As a homeowner, you might expect that any damage to your home qualifies as sudden and accidental. However, insurers have specific criteria when determining if a loss is “sudden and accidental” and use them to approve or deny claims. Attorney Bill Voss explains this vital form of coverage and how it affects your homeowners' insurance claim for water damage.
What Is Sudden and Accidental Damage?
Insurance companies set certain limits when determining whether they should cover a loss. In particular, insurers won’t pay for losses caused by lack of maintenance or normal wear and tear. A loss must be sudden and accidental—an unforeseen incident caused by a single event. The most common sudden and accidental damage claims involve flooding. Sudden water damage incidents are often caused by malfunctioning appliances (leaking dishwashers, washing machines, or water heaters), burst pipes, or water infiltration from a severe storm. Sudden and accidental damage coverage in Texas may be used to pay for the following:
- Walls or flooring. A broken dishwasher hose or overflowing toilet can ruin the floor beneath, requiring new floorboards or drywall installation.
- Furniture. Insurance should pay to replace personal property damaged by internal flooding, including home furnishings, TVs, clothing, books, and computers.
- Plumbing repairs. If a sudden drop in temperature causes a pipe to burst and flood your home, insurance should cover the cost of the replacement pipe and the surrounding water damage.
- Appliances. Accidental coverage should pay for any appliances impacted by flood damage, such as vacuums or clothes dryers.
- Electrical damage. Insurers may cover electrical problems from flooded junction boxes, outlets, and wiring.
- Additional living expenses. If water damage renders the home uninhabitable, homeowners may be entitled to additional living expenses benefits, such as a hotel stay or mileage reimbursement, while repairs are made.
What Isn’t Covered Under a Sudden and Accidental Damage Policy?
The determining factor in a sudden and accidental damage claim is whether the homeowners could have reasonably predicted or prevented the loss. Insurance won't cover any water damage or plumbing costs due to negligence on the homeowner's part, such as failure to clean the roof gutters or fix a leaking pipe. Sudden and accidental damage insurance also does not apply to:
- The source of the damage. Although property damage coverage will pay for items ruined by internal flooding, it doesn’t pay to repair or replace a malfunctioning water heater, refrigerator, or other cause of damage. This is because homeowners must pay maintenance costs, including replacing malfunctioning appliances. However, home warranty coverage may cover the cost of replacing an appliance.
- External flooding. Flooding from a storm system or hurricane is rarely under standard homeowners insurance policies. Texas property owners must purchase coverage under the National Flood Insurance Program (NFIP) to protect against storm surges or rainfall flooding.
- Sewer backup. Water damage from a blocked sewer line or drain backup usually isn't covered under standard homeowners insurance. Still, insurers may offer optional sewer and water backup coverage as a policy extension. Additional coverage is particularly useful in toilet backup claims since inspections may reveal a cause of damage in the sewer line rather than a malfunctioning toilet.
Let Us Help You Get Full Payment for Damage to Your Home
Insurance companies have teams of adjusters and lawyers who are paid to challenge every aspect of water damage claims. Even if the insurer acknowledges the sudden and accidental damage, it may delay payment or underpay homeowners entitled to full coverage under their policies.
The Voss Law Firm can help if your insurance provider refuses to honor your claim. Call us at 888-614-7730 or complete our contact form today to get answers to your questions, or start reading our free guide, Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse, and Refuse.
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