Water damage can be devastating, but unfortunately, having homeowners insurance doesn’t always guarantee your claim will be approved. In fact, many water damage claims are denied because they don’t meet the terms of the policy. The most common reasons include damage that happens gradually over time, lack of maintenance, or specific exclusions like floods or sewer backups that aren’t covered without special add-ons. Knowing why your claim could be denied can help you prevent costly surprises and keep your home protected.
Understanding What Your Insurance Actually Covers
One of the biggest misunderstandings homeowners face is assuming that all water damage is automatically covered. Most policies cover sudden and accidental damage, like a burst pipe or an unexpected appliance leak. But when it comes to issues caused by poor upkeep, slow leaks behind walls, or foundation seepage, you might be out of luck. Every policy includes a “Declarations” page listing what’s covered, an “Exclusions” section outlining what’s not, and sometimes endorsements or riders for extra protection like sump pump failures or sewer backups. If you don’t know exactly what your policy says, you could be on the hook for thousands in repairs.
Common Reasons a Water Damage Claim Gets Denied
Gradual Damage and Long-Term Leaks
Insurance companies almost never cover gradual damage. For example, if water has been slowly leaking behind your kitchen sink for months, resulting in mold and rot, it will likely be considered a maintenance issue rather than sudden damage. The same goes for roof leaks that get worse over time because of aging shingles or worn-out caulking.
Lack of Maintenance or Neglect
A big factor in claim denials is lack of proper home maintenance. If your pipes freeze and burst because you didn’t keep your heat on during a cold snap, your claim may be denied. Likewise, ignoring clogged gutters, cracked grout around bathroom sinks, or failing to replace old plumbing can all lead to damage that the insurance company sees as preventable.
Pre-Existing or Unrepaired Damage
Water damage that existed before your policy went into effect or damage that wasn’t properly fixed after an earlier incident is often excluded. If you notice water damage, always address it immediately and document any repairs you make.
Policy Exclusions: Floods, Sewer Backups, and Groundwater
Standard homeowners insurance typically does not cover flooding from rising water outside your home. It also usually doesn’t cover sewer backups or sump pump failures unless you added an endorsement. Many homeowners find this out the hard way when they file a claim for basement flooding only to discover they need a separate flood insurance policy or a sewer backup rider.
Mold, Fungus, and Wet Rot
Most insurers will not cover mold unless it’s directly caused by a covered event, like a burst pipe that was fixed right away. If mold grows because of a long-standing leak or poor ventilation in your bathroom, the claim will likely be denied.
Vacancy Clauses
If you leave your home unoccupied for more than 30 or 60 days without notifying your insurer, your coverage for water damage could be void. This is especially common for vacation homes or rental properties.
Failure to Mitigate Further Damage
After discovering water damage, homeowners are expected to take reasonable steps to prevent additional damage. That means shutting off the water supply, drying out the area, and calling for professional help as soon as possible. Failing to do so can be grounds for denial.
Filing Errors or Missed Deadlines
Some states require you to file a claim within a certain time frame—sometimes as little as 60 days. Missing that deadline or failing to submit the correct documentation can also lead to a denial.
Suspicious or Fraudulent Claims
Insurance companies investigate claims carefully. If they find evidence that the damage was exaggerated or intentional, the claim will be denied, and you could even face legal trouble.
How to Avoid a Denied Water Damage Claim
The good news is you can take steps to protect yourself. First, know what your policy covers—and what it doesn’t. Schedule regular home maintenance, like inspecting pipes, caulking, and appliance hoses. Keep detailed records, including receipts for repairs and annual inspections.
When water damage happens, act quickly. Take photos or videos before cleaning up, stop the water source if possible, and contact your insurance company right away. Keep all communication in writing and follow your policy’s claim procedures.
Consider adding endorsements for things like sump pump failure or sewer backup if they apply to your home.
What to Do If Your Claim Is Denied
If your claim is denied, don’t panic. Start by reading the denial letter carefully to understand the exact reason. Compare it to your policy to see if you have grounds to appeal. Gather evidence, like maintenance records and repair receipts, that show you did your part.
If you’re not getting anywhere with your insurer, you can hire a public adjuster to help negotiate or consult an attorney who specializes in insurance disputes.
Conclusion
When it comes to water damage, the best defense is prevention and a clear understanding of your insurance coverage. Keep up with routine maintenance, document any repairs, and make sure you have the right endorsements for your home’s unique risks. If your water damage claim does get denied, know your options—and don’t be afraid to get help.
If you need trusted professionals to assess your water damage, restore your home, or help you navigate a difficult claim, First and Last Restoration is here to help. Contact us today to get the support and expertise you need to protect your property and your peace of mind!
