Policyholder Question: Public Adjuster clarifies property insurance claim coverage question for a shower pan leak

by Jim Fortson on 2/16/2015

Q. A shower pan leak caused wood floor damage. Our insurance company says damage from a shower pan is not covered. That seems absurd to me. There is no way we could have known there was a leak until we saw the wood warping. Should our insurance claim be covered?

A. Your issue is a very common misunderstanding that occurs between the policyholder and the insurer in the loss adjusting field. Insurance companies in the U.S. typically do not pay for the cost of the failed item. However, they do cover the resulting damages as long as the cause of the loss is covered. In your case a worn out shower pan would be excluded as wear and tear, etc. That is not an insurable event. But, depending on your type of policy and its language, the resulting wood floor and other property damage would be covered. Of course, if you knew about the water damage and did nothing to prevent further damage, it’s likely the insurance carrier would not pay due to your failure to mitigate the damages.

We often get calls about water damage from broken pipes in concrete slabs or below tile floors etc. The same result applies. The insurance company will pay all costs to get to the broken pipe leak and the cost to replace and repair the torn out areas. But they will not pay for the actual cost of the pipe break repair which typically is minor. The cost to tear out and replace plus the cost to fix items damaged by water could potentially run in the tens of thousands of dollars. The cost to repair the item that broke or wore out is generally minimal.

If you have questions regarding any property insurance claim related issues please call 800.321.4488 or contact us to submit a question to one of our public adjuster or insurance claim experts.

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We are a company that specializes in repairs of shower floor leaks in Massachusetts. There have been instances where the insurance company has paid for the replacement of the tiled shower floor. I have not asked the clients, what parts did the insurance paid and which they did not, but I was able to remove the shower floor find the cause of the leak and rebuild the shower. We always recommend to clients to call their insurance company and report the issue and it has worked out well for them.

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Charles R. Tutwiler Thank you for your input.

Thanks for sharing such informative and detailed article regarding insurance claims for home repairing.

Moved into our new house and within a few weeks, the sewer backed up into the shower and leaked out of the shower pan all over the downstairs area (very stinky!). Everyone agrees this is considered a "Category 3" leak. Remediation company came and took out the tile, flooring, a lot of drywall and dried everything out. Insurance company has no problem paying them for everything they did (they seem to work together a lot). Insurance adjuster is saying that the tile and shower pan are part of the plumbing and are not covered, but IS saying that they will pay for the cement board behind the tile in the shower. They are also only planning to pay an amount roughly equal to the cost of the remediation for reconstruction (which is roughly equal to the estimate from the remediation company....because they provide reconstruction services as well). It seems ludicrous that reconstruction would cost the same as remediation. To rip stuff out and dry it out is a lower level of skill and doesn't require any materials.....but the adjuster is saying we are lucky that he is covering what he is covering. The remediation company isn't even available to do the job. We have 3 bids from other quality contractors that actually have availability and they are double the price.

Rick Tutwiler In my opinion, if the shower pan and tile had to be torn out to clean up the mess from a sewer back-up of BLACK WATER, it should be fully covered. In addition, the put back items and cost should also be fully covered. From what I can gather from this policyholder, I believe the adjuster may be confused and misclassifying the loss because the shower pan or plumbing pipes did not fail. This loss was from a sewer back-up. Here we have a “sewer back up” not a failed shower pan or broken pipe. As long as a sewer back up is not excluded in the policy the whole loss should be covered including the full remediation expense to put the insured back in the same position as they were before the loss happened, subject to any deductible that applies. The policyholder should also assert their right to use the contractor of their choice to properly repair the damage with quality building materials. If the shower pan failed or a plumbing pipe broke the insurance industry typically will not pay for the actual cost to replace the item that caused the loss, i.e., the cost of the shower pan or to fix the pipe (typically a very minor cost for both), but they would pay for all damages that resulted from the damages caused by the item that broke. In this case this policyholder should appeal to the adjuster’s claim manager. If that fails, the policyholder can write a letter to the President of the insurance company requesting a file review.

Policyholder Question: Public Adjuster clarifies property insurance claim coverage question for a shower pan leak

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