Risk Management Tips

What is a FLOOD?

In the insurance industry the choice of words you use are sometimes very important. For instance, when I say flood is not covered under your home policy some people take that to mean damage from a washer, or toilet malfunctioning, or a pipe break is not covered. These items are not “flood”, they are water damage. If a sump pump backs up from too much water, that is water back-up. Unwanted water in your home can be flood, water damage, or water back-up.
A flood is water on the ground that backs up into a house from an exterior source such as a creek, lake, river, or drainage ditch. This is not covered by a home policy nor can it be added by endorsement. This coverage is a separate “flood” policy backed by FEMA.
Water damage, usually from freezing or puncture to a pipe, damage to a roof from wind or hail, or appliance overflow from a mechanical breakdown, is covered under the Home Owners Policy. However, even though the damage is covered, the cause, such as the broken pipe or malfunctioning appliance, is often not covered. The item that you need to be concerned with is what caused the water damage.
Finally, water back-up, usually caused by sump pump or sludge pump failure, is not covered automatically in the policy. It has to be added by an endorsement to the policy. The reason this is not covered is due to where the water comes from. Sump pump water is from under the foundation of the home or “ground water” and is specifically excluded under the policy.

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The “GAP” Gap

Here is where the GAP gap comes in.  In today’s economy Gap Insurance is incredibly important.  The prices of automobiles are regularly over 20,000 with many being much higher.  However, as soon as you buy that new vehicle its value plummets; the $20,000 car you bought 10 minutes ago may only be worth $16,000 now.  Your auto insurance covers your vehicle on an ACV or actual cash value basis.  This means insurance pays the value of the vehicle at the time of the loss.

If you have an accident in your one month old car, you may owe $4,000 more than it is worth, this is called the Gap.  This gap can be covered with Gap Insurance.  Gap Insurance is sold at the car dealership or from your personal auto policy.

When you add Gap Insurance at the dealership it cost between $400 and $800 for the life of the loan.  If you purchase it from me on your personal auto policy it cost between $10 and $20 every 6 months with no additional deductible.  On the high side, purchasing GAP coverage from us will cost you $200 over five years, and you can cancel it when you no longer need it.  So GAP on your personal auto policy cost half to one-fourth the price of the dealership charges.  Also, watch that deductible- with dealership GAP you have to pay an extra $1000 deductible!

So the moral of this article is buying GAP Insurance is good, but watch out where you buy it.

Posted in Insurance Explained |

Do You Understand How Your Insurance Policy Pays Out On Roof Claims?

It is early spring here in the Ozarks, sunny days, warmer weather and storms on the horizon.  Storms are the nemeses of insurance companies, as they have the ability to cost insurance companies a lot of money, quickly.  They also inspire people with pickups, clipboards and cell phones to become instant contractors.  These people roll into a hail damaged town, make promises to wave deductibles, do spotty work and are never seen again leaving you to hope the work was done correctly.

One thing that will help us as we move into this storm season is if we know how our insurance policy will work during a claim.  Keep in mind an insurance policy is a black and white policy that sets the floor, or least amount, an insured or insurance company can do.  When times are good insurance companies seem to pay more than is expected in the policy and when times are bad they tend to follow the letter of the policy.  So let’s assume we had a wind storm that damaged the west side of my 9 year old roof.  What does the policy owe for based on Insurance Service Offices HO OO 03 (all companies are slightly different but this is a generic base policy):

Under  Section 1-Conditions

C: Loss Settlement

2.  Buildings covered under Coverage A or B at replacement cost without deduction for depreciation, subject to the following:

a. If at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, after application of any deductible and without deduction for depreciation, but not more than the least of the following amounts:

(1) The limit of liability under this policy that applies to the building;

(2) The replacement cost of the part of the building damaged with material of like kind and quality and for like use; or

(3) The necessary amount actually spent to repair or replace the damaged building

d. We will pay no more than the actual cash value of the damage until actual repair or replacement is complete.  Once actual repair or replacement is complete, we will settle the loss as noted in 2.a and b above.

Wow, that was clear, so what does that mean? Well according to the policy above, the insurance company would owe for the repair or replacement of the damaged roof minus my deductible.  So if the west slope of my roof is 6000 to repair and I have a $1000 deductible the insurance company only owes $5000 in total.  However according to letter (d) above the insurance company only owes a portion of this until the work is finished.  So if my 20 year roof is 10 years old the insurance company owes $3000 and the rest when I prove the repairs are made.

Now what if a roofer says I need a whole new roof because of the age of the roof but still the damage is on the west side?  The Missouri Department of Insurance actually has that answer on the frequently asked Questions portion of their web page.  Here is what they have to say:

“The company is not responsible for repair or replacement of the roof unless it is damaged by a covered peril. The policy does not provide coverage for repair/replacement that is due to ordinary wear and tear or from lack of maintenance. The company can authorize repair/replacement for just that portion of the roof that was damaged by the covered peril.” www.insurance.mo.gov/consumer/faq/hofaqs.htm

So the Department of Insurance is clearly saying the insurance company only has to pay for the damaged portion regardless of the roofers feelings.

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