Do insurers have a responsibility to pay for long term leaks in the house? The answer is usually no. Most homeowners’ insurance policies have an exclusion for long term leaks. The policies will pay for leaks that are discovered and attended to right away, and insurers do have a responsibility to pay for these leaks (after the deductible is met, of course). However, no insurer will pay for damage that could have been avoided by fixing the leak when it was first noticed.
Insurers will also contest paying for long term leaks that took a long time for a homeowner to notice. That is because there is a reasonable expectation that a homeowner would notice something that would indicate to them that a leak was going on and get it fixed before it became a larger problem.
If the homeowner only lives in the house part-time, or was away for several months for work or other reasons when the leak first occurred, there might be an argument that there was no way to avoid it turning into a long term leak, due to the absence of the homeowner. It will be an uphill battle to get a homeowners insurance policy to pay for leaks even in these circumstances, and the responsibility for them to pay for those leaks is questionable. However, if there is ever a chance to get a long term leak repaired by homeowners insurance, it is in this circumstance alone.
Since long term leaks are an exclusion to coverage, it is the responsibility of the insurance company to prove that the damage was not sudden and accidental, but occurred over a long period of time. A homeowner who makes a claim for leak damage and says the leak was recent can expect insurance adjusters to come to their home to gather evidence to prove their case. The leak and the damage it has caused will be closely examined, pictures will be taken, and statements from the homeowner may be taken, as well. The insurance company will use this evidence to try to prove the leak is a long term one instead of a recent problem.
If the insurance company cannot definitely prove the leak is a long term one and the homeowner cannot definitely prove it was a sudden leak, the case for the claim may go to court. There, it will be up to a jury to decide the true nature of the leak.
If the leak is determined to be a recent one, the insurance company will be ordered to pay the claim, and probably attorney’s fee and the court costs of the homeowner. If the leak is found by the jury to be a long term one, the insurance company will not have to pay for it, and the homeowner may responsible for the court costs of the insurance company.
Of course, most leak cases do not get to the point of going to court. Going before a jury is not the most desirable outcome for either the homeowner or the insurance company. If length of time over which the leak has occurred cannot be determined, both the homeowner and the insurance company’s interests may be best served by a compromised settlement.
In every case, the best outcome is for the homeowner to avoid long term leaks by taking care of leaks as soon as they occur. This way, there will never be any question of the nature of the leak, and the homeowners insurance company will pay the claim without argument.
Attorney Luckman’s practice areas include personal injury, insurance and disability claims, long term care claims and insurance law. There are no legal fees in contingency fee cases and no fees at all unless your case is successfully resolved through negotiation or court award. For a complimentary case review, call Attorney Eric Luckman at (561) 867-6010.