From Overflow to Coverage: The Importance of Policy Knowledge
A contractor colleague referred me to their neighbor, dealing with an insurance claim relating to a plumbing issue. The contractor was concerned about coverage, as the insured didn’t have specific sewer backup coverage clearly outlined in their policy. I assured them that I would do my best and immediately began reviewing the policy, as is standard practice here at EB Adjusting.
A toilet engulfed in sewage, reflecting extensive contamination on the bathroom floors.
While combing through the policy, I discovered a key detail: it differentiated between a sewer backup and an overflow of the plumbing system, with the latter being covered. When I received the plumber's report, I was thrilled to confirm that the cause of the loss was indeed a plumbing system overflow, just as I had suspected. Armed with this crucial information, I submitted the necessary documentation along with the estimate, and after some back-and-forth with the insurance company, I successfully got everything covered.
Post-mitigation: the bathroom shows flood cuts, a missing toilet, and freshly cleaned floors.
To maximize your claim, One of the biggest challenges in this case was that the insurance company chose to adjust the claim remotely, without sending a representative to inspect the damage in person. Anticipating this, I made sure that every aspect of the mitigation and the initial loss was thoroughly documented. This gave me the leverage needed to present compelling proof and get the claim fully compensated.
A moisture meter displaying readings alongside sewage-covered floors, serving as critical documentation for the claim.
Initially, the insurance company offered around $12,000. After extensive discussions and presenting the right evidence, I was able to increase the claim total to over $23,000, over double the initial estimate. In this case, the insured was extremely busy, and having a public adjuster like myself manage all the communications and coordinate between parties significantly reduced their stress and contributed to the professional experience we provide here at EB Adjusting. Additionally, my knowledge of the policy played a critical role in securing such a favorable outcome.
This case highlights how a public adjuster can be an invaluable resource, especially when navigating complex coverage issues and dealing with remote claim adjusters.
