Nik Sackstein was a senior citizen and longtime homeowner who experienced significant damage to his home when monsoon intensity rains came flowing through his roof and damaged the interior walls of his home.  However, the senior who faithfully paid premiums for years was not concerned because he had homeowner’s insurance through Farmers Insurance.  When Mr. Sackstein submitted his claim, the insurer sent out an adjuster who went up on the roof to investigate the damage. 

Later, Mr. Sackstein told a CBS News affiliate that the situation went sideways as soon as the adjuster climbed down from the roof of the house.  The adjuster informed the befuddled homeowner that the roof tiles were all intact, so the damage to the interior of the home must have been caused by leaks resulting from lack of maintenance.  According to the adjuster, pine needles and leaves that had dropped from trees onto the roof worked like a dam causing water to pool on the roof.  Although Mr. Sackstein was able to go up on the roof and easily sweep away the debris, the damage had already been done.  His claim was denied because of the alleged failure to perform five minutes of virtually effortless maintenance.

Mr. Sackstein’s significant loss was not covered at all by the insurer because it attributed all of the damage to improper maintenance rather than wind damage.  To add insult to injury, the adjuster informed the homeowner that the claim would have been completely covered had the debris not been present on the roof.  This homeowner learned a costly lesson that should serve as a warning for all property owners to heed: insurance claims can be denied if a homeowner does not engage in basic maintenance to ward off deterioration from ordinary wear and tear.  If a homeowner simply conducts a quick visual inspection of their roof every six months to a year, for example, this might be sufficient to identify problems that require attention.  If roof tiles are missing or debris has accumulated, then the homeowner can hire someone to take care of this maintenance issue while it is a minor issue.

The response of Farmers to Mr. Sackstein was typical for this type of situation.  The insurer confirmed the policy covered water damage to the interior of the home that resulted from the penetration of water through an opening caused by specific conditions like wind or hail.  The insurer went on to explain that the company’s investigation did not reveal any such opening, such as a blown out window, hole in an exterior wall, or ripped off roof tiles, so the policy did not cover the claim.

Because roof damage is one of the most common types of property damage claim filed by homeowners, it is important to have your roof inspected and perform basic maintenance.  This lesson extends beyond just the roof of a home.  Homeowners should perform routine maintenance that might prevent more serious damage in the event of a severe storm.  While experiencing severe damage to your home in a fire, hurricane, or other form of catastrophic event is always traumatic, your level of stress is likely to increase exponentially when your claim for tens of thousands of dollars or more is denied.

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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