3 Reasons why a Property Insurance Claim may be Denied in India and What to Do About It

Sunita takes pride in her ground-floor apartment in Thane. She ensures fresh painting of all her walls every year and regular cleaning of all the drains. A hidden internal leak from the building’s main drainage pipe grew over the last three years and rotted the concrete wall behind Sunita’s bedroom. She has no knowledge of it yet. Then, suddenly, a 72-hour downpour happens, and water, along with sewage, bursts through her wall and damages all her belongings. Sunita files a claim against her property insurance. But it gets denied. The insurance surveyor brings out a moisture meter, points at the deep-seated black mold inside the concrete, and writes: Gradual wear and tear. Such claim denials are exactly why homeowners need to understand the cause of the denials from their property insurance provider and know what to do to prevent them. Here are three common causes of home/property insurance claim denials in India, and solutions to prevent those denials. Reason 1: "Wear and Tear" instead of "Sudden Peril" It has been raining in your city for 3 days straight. Afterwards, you notice that rainwater is leaking into your home and damaging all your furniture. You think that since your property insurance also covers flood and storm, you will be insured for the damages. On the other hand, the Insurance surveyor, upon inspection, denies the claim and points out that the water leak happened not because of a sudden breach, like a tree crashing into your wall, but due to the gradual wear and tear of the walls during the last few years. Now, the property surveyor’s assessment may be erroneous, but you are unable to do anything. Reasons for Claim Denial: The insurance company denies the claim due to the “Gradual Wear and Tear / Lack of Maintenance” exclusion clause in their policy. The policy is structured this way because insurance is a contract of indemnity, or a promise to help you recover only the losses caused by the sudden accident, and not a maintenance contract. How to prevent it: ● Every year in April, get professionals to audit your home for leaks and damages and get them all fixed. ● Also, save all the receipts of the repair work done along with photographs. These will become documentary proof for the surveyor in case of a claims dispute.

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