experience– our insurance carrier is covering the damage to the basement without further question. But if they *didn’t* cover it because the sewage flowed through the foundation walls– which it did, and which it pretty much had to do– I’d be furious, because that’s what happens in a sewage backup.)
brokedown | 13 years and 7 months ago
Thanks again, run- joe- I’m glad to know that about the cracks in the pipe, and also about your experience of the flooding. I’m sorry to hear that you had trouble, too…. And I am worried that the foundation is compromised! The first contractor who came to look at it said that there’s nothing to worry about — the holes are small, and we haven’t had any leaking in the rains since then. But I think I want to have to structural engineer check it out just in case, because the thought worries me, and I don’t want to get into more trouble with this down the line (when it won’t even be covered by insurance anymore). We do also have basement drains, so the water came into the basement from every possible side. It came into the house through the french drain in the entry way.
newsouthsloper | 13 years and 7 months ago
I would think the drain under your stoop is exterior to the building. The building begins where the foundation walls are. As far as your question about Policy language effectively excluding all sources of sewage Back-up, the reason is because Insurance companies do not want to cover those things. I normally advise against hiring public adjusters because they almost never add any value to the process and only make you think they have done something you could not have done yourself. But in this case, it sounds like you have nothing to lose if the carrier is declining coverage anyway. Also, before you do so, mention “Bad Faith” and file a complaint with the state department of Insurance. that almost always provokes action on their part.