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Subject: Water Damage- HOA is primary?
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JenniferS22
(California)

Posts:3


05/02/2019 10:43 AM  
We're in CA and live in a 32 unit PUD. When I purchased the unit I was told that the interior of the home is the HO's responsibility, as such we have HO's insurance.

3 weeks ago we had a water leak in the wall that damaged our floors and walls. I contacted my insurance and submitted a claim, had the remediation work completed and submitted an estimate to have everything repaired. My adjuster is now telling me that he is reviewing everything but that it appears that the HOA's insurance is "primary" if the damage is more than 5K, which it is. He says that I will need to submit my claim for their review and if they deny their primary role, then they can apply for coverage under my insurance.

Is that how these types of claims are typically managed? Seems like the HOA insurance would, of course, deny that they are primary. Although the CC&R says they are but the CC&R's don't specifically state who is responsible for what other than maintenance of the residences being the responsibility of the homeowner. Shouldn't my insurance submit my claim to the HOA's insurance or is that my responsibility? It appears that filing a claim with the HOA insurance is a just a stall tactic or, perhaps this is just a matter of procedure?

Meanwhile, I am just waiting to have my living room to be repaired...

Can someone please advise on this?


RoyalP
(South Carolina)

Posts:737


05/02/2019 10:56 AM  
a good question for a 'public insurance adjuster'

'google' it

or

http://www.capiainc.com/
LetA
(Nevada)

Posts:682


05/02/2019 11:03 AM  
Like IP said, a certified public adjuster, works for YOU.. The claims adjuster works for your carrier and will turn on you in a hot second. If your carrier really cared they would file the claim with your HOA and they duke it out.
JenniferS22
(California)

Posts:3


05/02/2019 11:21 AM  
I have. It looks like it may not be worth a public adjusters time if the damage is less than 100K, as they are paid a percentage.
CathyA3
(Ohio)

Posts:243


05/02/2019 12:05 PM  
Could be a stall tactic. Could be that the adjuster is confused - even they sometimes scratch their heads over this stuff.

Things to check:

* Look in your governing docs to see the definitions of Unit and Common Elements. (I'm assuming you're in a building with multiple units. If you're in a detached home, then the entire structure should be yours and the HOA shouldn't be involved at all.)

* Find out what type of insurance your HOA carries. If it's "all included", then parts of the interior of the Unit should be covered if their is an insurable event such as a pipe breaking. If your HOA's insurance is not "all in", then your personal policy would probably cover you.

* If your HOA has "all in" insurance, make sure you understand the difference between an insurable event vs. routine maintenance. An insurable event is something that is sudden and unpredictable (for example, a frozen pipe bursts and sends a river of water into your home). A slow leak, on the other hand, is usually considered routine maintenance - in this case the home owner would be responsible for repairs to the Unit and the HOA would be responsible for repairs to the Common Elements.

* You also have to consider the HOA's deductible. If it's $20,000, then the homeowner will be responsible for the first $20,000 of repairs that the HOA's insurance would have picked up otherwise. This is why an insurance agent asks to see a copy of the HOA's insurance policy before they write a policy for the homeowner - you don't want any gaps in coverage unless you're prepared to self insure to some extent.

(Disclaimer: not an insurance professional.)
RichardP13
(California)

Posts:3534


05/02/2019 1:17 PM  
As a manager I deal with these issues regularly.

A HOA master policy is written in such a matter as to cover exactly what the association is required per their CCRs and/or governing documents.

When a leak occurs, first thing is to stop the leak, first the homeowner and if they are not available the HOA. Then we require the homeowner to contact their insurance carrier first and allow the claims adjusters to handle the problem. The adjusters will cover what the homeowner paid for and if questions arise they will get in touch with the HOA's carrier and their adjuster. In 10 years, never had a problem.

Been there, Done that
JenniferS22
(California)

Posts:3


05/02/2019 1:21 PM  
In your experience, does the HOA accept these claims or are they denied and then subject to the HO's policy? How long does it take to get a decision from the HOA's insurance? Thank you for your response, BTW.
RichardP13
(California)

Posts:3534


05/02/2019 1:40 PM  
In my experience, the homeowners insurance is what is contacted first. Once they have completed their inspection, they may or may not turn to the HOA's carrier to pass on. The insurance carriers have to b e the expert as they would know exactly what they insured each party for.

Been there, Done that
JeffT2
(Iowa)

Posts:465


05/02/2019 6:53 PM  
No, I don't think it is a stalling tactic.

Based on what your adjuster told you, both you and the association have insurance that covers your unit, which is what Cathy mentioned as "all in." So when two insurance companies cover the same thing, then who pays for the damage? The association's insurance is "primary," so it pays, minus the deductible. As Richard noted, the association's policy will cover what your governing documents require, including being "primary." This is fairly common.

Your insurance should cover the association's deductible ($5,000?), minus your deductible.

Your adjuster should have been more helpful and explained all of this. I would put in a claim on the association's insurance right away. No reason to think they would not settle the claim promptly.
SelenaB
(Pennsylvania)

Posts:3


05/02/2019 10:54 PM  
I agree! A public adjuster is one who gives proper advices and inspects and estimate everything properly and they are the ones who help you throughout the tedious insurance process. But you should hire a licensed and experienced public adjuster like https://www.alliancepublicadjusters.com/water-damage-glendale/ who will give you proper advice and they will represent you on your behalf.
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