Insurance claims (home) questions

Jem

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So I've already posted about my issues with water getting in the house and then the resulting carpenter ants issues.
Ants have hopefully been taken care of as we had the exterminator come twice now. And we think we found the source of how the water was getting in...but now we are dealing with the aftermath of damage to the home. I know for sure there is some, but unsure of the extent.
I've contacted a restoration company that deals with water damage (among other things), and one of the first questions they asked was if we are going thru insurance. I also contacted an independent contractor, and he also asked about insurance.
I just want someone to tell me where the water was coming in and the extent of the damage. But it seems like they have to start an insurance claim at the same time??? If I can fix some of the issues myself, and hold off on some things I want that option. I'm also terrified of going thru the insurance due to increased premiums. And what if they find mold? Will they force me to fix it right away and evacuate us from the home?
Has anyone dealt with a house insurance claim before? I also contacted my insurance and it seems like my insurance wouldn't cover it if I put in a claim...but the restoration company thinks otherwise. What if the costs to fix are out of my budget and my insurance denies my claim? Will I be forced to fix everything because there is a "paper trail" that my house could be "contaminated" or "unsafe"?
I'm so stressed....I'm scare of this possible Pandora's box scenario.
 

Buffster7

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I have not seen your previous post, so forgive my asking, but what was the source of the water damage?

Usually with home damage, you'll want to have the home inspected by an independent party to determine extent and source of damage. Then you can check your policy to see if that is covered by your insurance. (For instance, poor construction or improper flashing that leads to water damage is usually not covered, but a pipe bursting resulting in water damage might be covered) If it is, you file a claim and the insurance company will send their adjuster out there to do their own inspection. If the adjuster agrees with the initial inspector that there is damage and it's caused by something that is covered by insurance, then they'll cut you or the repair company a check.

I'm no expert, but dealing with some repairs of my own right now. For one of the repairs, my insurance company suggested I have the issue looked at by a contractor prior to involving them. Good thing I did, because that issue would not have been covered by insurance, and you don't want to file a claim unless you're certain it's covered and risk your rates being raised.

On the next issue, my roof, I had a roofing company come inspect my roof. They found enough hail damage to replace the roof. I then filed a claim. Insurance then sent their adjuster out....and so on. In your case, you should be able to get a contractor out to inspect, report findings, and provide a bid to repair without involving insurance.
 
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Jem

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We "think" the water was entering from overflowing eavestroughs during heavy rain storms. But we don't really know how the water is/was getting in. That's one of the things I want someone to look into. If we can just stop the water from getting in and let things dry out, it may lower the cost of repairs, if the structural parts of the home are fine. We are also actively taking measures to stop more ants but that is also what I need help with...how they got in.
 
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Jem

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I'm no expert, but dealing with some repairs of my own right now. For one of the repairs, my insurance company suggested I have the issue looked at by a contractor prior to involving them. Good thing I did, because that issue would not have been covered by insurance, and you don't want to file a claim unless you're certain it's covered and risk your rates being raised.
That's where we are right now (getting a contractor to look), but I'm just scared of what they'll find...and if I can't repair it right away, I'm stuck with (even more) damage to my home. The walls will need to be opened up as that is where the water was settling...in the wall cavity of an exterior wall.
 

Koveshnikov

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So I've already posted about my issues with water getting in the house and then the resulting carpenter ants issues.
Ants have hopefully been taken care of as we had the exterminator come twice now. And we think we found the source of how the water was getting in...but now we are dealing with the aftermath of damage to the home. I know for sure there is some, but unsure of the extent.
I've contacted a restoration company that deals with water damage (among other things), and one of the first questions they asked was if we are going thru insurance. I also contacted an independent contractor, and he also asked about insurance.
I just want someone to tell me where the water was coming in and the extent of the damage. But it seems like they have to start an insurance claim at the same time??? If I can fix some of the issues myself, and hold off on some things I want that option. I'm also terrified of going thru the insurance due to increased premiums. And what if they find mold? Will they force me to fix it right away and evacuate us from the home?
Has anyone dealt with a house insurance claim before? I also contacted my insurance and it seems like my insurance wouldn't cover it if I put in a claim...but the restoration company thinks otherwise. What if the costs to fix are out of my budget and my insurance denies my claim? Will I be forced to fix everything because there is a "paper trail" that my house could be "contaminated" or "unsafe"?
I'm so stressed....I'm scare of this possible Pandora's box scenario.
you can add additional risks to your insurance ... if it does not cover any risks by default ...
 
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Jem

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I didn't get things about mold, paper trail and your responsibility to fix it ... this is your home, isn't it? ...
Yes it's my home....
What I mean is can they force me to fix things with them right away, or do I have the right to fix things on my own, as and when, I can afford it. If they give me a ridiculous quote, and my insurance doesn't cover it....Do I have the right to only fix part of the job or take of things on my own?
I'm NOT trying to absolve myself of responsibility, or going to live in a mold infested cesspool! I just can't afford a huge bill right now, and don't want to be forced into something that can wait. Sometimes you can eradicate mold yourself...my sister did, from a leaky roof. But because I need someone to tell me where the water is getting in, they will have a "paper trail" that there is problem with my home, and I just want to know if they can "report me".....I will fix things, I just need to save as much money as possible. Let's face it, a contractor, especially if they a quoting for (possible) insurance purposes, jack the price and include EVERYTHING, that "needs" to be repaired. I just don't trust the process.
 

Buffster7

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but the restoration company thinks otherwise. What if the costs to fix are out of my budget and my insurance denies my claim? Will I be forced to fix everything because there is a "paper trail" that my house could be "contaminated" or "unsafe"?
I'm so stressed....I'm scare of this possible Pandora's box scenario.
I understand and sympathize with the anxiety of what the inspection will reveal. First things first, source of water entry must be identified and addressed - the repairs can come later. Carpenter ant damage won't be covered by insurance, but I would be interested in knowing why the restoration company thinks that it or the water damage might be. It's worth investigating.

If the restoration company believes it to be a valid claim, they'll submit pictures and a report to your insurance company on your behalf. Explain your financial concerns and that you don't want to file a claim unless they're confident that you have a case, see what they say. They want the business, and they may be willing to go to bat for you if they feel your claim is valid.

I'm not sure what you mean about being forced to fix everything - I don't know the extent of damage you have, but no one can force you to fix your own home. You fix your home like you'd eat an elephant... a bite at a time. You could be surprised when they get in there - it may not be as extensive as you fear!
 
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Jem

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First things first, source of water entry must be identified and addressed - the repairs can come later.
We are on this part, it's what I want fixed right away.
I don't know the extent of damage you have, but no one can force you to fix your own home.
I was just worried if they would file some sort of report with the insurance or city if there is mold or mild structural damage...I will fix it, but it may just take some time. I will do what I have to, to make sure things are safe, but it may just look like a war zone for a while.
 

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As far as I know---although Canada may be different---the city can't force you to fix the inside of your house. There are ordinances about the outside if you live in town, but indoors is your business. If you have kids, social services will step in if there's no heat or running water, or other inappropriate conditions exist, and a disabled adult may also have to deal with social services, but in general adults can live however they want, unless it gets so bad the health department has to step in.

Maybe call the city to ask if there are any local ordinances about that?
 

susanm9006

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The insurance company won’t force you to fix anything, even if they find damage that you are insured for and they pay out a claim, it is usually a check to you. I had hail damage for example and got a check but the insurance company doesn’t follow up to see if you made the repair. But getting insurers to agree to damage is another thing entirely. First it needs to be a covered peril, like storm or wind damage. A clogged gutter probably isn’t covered, because you have an obligation to keep your property in repair but some of this depends on the type of policy you have. And if they do cover any of it, It will be subject to your deductible. I would pull your policy and read it to understand what coverage you have and what your deductible is.

If I were in your position, I would have multiple contractors come out, assess the issue and give you an estimate of remediation costs. Having different companies look at the house gives you the most information on what the problem might be and sometimes there isn’t consensus on the problem or the solution. None of these are going to turn you in or force you to do anything you don’t want to do. Taking the time to get educated will save you dollars in the long run and help you pick the right contractor to do a permanent repair.
 
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Jem

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If I were in your position, I would have multiple contractors come out, assess the issue and give you an estimate of remediation costs.
I was able to get 2 contractors. Many that I called either don't deal with what's wrong...they only do basic renos, or they flat out said they can't help me at this time. It's the busiest time of year plus there is a significant shortage of building supplies right now and many housing contractors were delayed due to Covid, so they are trying to catch up. I have managed to get a specialized remediation company that deals with water,fire, etc damage that is supposed to contact me to set up an estimate and also a general contractor from a private business, that I'm to call back to get him out for an estimate.
 

susanm9006

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One little gizmo you might think about picking up is a moisture meter. You can run it along walls, ceilings or baseboard and it will tell you the moisture levels so you can find the wet spots which may lead to where the water is coming in.
 
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Koveshnikov

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One little gizmo you might think about picking up is a moisture meter. You can run it along walls, ceilings or baseboard and it will tell you the moisture levels so you can find the wet spots which may lead to where the water is coming in.
thank you for this great idea :) such a thing will come in handy :)
 

Talien

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Your insurance company can't force you to fix anything, but they can (and often will) drop you if you don't address what they want you to take care of. Black mold falls into that category, if it's discovered and your insurance company finds out you will need to address it within the timeframe they give you or risk having your coverage dropped.

It may be different in Canada but that is how it works in the US, or at least here in Michigan.
 
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