Clog and overflow water events are often mischaracterized as sewage backup by unwitting property insurance consumers. Although a clog within a plumbing system resulting in an overflow is almost universally covered by homeowners’ policies, sewage backup is not. Sewage backup is considered ground water and excluded unless a severely limited addendum has been purchased with the policy.
Incorrectly using the term sewage backup while reporting a water damage insurance claim, routinely triggers a bogus denial during the initial claims call. Platitudes expressed via insurance company advertising campaigns, promising fair, and equitable treatment, are rubbish. You will be denied based on semantics and financially abandoned regardless of claim legitimacy.
Semantics Based Denials
Denial of coverage is the goal of insurance companies industrywide. Insurance company claim specialist’s primary objective is to deny claims on the initial call to limit payouts. Additionally, insurance adjusters are trained to ferret out any possible avenue that would refuse coverage, leaving the property owner to finance costly emergency restoration services without the benefit of their policy.
There are several tactics utilized by the insurance industry to abandon property insurance claims that constitute false denial. This article explores one such situation, whereby insurance companies routinely abandon their customers based on word choice when reporting a property claim.
Sewage Backup or Clog and Overflow?
Water main breaks or flooding caused monumental rains in low lying areas can overtax sewer systems, causing water to flow from the sewer into a lateral then into the property through the nearest drain. Flooding originating outside the plumbing system that flows backward through the plumbing into the property is a backup.
Conversely, an overflow occurs when there is a blockage within the plumbing system that wastewater cannot escape. Introducing water into a blocked drainage system will ultimately cause an overflow at the upstream drain nearest the clog.
Sewage Backup is Groundwater
Property insurance policies generally exclude water damage caused by groundwater flooding. Exclusions include groundwater infiltration caused by water main breaks, storms, overflowing bodies of water, runoff of surface water, mudflow waves, tidal water, and spray from flooded areas or bodies of water. Additionally, water damage caused by sump pump failure, or any system designed to remove subsurface water from a building’s foundation is considered ground water and not covered by standard homeowners’ policies.
Although homeowners’ insurance does not typically cover groundwater flooding events, most carriers offer extremely limited backup coverage with the purchase of an addendum to the primary policy. Sewer backup endorsements cover backups into the house from municipal waste lines or overflows and escapes a sump pit. Comprehensive coverage for groundwater flood damage, however, requires a separate flood insurance policy. Lenders typically require flood insurance in areas at risk of groundwater flooding.
Sewer Backup is Uncommon
Blockages within a plumbing system causing an overflow are commonplace. Sewer backup is exceedingly rare, requiring flooding rains coupled with specific geography. Incorrectly using the word ‘Backup’ to describe a water event in your home will trigger an instant denial and there will be no further investigation into the matter.
Insurance company representatives will not correct your choice of words. There will be no research of weather conditions on the loss date to determine if a sewer backup was a possible cause of loss. Ironically, if you describe a covered water event, indemnification will not be awarded until after a thorough investigation.
Handling a Water Damage Claim
Insurance claims are a business negotiation. Insurance consumers who paid faithfully for indemnification often face a struggle when coverage is requested. If your claim is denied, you should ask for an explanation. Since several different insurance company employees can work on your claim, it is important to understand who made the decision to deny payment and the basis upon which that decision was made.
If you are not satisfied with insurance company explanations of denial, you can always ask for a second opinion. If you believe you should have been covered for the damage and your insurance provider is standing firmly behind their denial, it is a good idea to seek professional assistance.
Sewage Cleanup in Philadelphia
Property Recovery 911 abdicates for insurance consumers facing refusal of coverage. We understand the mechanisms of water damage and routinely successfully negotiate coverage following false denial. Contact Us at (267) 808-7200 for residential, commercial, municipal, and industrial sewage cleanup in Philadelphia and the surrounding counties. In the event of such a crisis, we have the experience to restore the site safely and professionally to pre-loss condition. Our specialists are on call 24/7/365 and can be on location any time of day to resolve the issue quickly and professionally.