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Any Homeowners Insurance agents here? Need some guidance
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Any Homeowners Insurance agents here? Need some guidance - May 26, 2016, 02:02 AM

If Anyone who is in this field that can offer some advice?

Have a condo in VA. The unit directly above mines dishwasher took a shit the other day causing it to leak water into my living room. The leak traveled from one end of the ceiling to another end (approximately 8 feet in length) I was out of town when it occurred so it went unnoticed for a couple of days. Damages are half the ceiling caving in and bloated up laminate flooring... I as well as the condo owner above both have state farm homeowners insurance, but since it was her unit that caused the damage she ended filing a claim...
Statefarm calls my house yesterday and my wife picks up since I wasn't home and the agent proceeds tell her that since no negligence was involved in the dishwasher malfunction and that other party had no idea that the leak was occurring she couldn't be held accountable...So in other words since other party wasn't negligent they can't fault her...but, if she would of been negligent then damages to my unit could be covered...Is this seriously how insurance companies work?? I've contacted my hoa and condo association and they can't figure out what recourse to go with...

Am I fucked?
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May 26, 2016, 06:42 AM

I don't think that's how it works. Was it your neighbor's local agent? Call your agent. In the end, at least State Farm is paying for it so I wouldn't stres too much.
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May 26, 2016, 07:40 AM

So if the brakes fail on my car while its parked and it rolls in to another car, no worries cause there wasnt negligence? Sounds like a load of sh*t to me. Hopefully someone in the know can chime in.


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May 26, 2016, 08:27 AM

That's horseshit. Call your agent, file a claim and they'll work it out with the unit owner above's agent. I've dealt with lots of these issues and the insurance adjusters almost always try to pull some nonsense like this to see if they can get out of paying.

She's covered for all the damage except the repair to the dishwasher since insurance doesn't cover maintenance and repairs. In fact, if she WAS negligent then there's a good chance her insurance would deny the claim but either way, she's responsible.

Not sure about VA but in MD/DC, the unit owner at fault is responsible for the deductible up to $5k and the master policy takes over after that so your association may end up getting involved either way.


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May 26, 2016, 11:11 AM

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Originally Posted by jez01 View Post
If Anyone who is in this field that can offer some advice?

Have a condo in VA. The unit directly above mines dishwasher took a shit the other day causing it to leak water into my living room. The leak traveled from one end of the ceiling to another end (approximately 8 feet in length) I was out of town when it occurred so it went unnoticed for a couple of days. Damages are half the ceiling caving in and bloated up laminate flooring... I as well as the condo owner above both have state farm homeowners insurance, but since it was her unit that caused the damage she ended filing a claim...
Statefarm calls my house yesterday and my wife picks up since I wasn't home and the agent proceeds tell her that since no negligence was involved in the dishwasher malfunction and that other party had no idea that the leak was occurring she couldn't be held accountable...So in other words since other party wasn't negligent they can't fault her...but, if she would of been negligent then damages to my unit could be covered...Is this seriously how insurance companies work?? I've contacted my hoa and condo association and they can't figure out what recourse to go with...

Am I fucked?
I'll preface this by saying that I'm intimately familiar with MD and DC condo law but not VA, however, I cannot imagine the course of action would be too dissimilar.

The short version is, no, you're not fucked at all and your neighbor's State Farm agent is slightly misinformed.

I deal with this question at least 2-3x a year (Pres of my Condo Assc).

First, your upstairs neighbor is at fault but not totally. There was no negligence. This is in some ways like a force majuere incident. Consider if you had two detached homes next to one another and your neighbor's tree fell over during a storm and destroyed your fence and roof.

Your neighbor would be on the hook for restitution. Well incidents like these in attached multi-unit dwellings is fairly analogous. The damages you describe aren't great enough for the condo's Master Policy to kick in so don't expect any help from the Condo Association.

As a matter of fact Condo Association's Board of Directors generally like to stay out of inter-owner disputes as it relates to damages inside of your units (private elements) unless legally mandated to do so. We're concerned with joint common elements (anything outside of your four walls and front door) and community property.


Your resolution path generally is:

i. Contract you neighbor directly, and ask if they would like to pay for repairs directly. You'll provide them with a quote from a license and bonded contractor (normally I would want 3 quotes) and submit it for their review.
*Do not agree to front the money. I've seen too many cases where the other party reneges and refuses to refund the damaged party.


ii. Contact your insurance company and file a claim. Your insurance company will effect repairs and may elect to seek compensation from State Farm. This of course sucks because you end up putting a claim on your policy but conversely it will also put a claim against your neighbor's policy if your insurer elects to go to State Farm for repayment.

iii. Small claims court



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Last edited by Heist; May 26, 2016 at 11:13 AM..
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May 26, 2016, 11:12 AM

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Originally Posted by RileysDad View Post
That's horseshit. Call your agent, file a claim and they'll work it out with the unit owner above's agent. I've dealt with lots of these issues and the insurance adjusters almost always try to pull some nonsense like this to see if they can get out of paying.

She's covered for all the damage except the repair to the dishwasher since insurance doesn't cover maintenance and repairs. In fact, if she WAS negligent then there's a good chance her insurance would deny the claim but either way, she's responsible.

Not sure about VA but in MD/DC, the unit owner at fault is responsible for the deductible up to $5k and the master policy takes over after that so your association may end up getting involved either way.
^^^This guy is correct as well.



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May 26, 2016, 11:39 AM

Quote:
Originally Posted by Heist View Post
I'll preface this by saying that I'm intimately familiar with MD and DC condo law but not VA, however, I cannot imagine the course of action would be too dissimilar.

The short version is, no, you're not fucked at all and your neighbor's State Farm agent is slightly misinformed.

I deal with this question at least 2-3x a year (Pres of my Condo Assc).

First, your upstairs neighbor is at fault but not totally. There was no negligence. This is in some ways like a force majuere incident. Consider if you had two detached homes next to one another and your neighbor's tree fell over during a storm and destroyed your fence and roof.

Your neighbor would be on the hook for restitution. Well incidents like these in attached multi-unit dwellings is fairly analogous.

...
you're wrong about the tree analogy with detached houses.
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May 26, 2016, 11:49 AM

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Originally Posted by RileysDad View Post
Not sure about VA but in MD/DC, the unit owner at fault is responsible for the deductible up to $5k and the master policy takes over after that so your association may end up getting involved either way.
BTW _ that little quirk in the MD Condominium Act that was amended in 2009, now making Condo Assc's responsible for, and putting their Master Policy in-play for any damages >$5K irrespective of who's at fault

Guess who's largely responsible for that happening?

<----- This guy.

My Condo Association was a test case in MD Appellate Court in 2007 and beat Erie Insurance after they refused to pay several individual claims on our property and told the insurer to instead file claims against our Master Policy.

Master Policy coverage is there for catastrophic losses, and although we intentionally set our Master Policy deductible at $20,000 to cover disincentivize frivolous claims, as you can imagine these constant claim filings threatened the financial stability of the community by forcing us to decide whether the pay the claims out of community reserves or risk a non-renewal by our insurer which would send us into the ultra-expensive secondary market.

We won and Erie had to pay. The judge decision in fact set precedent for all individual condo insurers operating in Maryland. So, the insurance association fought back and lobbied Annapolis legislators to have the law changed to what we have today where any private element damages over $5,000 can be attached in a filing against the condo association master policy and it's now the job of the Condo Association to either pay for the damages and then try to recover the funds or allow the Master Policy to pay out on the claim.

Now every single condo associating in Maryland is financially threatened by such poor, financially harmful policy. But who said laws need to make sense.



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May 26, 2016, 11:55 AM

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you're wrong about the tree analogy with detached houses.
I'm sorry. You're right. I was thinking about a negligence scenario where your neighbor had a weak or diseased tree that they knew or ought to have known was a danger. Or they were informed of the issue.

Wrong analogy ...



“Any man who tries to be good all the time is bound to come to ruin among the great number who are not good. Hence a Prince who wants to keep his authority must learn how not to be good, and use that knowledge, or refrain from using it, as necessity requires”.

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May 26, 2016, 11:55 AM

LOL @ the tags. Just noticed them.



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May 27, 2016, 03:51 PM

they are just trying not to pay out. SOP for an insurance company dude. take a hardline. if they dont pay, sue. also, document EV-ER-Y-THINNNNNNGGGG

EVERYTHING. alll of it. I don't get people sometimes. record every single conversation. sometimes you just gotta get an attorney/file in small claims.
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June 7, 2016, 11:32 AM

Hey guys, I appreciate all the input that was given and for that I thank you all.
I ended up disputing the insurance decision to deny me coverage and a week and a half later I get another denial response.This time Statefarm is claiming that they provide coverage based on condo association bylaws and while they thoroughly went over the bylaws that pertained to my community they came to the conclusion that coverage would not be granted to my unit.

I screen shot a section that goes over unit responsibilities when it comes to damages... Heist, CGC.. How Would you interpret this?
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June 7, 2016, 11:36 AM

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Originally Posted by t84a View Post
I don't think that's how it works. Was it your neighbor's local agent? Call your agent. In the end, at least State Farm is paying for it so I wouldn't stres too much.
No, c Local agent just sells coverages, doesn't get involved in these issues from what I was told. True, about state farm is paying for it regardless, but my $1000 deductible would still have to come out of my pocket.
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June 7, 2016, 11:47 AM

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Your resolution path generally is:

i. Contract you neighbor directly, and ask if they would like to pay for repairs directly. You'll provide them with a quote from a license and bonded contractor (normally I would want 3 quotes) and submit it for their review.
*Do not agree to front the money. I've seen too many cases where the other party reneges and refuses to refund the damaged party.


ii. Contact your insurance company and file a claim. Your insurance company will effect repairs and may elect to seek compensation from State Farm. This of course sucks because you end up putting a claim on your policy but conversely it will also put a claim against your neighbor's policy if your insurer elects to go to State Farm for repayment.

iii. Small claims court
(i) Is looking more like it at this point. We are both insured by state farm. So I'm not sure how statefarm would attempt to seek compensation within its own. I'm getting estimates done outside of insurance and will be presenting them to the other owner. Hopefully we can work it out that way.
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June 7, 2016, 12:00 PM

Pretty clear cut to me. I don't know what on god's earth they are reading and interpreting as a clause that gives them an out from paying for your damages.

I've redlined the relevant passages.



Breakdown:
Unless the Condo Association provides for the replacement of dishwashers and individual plumbing at associations expense, and it is called out as a separate article in their bylaws then it could not be more clear who is responsible for repair of your ceiling and floors. It's right there in the article; not left for interpretation:

i. The unit from where the water damage emanated is responsible for all repairs and restoration INCLUSIVE of damages to other units or common elements of the building, not just the restoration of damages to their unit.

ii. You have the right to seek remedy for your damages from the unit owner as they were caused by a privately owned piece of property in another unit.

iii. The Association has the right to seek remedy from the unit owner from where the damage emanated if they do not pay for the insurance deductible or damages.

iv. The unit owner is responsible for all damages up until the point at which such damages would exceed the master policy deductible, at which point they would have legal right to file a claim under the Assc's master policy, however, the damages here do not rise to this level and as such they're on the hook.

Either get your insurance company to pay or I'll see you in small claims court.

Note: In certain circumstances, a Board of Directors may elect to pay for your damages (safety and welfare, potential to effect common elements or disrupt services to other units, etc.) out of the condominium replacement reserves or their general replacement account, but they will in turn take this amount and attach it as a debit on the other unit's owner's account as an assessment.

If they refuse to pay it down, the BOD will then file for a lien against the condo. I've done this before - it's perfectly legal, and a very nasty way to get recalcitrant and stubborn owners to do the right thing.



“Any man who tries to be good all the time is bound to come to ruin among the great number who are not good. Hence a Prince who wants to keep his authority must learn how not to be good, and use that knowledge, or refrain from using it, as necessity requires”.

- Nicolo Machiavelli 1469-1527


Last edited by Heist; June 7, 2016 at 12:09 PM..
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