Water damage insurance claim help: leaks, burst pipes and ceilings

It depends mostly on how the water got there. Standard policies are written for sudden and accidental damage.

Many policies exclude water that leaks or seeps repeatedly over time. Some exclude a leak that lasted more than 14 days. Others say “weeks, months or years,” and some make an exception for a hidden leak inside a wall or floor that nobody knew about. Your policy wording decides, so read the water and exclusion sections before you talk to the adjuster (the insurer’s damage inspector).

Many policies pay for the damage the water caused, such as wet drywall, ruined flooring and soaked cabinets. They may not pay to fix the pipe, water heater or appliance that failed.

Many policies also pay to tear out and replace part of a wall or floor so a plumber can reach the leak. Ask for tear-out and access work as separate estimate lines.

The estimate usually shows the full repair cost and that cost minus depreciation (a deduction for age and wear). Our guide to actual cash value vs replacement cost explains why the first check can look small.

Many policies cover water damage from a pipe that freezes and bursts, but usually only if you took reasonable care to prevent it.

Expect the adjuster to ask:

• Was the heat on, and what was the thermostat set to?
• Was anyone living in the home? If not, for how long?
• If the home was empty, was the water shut off and were the lines drained?
• When did you first notice the water?

Write your answers down; utility bills can show the heat was on. If a winter storm also damaged the roof or siding, our storm damage claim guide covers that side of the claim.

Your policy expects you to prevent more damage: shut off the main water valve, cut power to wet areas if it’s safe, and start drying. The Texas Department of Insurance notes that mold can start growing within a day after a leak, so speed matters.

Before anything is torn out, take photos and video of:

• The source: the broken pipe, hose or fitting, up close and from a distance
• Every wet room, including ceilings, baseboards and the floor below
• Stain lines on walls, which show how high the water reached
• Damaged belongings, before you move them

Bag and label the failed part, such as the burst pipe section or split hose. Ask the plumber to write the cause of the leak on the invoice. If drywall or carpet must come out early, photograph it and keep a small piece.

A mitigation company (a crew that dries the home with fans and dehumidifiers) often arrives within hours. Their work is often part of the claim, so read their paperwork.

Ask for the drying records

Good crews log daily moisture readings. Ask for copies: they prove what was wet and how long drying took.

Read before you sign

Some forms only authorize the work. Others hand over your right to be paid by the insurer, called an assignment of benefits. Some states limit these agreements. If a form assigns your benefits or lets the company deal with your insurer, slow down, ask questions and get a written estimate.

If you can’t stay in the home

If drying or tear-out leaves the home unfit to live in, many policies pay the extra cost of staying elsewhere under loss of use coverage. Keep every receipt.

Many homeowners policies limit mold coverage. Some cover mold only when it results from a covered water loss. Some cap mold cleanup at a set dollar amount. Others exclude it unless you bought an endorsement (an add-on to the policy). Check your declarations page and policy for the word “fungi” or “mold.”

Mold from a covered leak that wasn’t dried quickly can be harder to claim, so start drying at once and keep proof of when.

Standard homeowners policies exclude flood: water that rises from outside, like an overflowing river, storm surge or heavy runoff. Flood is covered by a separate policy, most often through the National Flood Insurance Program (NFIP). If water came in from outside at ground level, read our page on how NFIP flood claims work.

Water backing up through a floor drain or toilet is also usually excluded, unless you added water backup coverage. Rain entering through a hole made by wind is often covered.

Compare the likely repair cost with your homeowners insurance deductible. If the damage is close to the deductible, a claim may pay little and still appear on your claim history. Claim histories are shared through reporting companies such as LexisNexis C.L.U.E., which keeps up to seven years of property claims. You can request one free copy of your report every 12 months.

A ceiling stain can hide wet insulation and framing above it. If more damage is found after repairs start, the extra cost can be requested through an insurance claim supplement on an open claim.