Water Damage Question - 2nd Claim In One Year

[lkatz]

I'm trying to find out some information about how our homeowner's insurance company here in California ought to be handling two claims for water damage to our two-story condo.

A little over a year ago, we had a covered episode in which the upstairs bathroom got flooded, damaging the linoleum floor of that bathroom. The water also leaked through the floor and caused damage to the first floor hallway ceiling as well. At that time, the insurance company approved the claim and we ended up cashing out -- meaning that the insurance company sent us two checks to cover the costs of replacing the upstairs bathroom floor, fix the first floor ceiling, repaint affected areas, etc. As part of drying out the affected areas, a section of the bathroom flooring was removed (down the to the subfloor).

Due to family illness, we never got around to doing the repairs.

After a little over a year, a second episode occurred in this same bathroom. Due to a different cause this time, there again was flooding and again there was damage to the floor of the upstairs bathroom and again there was more damage to the first floor hallway ceiling, but more widespread damage to that ceiling this time around. The drying out company came out right away and dried up the damage with blowers and also removed all the remaining linoleum in the upstairs bathroom, leaving only the subfloor in that bathroom.

Our question is this: when we reported this second incident, the insurance rep started saying that, since we had cashed out the first time and hadn't actually done the repairs, he would probably deduct any amount they had paid us for the cash-out last time from any new additional costs that might now be incurred to fix the bathroom floor and the first floor hallway ceiling. If we hadn't cashed out the first time and if we had fixed the damage last time, then they would more likely pay for all the repairs again. But, since we hadn't gotten around to fixing or repairing things, in their view they would be paying twice for something that hadn't been repaired the first time around.

I'd like to find out if others have run into a similar situation or not or if there are any grounds that I can cite to question or challenge this policy. Would this be a policy or procedure specfic to one company? Any other thoughts on how we ought to proceed on this? Many thanks for help on this issue.

....Jason

 

[justalayman]

I would expect them to pay only for actual damages ubless they can claim that your failre to repair added to the sverity of the damage this go around.

In other words, if you did not replace flooring lst time, you can't expect to recieve money for new flooring that never got installed, i.e. you get actual damages.

 

[fjcook]

If you are tying to make money on the insurance, that's concidered insurance fraud.

The insurance company had reasonable expectation when they paid you the first time, that you would have the repairs made. I would say you are luckyy the insurance company is even willing to pay you any more since you were negligent in your duty as per you contract with them. I would not expect them to renew your policy, and unfortunately, with two claims in less than a year you are probably looking at a steep increase in premium when you switch to another company because you have just increased your risk ratio.

 

[moburkes]

If you are tying to make money on the insurance, that's concidered insurance fraud.

The insurance company had reasonable expectation when they paid you the first time, that you would have the repairs made. I would say you are luckyy the insurance company is even willing to pay you any more since you were negligent in your duty as per you contract with them. I would not expect them to renew your policy, and unfortunately, with two claims in less than a year you are probably looking at a steep increase in premium when you switch to another company because you have just increased your risk ratio.

Making money on an insurance claim, is not necessarily insurance fraud. However, as both people pointed out, you are not going to get "paid" 2x for the same damages.