Q. We 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.

Sewage backup is damage public adjusters deal with more than I would like to admit. A recent published appellant court case in Florida http://www.3dca.flcourts.org/Opinions/3D11-3277.pdf addresses the confusion surrounding insurance coverage for water and sewer losses in today’s all risk homeowners insurance policies. If you take the time to read this case, you will note this issue has been litigated not only in Florida but other states as well.  It seems the insurance industry either does not understand the issues or haven’t been following the case law as we continue to see water and sewer claims denied on a regular basis.  Without going into a lot of detail regarding the legal cases, depending on the wording of the policy in question, if the backup is on the insured side of the property line or actually in a plumbing pipe on the premises, coverage for these losses should be covered under an all risk policy. Why all the litigation and confusion in the first place?  It would seem pretty basic that these losses would be covered as they clearly meet the insurance test of a sudden, accidental and an unintended event.