What to Know About Pre-Existing Damage When Making a Property Damage Claim

If your home was damaged in a hurricane, fire, or other natural disaster, insurance is meant to help you cover the cost of repairs or rebuilding. However, in the event you had previously filed a damage claim, you may run into issues. Pre-existing damage exclusions are one of the most common reasons property damage claims are denied, and it’s important to know what to do if you find yourself in this situation.

Key Takeaways

• Pre-existing damage refers to any damage, such as normal wear and tear, neglected maintenance, or prior structural issues that existed prior to the current reported loss event.
• Insurance policies generally only cover new, sudden, and accidental damage. They include exclusions for pre-existing damage to prevent payouts for previous or ongoing issues.
• Although exclusions are common, you may still be entitled to coverage if you can demonstrate that a recent event aggravated a pre-existing condition, turning it into a major, sudden loss.
• A property owner can help prevent a wrongful claim denial by maintaining detailed records of home maintenance and inspection reports, as well as taking photos before a storm to document the property’s condition.

What is Considered Pre-Existing Damage in a Property Damage Claim?

Pre-existing damage refers to any damage that existed prior to the current reported loss event. It is an insurance policy exclusion to ensure that the insurance company only covers new, sudden, or accidental damage instead of a previous or ongoing issue. Some common examples of pre-existing damage can include the following:

• Damage that already existed before the insurance policy went into effect
• Wear and tear occurring from normal use of the property
• Damage caused by failure to maintain the property
• Water damage that existed before a recent storm
• Structural issues that were present before the event that prompted the claim

Notably, insurance companies often take the position that property owners have a duty to mitigate as part of their contractual obligation. This means that failure to protect your property from further damage after a storm or other event can also be categorized as a form of pre-existing damage.

How Do Insurance Adjusters Determine Pre-Existing Damage?

To determine whether damage was pre-existing for the purpose of denying coverage, an insurance adjuster will conduct an investigation. They will evaluate visual evidence, such as signs of neglect, decay, water stains that seem to have existed for a long period of time, and physical aging signs. They will also pull a comprehensive loss underwriting exchange report to determine whether any previous claims were filed for the same issue as that in the current claim.

For weather-related claims, an adjuster will analyze meteorological data to assess whether the reported damage is consistent with the timing and severity of the storm or hurricane. In addition, experts such as engineers, contractors, or other specialists may be brought in to evaluate whether the damage aligns with a sudden event or has existed long-term.

Is Pre-Existing Damage Ever Covered?

Almost all insurance policies contain a pre-existing damage exclusion. Generally, insurance policies only cover sudden accidental losses after a policy goes into effect. This is meant to prevent them from paying out for damages that existed before the current claim. Unfortunately, insurance companies frequently leverage these provisions as a basis to minimize their liability or deny a claim entirely.

However, in limited circumstances, an insurance company might be required to pay out. For example, if you can prove that a recent storm or natural disaster aggravated a minor issue that was pre-existing by turning it into a major covered loss, the insurance company may be forced to provide coverage. There are also several scenarios in which insurance companies make incorrect determinations, leading to a wrongful denial. Insurers often use normal wear and tear as a basis to deny a claim or dispute the timing of the damage, even when the damage results from a covered event.

How Can You Avoid Allegations of Pre-Existing Damage?

If you’re filing a property damage claim with the insurance company, it’s crucial to understand what steps you can take to prevent unnecessary claim denials. Importantly, maintain thorough documentation of all home inspections, maintenance, and repairs. You should also take photos of your property before any storms or severe weather events to document the appearance of the property.

If the insurance company denies your claim alleging pre-existing damage, request a written explanation along with the supporting evidence. It may also be a good idea to seek an evaluation from an independent expert, such as a licensed contractor who can provide their findings. If a resolution cannot be reached with the insurance company, a skilled property damage attorney can best advise you regarding the next steps to take and help challenge the unfair denial.

Contact an Experienced Florida Property Damage Attorney

If your home was damaged in a recent storm, hurricane, or severe weather event, and the insurance company wrongfully denied your claim based on pre-existing damage allegations, the knowledgeable property damage attorneys at Saka Bryant, P.A. can help. Contact us today to schedule a free, confidential, no-obligation appointment to discuss your specific situation and learn how we can assist you.