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Big Payout, or Big Denial?

Philip Marcelo | Hagadone News Network | UPDATED 9 years, 7 months AGO
by Philip Marcelo
| March 29, 2015 9:00 PM

BOSTON - After the Big Dig-out, it's time for the Big Payout. Or will it be the Big Denial?

New England's epic winter is on pace to produce a corresponding number of claims as thousands of homeowners seek to repair damage. Successive storms dumped 110 inches of snowfall in Boston alone, a record for an entire season.

"It's a part-time job just to navigate it all," said Cathy Schwarz, a Plymouth resident who is working with her insurer and repair companies after rooftop ice dams caused leaks in her house. "Everybody says you'll get through this, but all I can see is a house that's just not livable right now."

The winter was so unusually severe that governors across the six-state region have requested or are in the process of requesting federal disaster relief to help state and local governments pay for snow removal and other costs. The requests, however, would not cover home or private property damage.

Local insurance agents and public adjusters - firms that help homeowners navigate the claim process - say they've been swamped with inquiries.

They urge homeowners to be patient. A high volume of claims means insurance companies will need more time to process and finalize payments. Homeowners might also run into trouble securing contractors to do repair work because of high demand.

"It's going to seem like the winter that does not want to end," said Marc Baron, a partner at the New England Adjustment Company in Massachusetts. "This work is going to go on well into the summer."

Some property owners are already bracing for paying costs out of pocket.

"I'm sure I'll have to put some money up," said Daniel Alperin, a homeowner in Newton who is working with his insurance company after ice dams damaged at least four rooms in his house. "Obviously their job is to protect their interests, so it's a negotiating game, like anything else."

Others remain hopeful.

"We're hoping we hear positively from our insurance company and that the majority is covered," said the Rev. Patricia Miller Fernandes at Worcester's Epworth United Methodist Church, which suffered roof damage that could cost hundreds of thousands of dollars. "That's why we pay them every year, after all."

Schwarz, the Plymouth homeowner, says she's moving ahead with repair work while she awaits the final verdict from her insurer.

Workers have been tearing up water-damaged walls, ceilings and floors in about eight rooms in her house. The family is hoping insurance will also pay to relocate them elsewhere during the repairs.

"It's been such a nightmare dealing with what we're dealing with that I haven't had the time to read the fine print," Schwarz said when asked whether she's concerned insurance won't cover most of the expenses. "But it's crossed my mind. If it happened, it would be horrific. We don't have that sort of money to restore our home."

Jeanne Salvatore, spokesman for the Insurance Information Institute, a New York-based industry group, says most homeowners shouldn't have reason to worry.

"The good news is that a lot of winter-related damage is covered by standard auto and home policies, whether its burst pipes or ice dams or fallen trees or limbs," she said. "All of this is covered."

What's generally not covered are problems that could have been prevented if homeowners had taken "reasonable steps" to mitigate them, such as addressing a water leak before it gets too big or spreads to other rooms, Salvatore says.

Flooding caused by melting snows is also not covered by typical homeowner's insurance, she added. That requires special flood insurance.

Industry watchers caution that it's not so simple.

"Some of the very large, national firms are definitely conducting business as usual," says Baron, the public insurance adjuster. "They're looking for ways to minimize payments and to potentially deny claims based upon the fact they there was wear and tear over time."

William Swymer, an insurance expert that lectures at Bentley University in Waltham, says insurers will be taking a hard look at claims dealing with personal property within the home. "Those claims will be fought harder. It's going to have to be really obvious," he says.

But Swymer did not expect insurance companies would be rejecting claims outright. "To start denying a lot of claims would generate a lot of bad publicity," he said.

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