When does pre-existing damage become a reason for the rejection of insurance claims?

Many homeowners face a common predicament: the refusal or reduction of payouts for their homeowners’ insurance claims citing ‘pre-existing damage.’ This scenario is widespread and affects a significant number of property owners in the state. Insurance companies frequently assert that the issues in question already existed before the incident prompting the claim.

Why aren’t pre-existing damages covered? 

Insurance is designed to provide financial assistance for new or unforeseen property damages and is not intended to address problems existing before the policy’s inception. This serves to help insurers manage risk and maintain reasonable insurance costs for policyholders.

Common Reasons for Claim Denial 

Exclusion Clauses: Insurance policies often exclude coverage for known or pre-existing conditions. These could encompass structural problems, water damage, and termite infestations.

Lack of Maintenance: Insurance companies may reject claims if they determine that the damage resulted from inadequate maintenance. For instance, if roof issues existed before obtaining insurance, yet no action was taken to rectify them, a subsequent claim might be denied.

Nondisclosure: If you fail to disclose known pre-existing damage when purchasing the policy, insurers are likely to deny your claim. It’s important to remember that insurers rely on accurate information to evaluate risk and determine coverage.

Causation: If pre-existing damage contributes to the cause of a claim, insurers may deny coverage for the entire claim. For example, if pre-existing water damage worsens due to a covered event, the insurer may argue that the initial damage was responsible for the subsequent loss.

The insurance policy may contain specific terms and conditions that explicitly state their refusal to cover or limitation of coverage for certain types of pre-existing damage. Thus, it’s crucial to comprehend your policy’s terms and constraints.

Preventing Claim Denial

To avoid claim denials related to pre-existing damage, ensure that you disclose all known issues when procuring insurance. Reach out to your Triton Insurance Group agent for professional assistance to gain a clear understanding of what you need to disclose.

Additionally, it’s essential to take the necessary measures to maintain your property, perform regular inspections, and promptly address repairs. Don’t forget to maintain records of maintenance and renovations, as these can serve as evidence when needed. These proactive measures can help reduce the risk of claim denial due to pre-existing issues.

Triton Insurance Group is Florida’s premiere independent insurance agency, providing auto insurance, homeowners insurance, flood insurance, boat & watercraft insurance, business insurance, worker’s compensation insurance, umbrella insurance and equine insurance. We are ready to help you with all of your questions. 

Florida HQ
100 N. State Road 7 Suite 304
Margate, Fl 33063
Office: 866-400-7674
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Franklin, TN 37064
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Triton Agency works with hundreds of carriers so we can provide unbiased advice based upon what is best for our clients in both policy features and pricing. Whatever your Insurance needs (Home, Auto, Umbrella, Business, Liability or Workers' Compensation), we welcome you to experience the Triton difference.