Hidden Water Damage: Uncovering Insurance Fraud by the insurer!

Insurance is designed to provide financial protection to policyholders in case of unexpected losses. However, in our opinion, insurance fraud by the insurer; is an unfortunate reality, leading a decline in consumer trust.

When this promise isn’t upheld because of unscrupulous practices, it’s called insurance fraud. One such practice in the building insurance sector is the insistence on visible water damage for a claim to be processed, despite the fact that water damage isn’t always perceptible to the naked eye.

A particular type of fraud that needs illumination involves an insurer insisting on “visible” water damage for buildings insurance claims, even though the damage could very well be hidden.

Water damage can manifest itself in various ways, and not all of them are visible to the untrained eye. Hidden water damage can include issues like structural weakening due to prolonged water exposure, mold growth behind walls, rot in wooden structures, or damage to electrical systems.

Visible water damage is the type we can easily observe. For instance, water stains on walls and ceilings, warped or swollen floorboards, or mold and mildew growth.

On the other hand, hidden water damage is not immediately apparent and may exist behind walls, under flooring, or in other concealed areas of a building. Signs of hidden water damage can include unexplained dampness, musty odours, or sudden increase in water bills or heating system dropping pressure.

Understanding the Nature of Water Damage

Water damage in buildings often starts unnoticed. Leaks within walls, roof leaks during rainstorms, or minor seepage during floods can create a slow build-up of damage over time. The damage may become visible only when it has escalated to a point of major concern. By then, the cost of repair can be significantly higher, possibly leading to a larger claim on the insurer.
For instance, a leak in a pipe behind a wall may not immediately cause visible damage. However, over time, the water seepage can degrade the building’s structural integrity or promote the growth of mold that may lead to health issues for the building’s occupants.

The Unfair Demand for Visible Damage

When insurers demand visible water damage to process a claim, they are potentially evading their liability for less apparent, but equally serious forms of damage. By focusing only on visible signs, insurers may unjustifiably deny claims, resulting in a form of fraud against their own customer. The consequences can be severe for policyholders who must bear the costs of repairing hidden damages out of pocket.

The Fraudulence: Disregarding Hidden Damage

When an insurer stipulates that they will only consider claims based on visible water damage, it can be considered a fraudulent practice. This is because such a policy unjustly disqualifies legitimate claims based on hidden water damage.

Water damage does not always immediately manifest itself in ways that are visible. It can take time for the effects of water leaks or seepage to show up in visible areas of a property. During this time, significant damage may be occurring within the structure of the building. By ignoring this type of damage, insurers are effectively denying their customers the compensation they are rightfully due for the damages sustained by their properties.

The Legal Implications

From a legal standpoint, an insurer who denies valid claims based on the absence of visible water damage may be acting in bad faith. Most insurance contracts oblige the insurer to investigate all claims thoroughly, not simply deny them based on superficial inspections. Insurers are also legally bound to give the benefit of the doubt to their policyholders.

The Impact on Policyholders and the Insurance Industry

Such fraudulent practices can have a cascading effect on the entire insurance industry. The reputation of insurers as a whole can be tarnished, leading to a decline in public trust. Policyholders, in turn, might be discouraged from buying insurance, considering it ineffective in providing protection.

Conclusion

It is essential for policyholders to understand the full extent of their rights and the obligations of their insurers. If you suspect your insurer is insisting on visible damage as a way to avoid a legitimate claim, it is time to consult with a leak detection company who can help you navigate this situation.

While it is crucial to remain vigilant about insurance fraud, remember that not all insurers engage in such practices. Policy wording must be checked, but unfortunately it is often only after an event, that poor quality or harshly termed policies are uncovered.

Many insurance companies uphold their responsibilities diligently, treating policyholders with the fairness they deserve. Thus, consumers should consider the reputation, reviews, and track record of an insurer before choosing to do business with them.