Taking a Proactive Approach to Understand the Insurance Claims Process

Insurance policies can be complex but as a manager for a homeowners or condo owners association, it is important that you understand the language and details of the complex insurance policies designed to protect the building and the association.

Insurance companies written policy language is not always comprehendible which makes understanding the small print in the policy imperative if you would like them to pay for the damages.   To avoid delays or denials it is important to be familiar with the policy before it is too late.

Community associations and HOAs depend on their insurance policies to provide the coverage that they will need when a property emergency occurs.  Unfortunately, many associations do not know the exact coverage which may cause financial consequences.

Service1st Restoration believes in taking a positive approach to disaster recovery.  Having seen many associations and HOAs struggle with coverage after a property loss, the following suggestions may help you plan for unexpected situations:

• Meet with your insurance agent and review the policy and its coverage (if your agent will not make time to review the policy with you, consider finding a new agent that will. There are a lot of great agents that focus on providing exceptional service – you want someone on your side in the event of a property loss)
• Review your insurance policy and overall coverage annually with your association/condo boards to confirm it fits your community needs
• Be familiar with the deductible amounts and what will be covered
• Understand what the insurance company will require from you during the claims handling process
• Know the common perils that affect the structure of the building(s) or community that they govern and be sure coverage includes:
  • Structural damages to the building, including windows and sliding glass doors
  • Roof damage, including gutters and skylights
  • Damage to common areas, including parking covers or garages, railings, lobbies, elevators, swimming pools, tennis/basketball courts, landscaping, etc.
  • General liability for the association

A few examples of claims that an HOA Association would typically file:

• Storm and hurricane damage
• Fire and smoke damage
• Broken water lines
• Broken sprinklers
• Roof damage
• Damage to common areas including elevators, parking covers, lobbies, and shared recreational areas

Understanding the policy is as important as understanding the HOA bylaws and condo/unit owners’ policy requirements.  Bylaws should be comprehendible, so policies are written correctly upfront, as well as being able to determine whether the association or the unit owner is responsible for covering the damages. The bylaws should include definition of what the common areas/elements are, versus what is considered the individual owner’s property and responsibility.

If the HOA provides hazard and liability insurance, as part of the unit owners’ monthly condo dues, there should be explanation on this coverage and what featured items would be included.  The bylaws should also state the minimum individual unit owner’s insurance policy requirements for their own properties, belongings, and everything within the walls of their individual unit(s). This policy should also protect against liability claims and help cover the costs of living if the unit is uninhabitable.

When an insurance company disputes an HOA’s claim(s), it is typically because structural damage to multiple condos, units or common areas has occurred. When damages are extensive and there are challenges documenting the claim, it makes the claim process complex which could be used to the insurance company’s financial advantage.  Make sure to thoroughly document all areas of damage and be prompt when filing a claim.  Service1st Restoration will assist with documenting the loss through photos and written documentation to show evidence of the cause of loss and the mitigation to prevent further damage.  There are times when the property will not be released, due to investigation of the cause.  This may delay emergency clean-up services, but Service1st will help secure the property and can communicate this with the assigned insurance adjuster.  The adjuster may require proof of the cause of damage and will assess to evaluate the cause for the validity of the insurance coverage.

Associations have an obligation to completely document the claims process.  Failure to do so could result in the denial of an insurance claim.  Service1st has helped community associations and HOA’s take a proactive approach to claims handling.  If you are in charge of your plan and would like assistance setting up recovery efforts, contact Service1st at:   http://Tel:1-717-232-5444   or Email:  info@serve1st.com

Learn more about the Emergency Services offered, Disaster Planning and The Emergency Preparedness Partnership (EPP) Program https://service1st.pro/epp-emergency-preparedness/