Is Structural Damage Covered by Home Insurance?

Home insurance protects homeowners from unforeseen events that can damage their property. Whether structural damage is covered by a home insurance policy depends on the specific cause of the damage and the terms outlined in the policy. This article clarifies common scenarios regarding structural damage coverage.

Understanding Structural Damage in Home Insurance

Structural damage refers to any compromise to a building’s core integrity, distinguishing it from minor cosmetic issues or normal wear and tear. This type of damage affects the fundamental components that ensure a home’s stability and safety. Key structural components include the foundation, load-bearing walls, roof framing, and main support beams.

Home insurance policies typically include dwelling coverage, which specifically protects the physical structure of the home itself. This coverage extends to the walls, roof, floors, and attached structures like a garage or porch. However, the existence of structural damage does not automatically guarantee coverage. The determining factor for coverage is primarily the specific cause, or peril, that led to the damage.

Covered Perils and Common Exclusions

Standard homeowner insurance policies, such as an HO-3 policy, typically cover structural damage resulting from specific sudden and accidental events. These policies often operate on an “open perils” basis for the dwelling, meaning they cover any cause of damage unless explicitly excluded. Common covered perils include fire, lightning, windstorms, and hail, which can cause significant damage to roofs, walls, and other parts of the house. Explosions, vandalism, and falling objects, such as trees, are also generally covered.

Certain types of sudden and accidental water damage are covered, such as damage from burst pipes or appliance overflows. For example, if a washing machine suddenly leaks, causing structural damage, the policy may cover it. Insurance policies are designed to cover unforeseen events, not gradual deterioration or preventable problems.

Conversely, many causes of structural damage are commonly excluded from standard home insurance policies. Flood damage, which includes damage from overflowing rivers, heavy rain, or water seeping up from the ground, is a frequent exclusion and requires separate flood insurance, often through the National Flood Insurance Program. Similarly, earthquake damage is typically not covered and necessitates a distinct earthquake insurance policy. Damage caused by earth movement, such as sinkholes or landslides, is also generally excluded.

Damage resulting from wear and tear, deterioration, or a lack of maintenance is usually excluded from coverage. This includes issues like rotting wood from long-term leaks or foundation problems due to soil settlement over time. Mold is often excluded unless it is directly caused by a covered peril, like a sudden burst pipe.

Pest infestations, such as damage from termites or rodents, are also generally excluded, as they are considered maintenance issues. Additionally, damage from sewer backups or sump pump failures is commonly excluded from standard policies. Homeowners can often add an endorsement, or rider, to their policy to obtain coverage for sewer and water backup. Other general exclusions include government action, war, and nuclear hazards.

Navigating Your Home Insurance Policy

Understanding your home insurance policy’s specific coverage is important. The policy declarations page serves as a summary of your coverage, outlining limits, deductibles, and the policy type. This page typically lists various coverage types, such as dwelling coverage, and the corresponding coverage limits. It also specifies your deductible, which is the amount you pay out-of-pocket before your insurance coverage begins.

For a comprehensive understanding of your coverage, review the full policy document, particularly sections like “Perils Insured Against” or “Exclusions.” Additional coverages for specific risks, such as sewer backup or extended water damage, are often added through endorsements or riders, which will be noted on your declarations page or within the policy forms.

Deductibles can vary, with some policies having higher percentage-based deductibles for specific perils like wind or hail. Understanding how these deductibles apply can significantly impact your out-of-pocket expenses during a claim. Homeowners should also understand the difference between Actual Cash Value (ACV) and Replacement Cost Value (RCV) for structural damage. ACV policies pay for the depreciated value of damaged property, considering age and wear. In contrast, RCV policies pay to repair or replace damaged property with new materials of similar kind and quality, without deducting for depreciation, though they typically have higher premiums. If any policy language is unclear, contact your insurance agent or company directly for clarification.

Steps for Filing a Structural Damage Claim

When structural damage occurs, taking immediate and systematic steps is important. The first priority is safety; ensure the property is safe to enter and take measures to prevent further damage, such as turning off water or temporarily securing compromised areas. This initial mitigation can prevent additional losses and demonstrate responsible action to your insurer.

Comprehensive documentation of the damage is crucial for a successful claim. Take extensive photos and videos from multiple angles, capturing both wide shots of affected areas and close-ups of specific damage. Documenting the damage before any cleanup or repairs, beyond necessary emergency measures, provides clear evidence for the insurance company. Include details like the date and time of the incident to support your claim.

Promptly notify your insurer about the damage to initiate the claim process. This can typically be done via phone or through an online portal provided by your insurance company. After notification, an insurance adjuster will be assigned to investigate the claim. The adjuster’s role is to assess the damage, determine if it is covered under your policy, and evaluate the appropriate settlement amount.

It is generally advisable to avoid extensive permanent repairs until the adjuster has assessed the damage. However, necessary temporary repairs to prevent further loss should still be made. Obtain detailed repair estimates from qualified contractors to present to the adjuster.

Once the adjuster completes their assessment, they will typically present a settlement offer. Carefully review this offer and ask any questions you may have about the valuation or scope of repairs. Maintain detailed records of all communications, including dates, names of individuals spoken to, and copies of all submitted documents and estimates, throughout the entire claims process.