Back It Up

by Mark Goldwich

Water damage claims are one of the most frequent and costly type of home insurance claim. Whether from burst pipes, roof or appliance leaks, flooding, or sewer back-ups, the damage from water can be fast and devastating. Not to mention the mold that can quickly grow if the property is not immediately and completely dried out.

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Water damage can be even worse in the case of commercial buildings. The large multi-national carrier Zurich ( says, “Water damage is the number one source of property claims for owners of high-rise residences, hotels, office buildings, retail establishments and other commercial structures.” They noted the total damages to commercial property caused by water is in the billions of dollars each year. In a 2010 study, Zurich found 62% of all water losses were caused by wear and tear or human error, which they suggest could have been prevented by water prevention programs.

However it happens, water can be fast moving, and not immediately obvious, traveling through wall cavities and other tight spaces before being noticed. If the water source is pressurized, and no one is in the property at the time of the leak, tremendous amounts of water can be released in just a few hours, let alone a weekend, or longer. All that water usually leads to damage.

Water damages all kinds of property, and does so relatively quickly. Many building materials and personal property absorb water on contact. Water causes items to stain, swell, sag, weaken, and to rust, and cause electrical components to short out or fail. Finished surfaces may bleed onto carpets, and oriental carpets may have colors run or fade.

The good news is most water damage can be covered by insurance, but you have to know what the insurance covers so you can get the right insurance, with the right endorsements. That is a whole other discussion altogether, and one that should be done with a good insurance agent.

I did want to point out something that demonstrates the level of complexity and subtlety that can be found in insurance policies, and the importance of knowing someone that can assist you through the process, especially when it involves something as frequent, damaging, and costly as water claims.

The example I am thinking of is water “back-up”, as opposed to water “fill-up”. In most insurance policies, damages caused a water “back-up” is not covered, in fact it is specifically excluded, unless you have a specific endorsement called “Back-up of Sewer or Drain”, or something similar, that gives you back the coverage. Since it is an endorsement, it comes at an additional cost. And because insurance is expensive enough, many people tend to decline such endorsements that increase their premiums. On the other hand, most insurance policies do not exclude “fill-ups”, so they can be covered.

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So, what is the difference between a “back-up” and a “fill-up”? As the name implies, a water “back-up” is when water backs up through your sewer or drain pipes, and enter your home, usually at the showers, tubs, and toilets. This water usually originates from beyond your drain line, and unless you have a septic system or drain field on your property, it usually originates away from your premises (community sewer system).

In a “fill-up” situation, there is a blockage in the drain line on your property (or common property in the case of a condominium or similar property), and the water “fills” up in the drain line until it enters the home, again, usually at the showers, tubs, and toilets.

For ease of understanding, I explain it this way…if localized heavy rains cause the city sewers to fail and water is pushed through the city lines and into your lines and it comes out of your drains and toilet, that is a “back-up”, and is generally excluded by homeowners insurance. But if your son is playing with a tennis ball at the same time he is using the bathroom and happens to drop the ball in the toilet as he is flushing (anyone care to guess how I thought up that scenario?), and the ball clogs the line and causes water to come out onto your floors, that is a “fill-up”, and is generally covered under most policies (currently). Obviously, there can be many different scenarios for each type of loss (especially the “fill-up”), but I hope you get the basic picture. If you do, you’re a step ahead of nearly all homeowners, and far too many insurance adjusters.

In the end, the damage looks exactly the same. Water (sometimes called “grey water”, “black water” or “category 3 water”) comes up from drains and toilets. But in one case, the resulting water damage is excluded, and in the other case it is covered. If that wasn't bad enough, I have personally handled several cases where the insurance company adjuster did not seem to know the difference, did not know there was a difference, or didn’t bother to determine whether it was from a “back-up” or a “fill-up”. They simply denied the claim, citing the standard “back-up” exclusion – that is, until I required they revisit the claim and correctly pay the appropriate claims as “fill-ups”.

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I have no doubt this denial scenario happens many times a week, every week of every year, throughout the country. This results in millions of dollars not paid to premium-paying policyholders who purchased the coverage, but did not understand why the claims were improperly denied, did not get adequate treatment from their insurance company, and did not get assistance from an experienced consumer advocate (usually because they did not know they could).

It just goes to show how a subtle difference in terminology, based on the understanding of how a specific loss takes place, can make all the difference in whether or not a claim is paid, and the importance of knowing who to use as a resource for a particular situation.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.  

The Heat is On

by Mark Goldwich

It’s only the middle of June, but the heat has really spiked  this week in Northeast Florida, leading me to think about just a few of the insurance and home maintenance issues related to higher temperatures.

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First, we know that air conditioners are working overtime during the hot summer months, so whether you have central air, window units, wall or split units, now is not the time for them to fail. Be sure your AC is well maintained by cleaning or replacing the air filter regularly, or having a licensed company perform a maintenance check and do any needed repairs. The relatively small amount of money spent on regular maintenance will certainly outweigh expensive replacement costs, as well as keeping your unit running more efficiently. Our friends at DWG Inc. have a great blog at that can answer all your AC related questions.

If you don’t maintain your AC properly, you will usually find one of two things happen. The unit will either stop cooling your living space – this is bad; or, the unit will stop cooling your living space and leak water – this is very bad. Sometimes the leak is fairly minor, especially if caught quickly, but I have seen cases where a few gallons of water escape, damaging floors, baseboards, drywall, and even cabinetry. This usually happens when too much algae growth clogs the AC drain line, and instead of discharging water outside the home, it leaks inside the home. If you have ever watched how much water comes out of a good sized central AC drain line, you know that in just a few hours, you can be dealing with tens of thousands of dollars in damage. Or, depending on the insurance company adjuster you get, you could be told it just needs some minor drying and cleaning. Sometimes it’s just a matter of perspective.

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Hot summer weather also seems to bring more frequent and violent afternoon thunderstorms, often packed with high winds, lightning, and heavy rains. While you can’t do much about the weather, there are things you can do to minimize potential expenses.  Be sure your roof is in good condition by either checking it yourself, or hiring a roofing professional to do this for you. If there are excessive leaves and twigs on the roof, clear them off (I was recently on a roof that had so much leaf debris on it, that the debris was decomposing into a soil-like substance, and was now growing weeds out of it – I asked them for a broom and swept off several trash bags worth!).  If roof vents or other components have rubber seals or tar caulking, check those for weathering cracks and do needed repairs. Especially beyond 10 years, the hot sun can wreak havoc on roofs.

Check your gutters and downspouts for debris that will prevent them from moving water away from your home’s foundation. Keeping water away from your foundation is always a good idea. This is why your yard should slope down as it gets further from the foundation, and why you should not plant shrubs too close to the exterior walls. Since gutters and downspouts are made to move water away from the foundation, this only works if they are kept clear of debris. Exposure to water, especially repeated and prolonged exposure to water, is not good for a home’s foundation. It could cause erosion or compaction of soils which could damage your slab or foundation, seep into your home through minor cracks, and create mold conditions in and around your exterior walls.

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You can trim back large tree limbs that are hanging over your property, or remove dead trees altogether. It might surprise you how a relatively small tree limb falling onto your roof can create a much damage a normally looking tree can do when it crashes through your roof and into your living room! And while these events should be covered by your homeowners insurance, with the way deductibles are rising, it might be a lot cheaper to just do the maintenance.

Too many days of torrential thunderstorms can cause localized or widespread flooding, as thousands of people in Texas can attest. Even if your home is not directly affected, you could be required to evacuate your home for days at a time (as inconvenience as this is, it sure beats being directly affected by flood). Look into purchasing flood insurance if you do not already have it. There is very little that can be done to prevent flood damage, but having flood insurance is probably the best start in terms of minimizing your exposure to this disaster. Take a look at for more information on buying flood insurance or taking other steps to reduce the impact a flood can have on you, your family, and your property.

You can buy surge protectors to prevent electronics from being damaged by lightning and power surges. When lightning strikes your home, many of your electronics can be damaged, costing thousands of dollars to replace (and as ever-increasing numbers of electronics have more and more digital components, it is rare that these can be repaired following a strike or surge as they once were.) As inexpensive as surge protectors are, they can more than make up for the expense of having to file a claim following a lightning strike or power surge.

Lightning strikes can also be a source of home fires, just as they are a source of brush fires. Be sure your smoke detectors are working, have the proper fire extinguishers well placed (and know how to use them), have a fireproof safe for your most important documents and valuables, and have an emergency plan (and a recovery plan) the whole family is familiar with.

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Summer heat also means a lot more time in the pool (if you have one), or at someone else’s pool (if you don’t). This again means more maintenance if it’s your pool. Pools increase the chance of accident. You may want to check the chemical and PH levels more often, check and maintain the pump and filter, be sure everyone knows how to swim.  Just as public pools provide a lifeguard, make sure a responsible adult is present at all times when children are in or around the poo;.

Home maintenance and loss prevention is a lot like insurance – you pay a little now to avoid having to pay a whole lot later, and in the meantime you can enjoy some peace of mind while getting more sizzle out of your summer.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim. 

What Are the Odds?

by Mark Goldwich

If one thing is for certain, it is that there are no guarantees in life. Or, as other people have said, the only sure things in life are death and taxes. I never did agree with the taxes part of that statement, since you can choose jail (or death) over paying taxes.

Anyway, now that I started thinking about death, a concept I’m not at all fond of, I wanted to look at the ways people die, and how they can avoid that, or at least put it off for a while. So I got on the National Safety Council website ( and found an article titled “What are the odds of dying from…”

To me, this is good information to have for a few reasons. One, if you know the most likely ways you are going to die, you can then learn some steps to help you beat the odds. Also, if you know the least likely ways you are going to die, you can ease your mind a bit when it comes to worrying about dying in a particularly nasty, but highly unlikely way.

For example, the NSC showed Heart Disease and Cancer led the way towards death with 1 in 7 odds. So, if you do just a little research, you can take some pretty easy steps to greatly reduce your odds. Stop (or never start) smoking, exercise regularly, maintain a healthy diet and weight, and see your doctor.

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On the other end of the spectrum, dying from a lightning strike came in last with the odds of 1 in 164,968. Now, I was not thinking of this the other day when I was playing catch in the front yard with my son, under a tree, with lightning cracking nearby. If I did, even though the odds are not high, I would have gone into the house even sooner than I did. Still, there are many other ways to die, but I'm not going to list all the odds. What I will do is give you a few, with some thoughts on how you can reduce your risk. 

Did you know the odds of dying in a motor vehicle crash are 1 in 112? That’s worse than I thought it would be, making me glad I always wear a seatbelt.  Other than that, I could really stand to be more careful when I drive (no texting, no speeding, no aggressive lane changes). Besides improving my life span, good driving habits can save me money on insurance premiums.

Does knowing the odds of death by firearms discharge are 1 in 6,699 make you feel better? This one is tricky, because many of these deaths are caused by the person’s own gun, which means not owning a gun would better your odds. Then again, as a gun owner, I would recommend you take a firearm safety course, use a trigger lock, and take extra care whenever handling or cleaning a gun. After all, the answer to avoid dying in a car accident would be to never drive or ride in a car. This notion highlights the difference between “possible” and “realistic”.

How about choking to death from eating food? The odds of this are listed as 1 in 3,375. As someone that has used the Heimlich Maneuver twice on my own daughter before her 7th birthday, may I suggest being careful to cut food into pieces too small to choke on, not putting too much food in your mouth at one time, and chewing food well before swallowing. And parents, please particularly watch out for hard candies with your kids. My daughter’s first choking “incident” was on a Life Saver – how ironic!

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Most people have a fear of dying in a plane crash, much more so than dying in a car crash, but when you consider the odds of dying in a car vs. a plane are 1 in 112 vs. 1 in 8,015, I’ll take that plane ride any day of the week. I recall someone asking me why I would jump out of a perfectly good airplane (back in the day when I would skydive for fun on weekends). Even then, without knowing the odds, I would always say, “there is no such thing as a perfectly good airplane” meaning, all planes seem perfectly good, right up to the time they crash. The fact is, skydivers are much more likely to die on the car ride to or from their jump site, or when the plane they are to jump from crashes (this takes out the whole group of jumpers, not just the one that might die during the jump).

Insurance is a system by which financial risk is avoided or reduced by transferring the cost of that risk to another. The event may still happen, but your financial risk is reduced or eliminated. Similarly, taking extra precautions reduces your risk of accidents, and in the case of accidents, it is not just money you are trying to save, it is your health, or even your life. 

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.