A client being surprised to learn they don’t have coverage for a loss is a bummer, but sometimes it’s inevitable.
A couple issues that come up pretty frequently are on home insurance policies.
First, losses that occur over a long period of time don’t meet the “sudden and unexpected” requirement for coverage. So a slow leak under a bathroom sink that’s been rotting your sub-floor for the past several months is probably not going to be covered.
The next thing that clients are often surprised to learn is that it’s not the insurance company’s responsibility to cover the cost of repairing whatever was causing the issue. When a pipe bursts and floods your home, your home insurance policy’s job is to cover the damage caused by the water.
It’s your job, as the home owner, to cover the cost of stopping the water from causing more damage. That’s called maintenance.
If you need to re-plumb your home to prevent future leaks, that’s on you.
If your roof leaks and suddenly allows a bunch of water in to destroy your ceiling, your insurance is there to cover the damage to the ceiling, but you need to pay the cost to repair your roof.
Deferring maintenance has no silver lining.