| Author |
 Topic  |
|
|
wberg
USA
6 Posts |
 Posted - 08/12/2003 : 20:05:02
|
I would like to pose the below coverage question. The parameters are as follows:
1.) Policy = HO 0003 4/91 Edition.
2.) Endorsements = No sewer and drain backup. Replacement cost on dwelling and contents.
3.) Deductible = $250.00
4.) Loss amount = $2,600.00
Loss specifics:
On a given day the insured suffers a backup from a basement toilet. The basement is unfinished. Cleanup is done by the insured. Insured calls plumber, snake out is done, drainage is slow. Plumber does video, states the line needs replacement, they proceed to replace 30' of sewer line to the street connection, the line under the pad is untouched and the plumber tells insured to call carrier after the work is completed some ten days later.
Insured reports claim, stating no damage to unfinished basement, yet, concerned about hygiene after they cleaned up. When asked about what caused the backup, it was stated, "Don't Know".
Is this a covered loss?
If roots damaged line, is it covered?
If deterioration of the line is involved, is it covered?
If ground shifting due to heavy rains caused breakage of the line, is it covered?
If toilet paper had clogged the line, is it covered?
With the absence of the sewer/drain endorsement, could this be considered an overflow?
Granted that the cause of the backup is unanswered, the plumber neglected to tell the insured or the insured has failed memory. Calls to the plumber by the assigned adjuster go unanswered.
Where to from here?
What would happen if the endorsement was present?
|
|
|
CCarr
Canada
1200 Posts |
Posted - 08/17/2003 : 22:41:41
|
William,
I am concerned that no one has offered any thoughts to the "coverage question" you have posed.
The detail you provide before you ask your first question is unfortunately quite typical on too many claims of this type.
Dealing with each question -
(1) Is this loss covered? - I don't know, there is not enough relevant detail for a "yes" or "no" answer.
(2) If roots damaged the line is it covered? - That would / could be a carrier specific decision. I can see "Definitions" being a concern, i.e. occurrence, accident, wear and tear, deterioration.
(3) If deterioration of the line is involved, is it covered? - No, without regard to any other issue.
(4) If ground shifting due to heavy rains caused the breakage of the line, is it covered? - No (see Section I - Exclusions, 1b), without regard to any other issue.
(5) If toilet paper had clogged the line, is it covered? - Yes, as long as the carrier does not consider a toilet bowel as a sewer or drain.
(6) With the absence of sewer / drain endorsement, could this be considered an overflow? - Not sure that I understand that question. What you have described is an overflow / back up of a plumbing system. The presence or absence of the noted endst does not change what happened; but restricts coverage (without the endst) or broadens coverage (with the endst).
(7) Where to go from here? - The answer lies in your preceeding paragraph. The cause of the back up must be determined. "Unanswered calls" to the insured and plumber are insufficient detail for a carrier to decide anything.
(8) What would happen if the endorsement was present? - Repeat, as per my thoughts #1 to #7. |
 |
|
|
trader
USA
236 Posts |
Posted - 08/18/2003 : 00:36:11
|
| I wanted other,s also. If you sent me the file with these facts, I would surmise the line collopsed out near the street, and rain soaked into the ground and backed up into the basement toilet. No coverage for any losses. Falls into the catagory of "all bad things that happen around an old house" are more of a maintance issue than insured losses. |
|
|
|
Dadx9
USA
143 Posts |
Posted - 08/18/2003 : 19:20:44
|
| If there is no damage to the structure there is no named peril. If there is no named peril there is no consideration for the hygiene or mold. Without sewer / drain backup endorsement, where's the coverage. If there is endorsement then access to the pipe and ensuing damages covered. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
|
|
| |
Topic |
|
|
|
Sewer Backup/Drain Backup/Overflow
Forum Locked
