Homeowner Question: What is really covered and how should the appeal be expressed?

Question

HOI Experts:
My mom's HOI claim was denied. A shelf in her china cabinet fell. The china on the shelf, & china below the shelf, was destroyed. Adjuster said something was supposed to hit the roof of her house first,then fall through the roof onto the cabinet and cause the shelf to disengage & cause broken china.
The agent might have felt some "sympathy" for her loss and advised her to reword an appeal. This is what she sent to my sister, who asked me to work on rewording:

Her insurance claim on the china cabinet losses was declined. At any rate, the guy who came to her house gave her a couple of language tips to help her get coverage: "personal articles floaters all risk covers for collectibles" Mom asked me to put a sentence together using those words and having it make sense. I told her before I could do that I should look at her policy and the letter they sent. I looked them over and I couldn't find anything that worked." Does anybody have any wording suggestions?

Thank you "Me." This makes sense. But I would like to see more answers before I tell my sister and my mom to abandon this claim. I do appreciate your quick response. If this is "a lesson" in the kind of insurance people take out, and how we express it in our policies, please add details in your response. We all have HOI but few of us know we need such extra coverage.
Thank you again!

Answer 1

mbrcrats said it well.

The standard home owners policy (called an HO3) is broken down into sections. Coverage A is for the dwelling. Coverage B is for appertanent structures (out buildings, fences, swimming pools), Coverage C is for Contents (your personal property - stuff you take with you if you move). The other coverages for for liability/med pay and loss of use.

Your mother would be making a claim under Coverage C. If you go to that part of the policy - it is a named peril coverage. That means, it is only covered if the cause is specifically named. Falling objects is a named peril, but the policy does condition it on the falling object causing a hole in the structure (such as a tree branch fell through the roof and onto the china cabinet causing damage to the cabinet/china). Sorry but the loss is what it is... you can't change the circumstances and it does not sound like it is covered.

Something that may help, there are services out there that work with insurance companies for china replacement. The adjuster that handled your claim may be able to give you the name of a service that they work with. Your mother could contact the service directly and pay to replace the china out of pocket. She may get a better price by doing it this way.

Answer 2

OK, keep in mind, there is SOME variance in policies, and endorsements. The STANDARD homeowners policy, covers your building, and the "stuff" inside your building.


It covers the BUILDING for everything, except what's specifically excluded. It covers the STUFF, but ONLY for things that are specifically named. The only one named that could apply is "falling objects". There is a qualification, however, that says "this peril does not include loss to property contained in a building unless the roof or an outside wall of the building is first damaged by a falling object. Damage to the falling object itself is not covered. It's intended to cover, for example, trees, that fall into your house.

On the standard policy, "oops it fell" isn't specifically named. So "oops it fell" or "oops I dropped it" isn't covered.

You CAN specifically insure china and other collectibles, under an endorsement called a personal articles floater. Normally, this floater does NOT cover breakage, but you can buy it back so that it DOES include breakage.

You're not going to win an appeal, unless she already had the personal articles floater including breakage, on the policy. It would normally cost about $4 per $100 of insured value. So if the china is worth $5,000, then she'd be paying an extra $200 a year (if my math is good) to have china breakage coverage.

Sorry.

Answer 3

i think what the adjuster was trying to say was that she could add this coverage to her policy. china can be added as a floater or rider to her policy... you have to specifically add it and you have to specifically ask f/ breakage coverage f/ it to be covered in this situation. however, unless she had that coverage at the time this happened, there's no way of having it covered now. sorry. her agent should have asked her if she needed coverage f/ any high valued items, such as china, when she set up the policy f/ her in the first place.