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Richard - Bizlaw
Richard - Bizlaw, Attorney
Category: Legal
Satisfied Customers: 9890
Experience:  30 years experience corporate, litigation, international
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I just had an insurance company deny a claim of damage. The

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I just had an insurance company deny a claim of damage. The damaged was caused when my water heater, unexpectedly discharged a large volume of water into my mobile home. When I noticed the problem, saw water running across the floor where it should not have been. I immediately turned off the main supply, opened the drain valve on the water heater, and purchased a new water heater and installed it in another location. I made no further repairs at that time. That was in September 2008. Recently, after falling through the floor of my bathroom,I decided to remove the old water heater, and determine the extent of the damage. To my surprise the damage was extensive. It encompassed the length of the Master Bedroom, the bathroom and extends into the kitchen area, under the range and counter top. I contacted my mortgage provider, who referred me to the insurance provider. An adjuster came and viewed the damage. She determined,falsely that the vapor barrier, which does not exist, was
Your question got cut off with the line that reads "and viewed the damage. She determined falsely . . . " Could you put in what follows that line.
Customer: replied 7 years ago.
Our investigation of your claim has indicated the following:

1. Due to wear and tear, water began to seep from your water heater. You dicsovered the loss and installed a new water heater in September of 2008. No other repairs were made at that time.

2. In August of 2009 you discovered that a significant portion of the flooring in your master bedroom, all of the flooring in the bathroom, and a portion of the floor in your kitchen had rotted to the degree that it is non existent.

Our investigation further indicates tath the vapor barrier under your home did not allow the water to escape. The water evaporated and caused the floor to rot and disintegrate over a period of time.

This damage is not covered under the policy you have with our Company.

   In the first statement, she fails to mention the ruptured seam on the water heater, which was forced out by the water pressure.

   In the second statement, she fails to mention that the rotted area of flooring, is consistent with the stains left by the rush of water across the surface of the floor. and is not consistent with the evaporation of water from underneath.

    In here third statement, she states that the vapor barrier did not allow the water to escape. There is no vapor barrier in those areas, and I have photos that will verify that fact. These photos were sent to another adjuster for the same company a week before this adjuster viewed the damage. Also photos show the stained area which was rotted, and is not consistent with the evaporation process the adjuster claimed was at fault. I do not know how she determined the vapor barrier was at fault, since she never pulled up any of the damaged flooring to determine if it was there, nor did she crawl up under the mobile home to determine if it was in tact.


Therefore, I believe that this claim was denied based on false information, and that I am entitled to a settlement and that if this matter were to be presented to a jury, that the jury would find in my favor as well as provide severe punitive damages against the insurance company for denying my claim with flase information.
You should put the foregoing information in a letter to the insurance company and make a demand that they honor the terms of the policy. You should review the policy to find the clause that would cover your loss and refer to that clause. If this is unsuccessful, you will have to take them to court. Depending on the cost of repair, you may be able to take the case to small claims court.

If this answer is responsive to your question, please accept it. That is how we are compensated. I would also be appreciated if you provided feed back on your view of the answer. Finally, if the answer was especially helpful you can provide a bonus. If I can be of further assistance or you have other questions in the future you can ask for me and reach me at this site.

This communication is not intended as legal advice. A local attorney should always be consulted for legal advice. No client/attorney relationship is intended or created by this communication.
Customer: replied 7 years ago.
This is the clause in the policy, which they provided in the denial letter, but I did not include it in my last response:

COMPRENENSIVE COVERAGE DEFINED

WE'LL pay for direct, sudden and accidental loss of, or damage to YOUR mobile home, adjacent structures and personal effects-not caused by collision or upset in transit. This is subject to all policy terms and condidtions.

PHYSICAL DAMABE DOESNT PROVIDEPAYMENT FOR:

Loss or damage due and confined to wear and tear, freezing, neglect or mechanical or electrical breakdown or failure, or manufacturer defect;


Do these clauses make a difference?
By claiming that the damage was caused from wear and tear and not from the water from the water heater they seek to avoid their obligation under the policy by pointing to this language. However, that same language makes them liable if the damage is not from wear and tear.

I also suggest you get someone who is an expert in water damage to review the situation as you will need that testimony if you go to cost. Be sure to keep whatever it costs you as if you are successful in court you can recover that expense.

If this answer is responsive to your question, please accept it. That is how we are compensated. I would also be appreciated if you provided feed back on your view of the answer. Finally, if the answer was especially helpful you can provide a bonus. If I can be of further assistance or you have other questions in the future you can ask for me and reach me at this site.

This communication is not intended as legal advice. A local attorney should always be consulted for legal advice. No client/attorney relationship is intended or created by this communication.
Richard - Bizlaw and 6 other Legal Specialists are ready to help you
Customer: replied 7 years ago.
I am an expert in water damage, have been a building contractor for over 30 years. I will now accept your answer so that you may be paid. Thank you.
Customer: replied 7 years ago.
Would you or your firm be interesting in filing this claim on my behalf? I have estimated the damages to be in excess of $3,500.00. Would also like to know about seeking Punitive damages against the Insurance company for attempting to deny my claim with false and misleading information.
We cannot take on indvidual clients from this site. I think you will be able to handle this yourself. Good luck and thank you for accepting the answer.

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