Q: My insurance company has denied my claim for water damage from a broken sewer line under my house
They have denied the claim based on a line in the contract that says they will not cover water damage resulting from the release "from within any portion of a plumbing or automatic fire protective sprinkler system that is either: below the surface of the ground, or within or below the slab or foundation; or
(ii) from within any portion of a heating or air-conditioning system or an appliance that is either:
below the surface of the ground, or within or below the slab or foundation."
My home is a pier and beam home. They are claiming that as the house doesn't have a slab, the floor would take the place of the slab for the purposes of coverage.
I believe this is ambiguous. The broken sewer line is in the crawl space between the floor and the ground.
Do I have a case and if so, could I have a bad faith claim?
A:
What is covered by your particular homeowners policy depends on the language of the policy. There are a few different forms of HO insurance available and approved for use in Texas.
The ISO HO 00 03 policy as amended by the Special Provisions-Texas endorsement does not include coverage for losses to a dwelling and other structures caused by constant or repeated seepage or leakage from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or from within a household appliance. (See Special Provisions-Texas Endorsement No. HO 01 42 06 02, Section I-Perils Insured Against). Check the numbers at the bottom of your policy to see if they correspond to what is cited.
The HO-B provides coverage for water damage from repeated and continuous seepage or leakage of water or steam from a plumbing system, heating or air conditioning system, or household appliance which occurs over a period of time. (See Section 1-Perils Insured Against, paragraph 9.). This is a separate type of HO insurance policy which usually costs a bit more than an HO-A policy, and may not be offered for older homes.
Separate and apart from the exclusion you mention in your question, the ISO HO 00 03 policy does not cover losses to the dwelling and other structures caused by water which backs up through sewers or drains or which overflows from a sump pump, sump well, or similar device designed to drain water from the foundation area. (See Section I - Exclusions, A, 3, b). Check to see if your policy has this exclusion.
There are various fact specific issues that will need to be addressed with respect to your particular claim. For example, are you seeking coverage for water damage that occurred gradually over a period of time or as a result of a sudden failure.
Depending on the particular language of your entire policy and other facts, you may have a case based on the language you quoted and your description of the location of the sewer pipe break if the damage was not caused by a back up of water.
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