Rhode Island residents deserve the home insurance coverage they’ve been led to believe they have. Policies can be confusing and feel like everything favors the insurer when making a claim. How can homeowners get clarity on exclusions and find support from a Public Adjuster?
Here are the five main hidden policy exclusions most RI homeowners don’t know about.
The Risks of Not Knowing Your Homeowners Insurance Exclusions
Insurance policy exclusions aren’t always clear, and many insurers hope that you won’t fully understand what you’re not covered for. A lack of clarity about your homeowners insurance exclusions can lead to:
- Thousands of dollars in surprise out-of-pocket costs
- Unexpected claim denial for reasons that aren’t clear
- Feeling forced to agree to substandard repairs
- Long, stressful disputes with your insurer
- Significant drops in property value
While an insurer may have several reasons for denying a claim, it helps to be aware of the main hidden exclusions.
1. The Gradual Damage Trap
In this example, you may make an insurance claim for leaks from old pipes. An insurer could label this as gradual damage and argue that it’s not a fortuitous loss. The reason for the denied claim is a lack of maintenance. In other words, the responsibility is shifted from the old piping to a lack of care from the homeowner.
A skilled Public Adjuster supports your claim by reframing the event under the proximate cause doctrine, a standard used in Rhode Island courts that means an insurer must focus solely on the sudden burst itself.
2. The Wear and Tear Excuse
An exclusionary clause like this involves denying a claim for a storm-damaged roof on the grounds that it is old. A claim can be denied because the damage is attributed to wear and tear. Being backed by a reputable PA gives you the opportunity to prove the roof was directly damaged by the storm. A PA will gather evidence through certified weather data and forensic engineering reports.
3. The Earth Movement Exclusion
An insurer can deny a claim for foundational cracks, citing the earth movement exclusion. It’s a standard clause in most policies that helps your insurer avoid covering damage caused by sinking or shifting land. To combat this reason for denial, a skilled PA investigates further and applies the aforementioned proximate cause doctrine.
By citing Rhode Island insurance laws that adhere to this doctrine, your claim will be argued as being valid. A Public Adjuster asserts that the damage was caused by something you’re already covered for, such as a burst water main that saturated the soil.
4. Disputes Over a Complete Repair
This example involves your insurer agreeing that your claim is valid. However, they may then only agree to pay for minimal repair that doesn’t reflect the previous quality standards of your home. A Public Adjuster uses specific Rhode Island insurance laws to fight for a full restoration in three key areas:
- Code upgrades: Your insurer can refuse to pay for a full restoration under the Ordinance or Law exclusion. PAs argue that insurers should pay for mandated upgrades, such as a new sprinkler system required after a fire.
- Matching materials: Rhode Island’s Regulation 73, also known as the reasonably uniform appearance rule, requires an insurer to cover the replacement of an entire wall of siding to prevent mismatched materials.
- Quality of materials: PAs enforce the “like kind and quality” provision in your policy, which stops insurers from replacing hardwood floors or custom cabinets with substitutes made of lower-quality materials to reduce costs.
In all cases, a PA ensures your property is restored to its full value and safety, not just patched up.
5. Contamination and Mold
You may find that your insurer covers water damage in your home but denies any claims for mold or leaks caused by it. This tactic helps insurers avoid covering these costs by claiming that the mold is a separate event. Partnering with a PA to back you up can combat this. The argument challenges this refusal by asserting that mold is a direct continuation of water peril and therefore covered under your policy.
Your Partner in Fighting Back Against Unfair Technicalities
Your insurance policy is ambiguous for a reason. When it’s time to make a claim, this can become stressful and confusing. Performance Adjusting Public Insurance Adjusters argues against these exclusions on your behalf, helping you get the maximum possible recovery from your claim. As part of the Rhode Island community, we understand what it takes to fight claim refusals to protect homeowners in the area.
Let us push back against your policy exclusions by handling the claims process. Call 401-724-9111 or get in touch online for a free claim review to get started.
