What to do if insurance denies your water damage claim

What to do if insurance denies your water damage claim

The last thing you want to do is panic if your insurance company denies your flood or water damage claim.  Flood Metrix will not complete a water damage restoration project with the intent to bill insurance if the source of your water damage or flood is not typically covered by insurance.

No representative of Flood Metrix can state the fact of what your water damage insurance provider will or will not cover.  Flood Metrix will perform an initial assessment and document all water damage discovered during the process.  This information will be used to help your insurance company determine coverage.

Insurance companies are not always able to determine coverage over the phone.  Water damage adjustors rely heavily on documentation provided by the water damage mitigation company, the plumbers report and your insurance coverage.  Over 85% of the water damage claims handled by Water Damage, Mold & Flood Metrix LLC in 2021 were complete or in the drying phase before an insurance adjustor ever came on site.

We are trained for emergency response to Commercial & Residential Water Damage

The emergency part of flood & water damage restoration is executed with an “emergency response attitude” to stop/mitigate water damage.  You and your insurance company want this immediate response, but the insurance adjustor also needs documented information.  Flood Metrix aims to have an initial project report completed within 24-36 hours of responding to a flood damage or water removal project.

The Reason your Flood/Water Damage Claim Was Denied May Shock You.

Not all water damage claims are covered by insurance due to policy design or exclusions.  You may think there wouldn’t be any other reason your water damage claim could be denied, but you would be mistaken.

Insurance is meant to cover “sudden or accidental” damages not “long term/lack of maintenance” damages.  This is where the overwhelming majority coverage mistakes are made because making the determination of sudden vs maintenance issue is not always easy.

Review your homeowners’ policy for the appeals procedure

If you water damage claim is denied, then review your policy to better understand the appeals process.  Many homeowners do not realize that many claims are covered after they have completed the water damage claim appeals process.  The process can be long and stressful but well worth the reward.

Act within the allotted appeals time frame and be diligent.  It is a good idea to start by sending an email to your insurance company notifying them of your intention to formally appeal the denial of your water damage claim.

Contact your Insurance Agent, they sold you the policy

The insurance agent who sold you your policy has a vested interest in keeping your policy open.  They can be a valuable resource in helping you to navigate your water damage claim appeals process.

Credentials Check

Your adjustor may be inexperienced and lack knowledge of advanced restoration industry details. Or they may be very experienced, but still not be an IICRC Certified flood or water damage expert.

Check the credentials of your insurance adjustor, they may not be IICRC certified, which means their opinion is not an “expert opinion on water damage restoration”.  Your water damage service provider/company should have more IICRC certifications than your insurance adjustor.

Hire an IICRC Certified Water Damage Company

Always hire a water damage restoration company with IICRC certified technicians.  If a portion or all of your water damage claim gets denied due to how your adjustor interprets information about the flood, the IICRC credentials of your water damage restoration contractor can easily help get your claim paid.

Why is this important?

Whoever has more water damage IICRC certifications also has the most authoritative opinion on water damage restoration.  Flood Metrix has IICRC Certified Master water damage restoration professionals on staff.

Reports & Documentation

All lines items submitted for payment should be supported by an organized presentation of photos, videos reports and projects notes.  A claim or portion thereof can easily be denied due to non-submittal of supporting documentation.

“Water Bills Don’t Lie”

Another key factor in proving your claim is by submitting copies of your water bills.  This will show the sudden spike of water loss at the time of your flood.

Organize and submit evidence to rebut reason for denial.  Be sure to inform your water damage service provider, they can provide IICRC citations to support your claim.

Highlight IICRC S500 & S520 Water Damage/Mold Remediation Standards

Your insurance company is obligated to pay flood and water damage restoration costs in accordance with IICRC standards.

Insurance Ombudsman

You may have waived your right to sue your insurance company and may only have arbitration as your course of action.  Most insurance companies have an “ombudsman” responsible for handling escalated appeals.  It is their job to resolves such matters.

Contact A Public Adjuster, they don’t get paid until you do.

Public adjusters can also help apply pressure to your insurance company to pay your claim if it should be covered.  Public adjusters work for you and not for the insurance company.  You may find the services they provide invaluable to helping get a difficult water damage claim settled.

Scott A. White is Commissioner of the Virginia Bureau of Insurance with the SCC//State Corporation Commission.

Contact Commissioner Whites office if you are not satisfied the results of your appeal.  Visit https://www.scc.virginia.gov/

“Because the Power to Change the Matter is in the Metrix”

Frozen Pipes and Winter Water Damage

Frozen Pipes and Winter Water Damage

Frozen Pipes & Winter Water Damage by Metrix Restoration

Winter weather brings an added element of difficulty & danger to water damage restoration claims.  We all can understand how each flood or water damage cleanup comes with both general & special needs.

In this article we will highlight how winter weather affects water damage restoration operations, the most common causes of winter water damage & what you can do to protect your home.

Making water pipe maintenance a priority this winter is a good idea, especially if the climate of your area sustains temperatures of freezing or below.  Cracked & Busted Pipes due to freezing temperature is cited by most insurance adjustors and water damage restoration professionals as the #1 cause of residential water damage during winter, according to R. Noel, GM of Flood Metrix in Stafford, VA.

“Of course, roof leaks and ceiling damage caused by ice dams are also very common throughout the water damage industry in areas with longer winter seasons and heavy snow fall, but busted pipes still rank #1 in Northern VA, District of Columbia & Southern MD.”

How Frozen Pipes Cause Water Damage

The physical materials of your home are under constant “attack” by its surrounding environment.  Most homeowners understand that weather in general can affect the structural integrity of their home, and still never consider how nature itself is a natural “stress factor” affecting their home on a day-to-day basis.

Temperature differentials in air currents, air pressure, convection are each invisible factors of winter water damage, unnoticeable to the naked eye.

During winter temperatures can remain at freezing or below for weeks and months at a time.  In such climates freezing rains, icy wind chills and snow become like “military special force units” making structures more susceptible to flooding and water damage.

The good news is that keeping your home in good condition with up-to-date maintenance is the best defense against winter water damage.  In fact, keeping your home reasonably heated is enough to prevent frozen pipes from busting & causing water damage/flooding.

Energy.gov recommends an average inside temperature of 68 degrees Fahrenheit.

Unoccupied homes are much more susceptible to flooding due to frozen/busted pipes when compared to homes which are occupied with regular home maintenance.  One reason for this is that unoccupied homes are also more likely to have colder inside temperatures.

Additionally, unoccupied homes are more likely to behind on routine maintenance.  When you combine cold temperatures with points of direct exposure to water pipes, freezing becomes a scientific certainty.

Frozen water obstructs and water flow and multiplies pressure per square in throughout pipes until they crack or bust.  The chances of this happening begin to increase exponentially when temperatures reach 20 degrees Fahrenheit and below.

Water damage restoration companies must then use additional specialty drying equipment including directed heat, adding to the financial costs of flood damage.

 

 

Melting Snow & Water Damage

Everyone loves the beauty of freshly fallen snow, but nobody loves the water damage melting snow can cause. Drain backup and overflows are common due to melting snow.

The ground becomes heavily saturated while sewer systems are flooded with melting snow on top of its normal capacity.  For tips to help prevent water damage see our related article on water damage prevention.

Ice Dams and Roof Leaks

Busted pipes may be the most likely source of winter water damage, but there is a second most common source.  This source doesn’t begin with rain, snow or cold but with cluttered gutters.  When gutters are obstructed, water can’t drain off the roof of a house properly.  During winter months, water trapped in gutters along with debris freeze and combine with icicles to create “ice dams”.   Although ice dams are not typically responsible for flood damage, but slow leak water damage and mold are both closely related.  Regular gutter maintenance can reduce the likeliness of ice dams forming and prevent any resulting water damage.

Outdoor Water Outlets

Outdoor water outlets aka “water spigots” should be insulated and secured during winter months.  Corresponding hoses should be disconnected, drained & stored to prevent damage.  As these outlets are connected to water pipes, the main & lower level of these homes are at higher risk to flooding, water & mold damage. 

If you do experience water damage this winter, call the experts at Flood Metrix. Our professional water mitigation teams are here 24/7/365 to move you from Stress to Satisfaction after a flood or water damage.  Choose Metrix over the Matter Because the Power to Change the Matter is in the Metrix.

Check out the top causes of busted pipes and tips to prevent water damage.

Water Damage and Hardwood Floors

Will insurance replace water damaged hardwood floors?

In general, water damage restoration companies will not pull-out hardwood floors, kitchen cabinets, tile floors or bathroom tubs without the claims adjuster’s approval. Industry standard is for water damage companies to attempt to salvage such materials before they are declared unsalvageable.  This is all a part of the water damage insurance claims process.  Before your claims adjuster buys you brand new hardwood floors, he or she needs to document the FACT of their unsalvageable water damage.

After hardwood floors have been dried, they must also be allowed time to re-acclimate. The re-acclimation period ranges from 30-60 days.  It is not the job of the water damage restoration professional to determine whether or not hardwood floors are salvageable, that is the job of a flooring expert. Once the floors are dry, your insurance company will send out a vender to make a recommendation to refinish or replace the floors.

Keep in mind, the water damage flooring expert does not want to risk refinishing your floors if they are not 99% sure that they can make your damaged floors look brand new again.  Going through the water damage claims process can take time & cause stress, but you can trust Flood Metrix to explain this process and provide clear, accurate insight every step of the way.  The following notes are from a real flood damage claim.

 

Conversation with Water Damage Claims Adjuster

These notes have been prepared to summarize our conversation with regards to a recent water damage restoration flood claim.  After successfully drying the affected floors, visible water damage, specifically cupping, has been noted.  At the insurance adjustors request, the affected hardwood floors have been scheduled for removal.  We will remove the affected areas included in the water removal/cleanup portion of this project only & shall bill service with Xactimate WTR lines items.

Flood Damage Project Notes

The hardwood floor drying effort of this flood damage project was a success.  After an estimated 36 hours of flooding, the saturation levels of all affected hardwood floors had increased to an average of 45 out of 100.  The highest floor saturation reading taken was 63.  Please note that hardwood flooring is generally considered saturated once moisture content levels reach a reading of 21 & above.

            Advanced structural drying equipment was used to help dry the flooded basement, flooded kitchen level & flooded bathroom levels.  All water damaged areas of this flood damage cleanup project started with an average humidity above 70% with an indoor in door temperature of 55 degrees Fahrenheit.  Three negative pressure floor drying systems, directed heat, & 1 inflatable heat mat were used in combination with multiple air movers and dehumidifiers to achieve our dry goal.

Within 4 days we were able to restore over 90% of the water damaged floors to a moisture content level of 16.  Additionally, we were able to manipulate temperatures to 95 degrees and back down to 70 while decreasing relative humidity to an average of 45%. Equipment was then employed to salvage water damaged kitchen cabinets and affected wall cavities.

10 Reasons to hire a Water Damage Restoration Company

10 Reasons to hire a Water Damage Restoration Company

Top ten reasons to hire Flood Metrix for water damage restoration projects.

Customer Experience

The Flood Metrix mission is to move a customer from Stress to Satisfaction.  This includes more than just fixing the emergency flood damage, but also carries over into respecting our customers’ SPECIFIC needs & making sure the customer still feels like they matter, even after the job is complete.

Quality Assurance

At Flood Metrix we believe that water damage and mold remediation are not the kind of services where careless mistakes are allowed.  We rely on systems and science to serve our customers in the most professional and efficient manner possible.

Reputation

Flood Metrix is top rated with a 5 Star review average.  We are A rated with the better business bureau and preferred by most insurance carriers for water damage claims.

Organization

Flood Metrix is an LLC servicing Northern VA & Southern MD.  We carry all required licensing & insurance.  Our staff is uniformed & our vehicles are marked.

Credentials

Khonsol Badu is the owner & operator of Flood Metrix and is an IICRC Certified Master water damage professional with over 15 years of experience.

State of the art equipment

Flood Metrix uses advanced structural drying, water extraction, restoration, and documentation processes.

Insurance Preferred Vendor

We accept most property owners’ insurance & offer preferred vendor pricing.

All in 1 service provider

Flood Metrix offers emergency plumbing, water damage restoration, mold remediation, carpet cleaning, air duct cleaning and reconstruction services.

Service Guarantee

Flood Metrix offers a written service guarantee.

Price Match Guarantee

Flood Metrix offer a written price match guarantee.

BONUS REASON: Customer Rewards Program

How much does water damage restoration cost?

How much does water damage restoration cost?

How much doesWater Damage Restoration cost?

Below is a list of 11 factors affecting the cost of water damage restoration.

  • All water removal services are classified as “emergency services”

In Northern VA and Southern Maryland, the Xactimate standard emergency water removal fee is $185 during normal business hours and increases after 5pm.  Other price factors may include service zip code and emergency availability.  The use of water removal pump, weighted water extraction, hard surface water removal versus soft surface water removal are all determining factors of water damage restoration costs.

  • Invasive or non-invasive inspection

Most FREE inspections include a non-invasive investigation of water damage.  Non-invasive water damage inspections are visual inspections and include the use of specialized water detection equipment.  Invasive inspections include the cutting away & removal of wet or water damage materials to inspect.

  • Project Management

Water damage restoration project management fees include line items such as the creation of reports & travel time to pick up water damage repair items.

  • Difficulty Level of project preparation

This factor includes the need for content manipulation, floor protection, containment, & confinement of water damaged area.

  • Category of water

Category 1 (Clean Water) – “Clean Water” refers to wastewater that is still considered safe for consumption because there are no contaminants present that could pose any immediate threat. Category 1 wastewater comes from a clean source like a broken water line or leaky faucet. If left untreated, Category 1 can degrade into Category 2 or 3 when exposed to other contaminants.

Category 2 (Gray Water) – “Gray Water” is the type of wastewater generated in households or buildings that is not contaminated by any toilet discharge. However, it already contains bacteria and viruses that could easily cause an illness or discomfort. Gray water comes from showers, laundry water, bathwater, basin overflow, and more. Category 2 wastewater can quickly degrade into Category 3 when left untreated.

Category 3 (Black Water) – “Black Water” is the type of wastewater with a very high concentration of contaminants like fecal matter and urine. Extended exposure or accidental consumption of Category 3 wastewater may result in serious illnesses or even death. This is the reason why it is crucial to call a qualified professional to handle black water cleanup as quickly as possible.

  • Equipment Requirements

Water damage restoration equipment, monitoring, setup and break down is a significant part of water damage restoration cleanup projects.  Equipment is charged per piece, per day.  An equipment decontamination fee may also be included in this water restoration cost category.

  • Use of specialty equipment

Specialty equipment is the most expensive water damage cleanup equipment to run.  Specialty equipment includes items such as: hard wood floor drying equipment, directed heat, and air flow injection equipment.

  • Demolition & Decontamination

The demolition and decontamination measures of a water damage project are related to the “class and category” of the water mitigation.  Category 3 water damage is the most expensive water damage category.

  • Disposal

Disposal line items include dump runs which average $135 each & dumpster rental fees.  Included in dumpster renter fee are the dumpster itself and the tonnage of water damage cleanup waste.  This fee is usually around $85/per each additional ton.

  • Post Mitigation Analysis

Post water damage mitigation clearance testing fees average $350-$550.  Many times the fee for this service may be waved.   Ask a Flood Metrix representative for details.

  • Final Cleanup

Final cleanup is broken into two major groups, commercial & residential.  This fees included here are breaking down containment, floor protection and the final “construction cleanup”.

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