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Legal Ease
Legal Ease, Lawyer
Category: Canada Law
Satisfied Customers: 95895
Experience:  Lawyer
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Insurance claim - my policy includes additional coverage

Customer Question

Insurance claim - my policy includes additional coverage options/water escape/backup extension endorsement - the backing up or escape of water from a sewer, storm drain, drain, sump or septic tank is added to the list of causes of loss or damage that are included in the peril. I have paid a policy deductible of $2,000 + extra premiums of $75 + $55. The adjuster tells me that only the results of the peril and not the cause is covered under my policy therefore I have paid the plumbing cost of $499 for unblocking the sewage pipes. The wording of my policy does not seem to reflect his interpretation. Is that a correct policy interpretation on his part? Please advise.
Submitted: 3 months ago.
Category: Canada Law
Expert:  Legal Ease replied 3 months ago.

Unfortunately, I do not have good news for you. Insurance policies never cover the cost of making a repair to the pipes or anything that caused the damage but rather just to the actual damage.

For example, if your toilet floods and causes damage the

insurance would cover all the damages you incurred as a

result of the toilet overflowing but you do not have coverage

to pay the plumber to fix the plugged toilet.

Do you see what I mean?

Customer: replied 3 months ago.
I understand that insurance companies normally do not cover the causes of damages but only the results. However, the additional coverage clause of my policy for WATER ESCAPE/BACKUP EXTENSION ENDORSEMENT states that the backing up or escape of water from a sewer is added to the list of CAUSES OF LOSS or DAMAGE that are InCLUDED in the peril. It specifically states the CAUSES as opposed to results. I pay an extra premium of $75+ $55 for the application of this clause. I would appreciate if you could review the wording of the policy and advise.
Expert:  Legal Ease replied 3 months ago.
You are interpreting the wording incorrectly. They are saying that in most cases this type of water damage from sewer back up etc. would not be included but it is being included. They are not saying that they pay for the actual cause.

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