Just this week I got asked a question I am asked several
times every year. I was speaking with a woman who had recently had a water loss
at her home, and she was considering whether or not she needed our assistance
with her homeowners’ insurance claim. Along the way, as it tends to happen, we
talked about her insurance policy, what it generally covers, and what it
generally doesn’t.
While homeowners insurance policies vary from company to
company, there are many similarities when it comes to coverages and exclusions.
Most policies cover by one of two methods – “all risk”, which certainly sounds
like it covers the insured for just that, all risks, or anything that happens.
Does anyone really believe an insurance company will pay for anything that
happens to your property? Of course not. What they really mean, and what you
should hear (in your head) when they say “all risk”, is that the insurance
company will cover you for all risks that are not later excluded in the policy.
Image courtesy of commins.wikimedia.com |
If the policy is not an all risk policy, it is what is
called a “named peril” policy. With a named peril policy, you are given a list
of perils that are covered, and also a list of exclusions. Generally, there are
exceptions to the perils, and also to the exclusions. If the event that damaged
your property is a named peril, you still need to review the exclusions, but if
the event is not one of the named perils, it doesn’t matter what the exclusions
are – it’s just not covered.
It might surprise you then to hear both policies appear to cover
similar things, such as fire, windstorms, accidental pipe leaks, and theft, to
name a few. Both types of policies tend
to exclude
similar things, such as wear and tear, mechanical breakdown, flood, pollution,
rust, mold, repeated leakage, and more.
So what ‘s the difference?. There are two main differences.
First, the all risk policy covers more items, simply because it covers the
limited number of events listed in a named peril policy (and for that reason,
it is both more expensive, and it is
easier to market as a better insurance product). The other difference, at
least as how it has been explained to me, is that with the all risk policy, the
legal burden to prove a claim is not covered is on the insurance
company; whereas with a named peril policy, the burden prove a loss is
covered is on the insured.
After we talked about her policy and the coverage and
exclusions contained, that’s when she asked the obvious question: “Why
do I even have insurance anyway?”
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There are a few answers to this question (even though it’s
almost always said halfheartedly). If there is a mortgage on the property, as
is usually the case, the mortgage company requires the homeowner to purchase
insurance to protect the mortgage company’s financial interest in the property.
In that case, the homeowner has no
choice, but it may be for the best. If
there is no mortgage on the property, the homeowner does have a choice, and a
decision to make. They could purchase insurance, or not.
Most people in this situation decide to purchase insurance rather
than saving the money they would otherwise be spending on insurance premiums to
use that money to pay for any unexpected events that the crop up. They know it
would take several, if not many, years to save enough money to cover the
expense of even a relatively minor loss. And they also know a major loss, at
almost any time, would leave them wholly unable to rebuild or replace
everything lost. This could mean
financial ruin for them.
Ultimately, people buy insurance because they can’t afford
to suffer a major loss without it. They prefer to transfer the risk of paying
for such a loss to a company that is financially able to pay a large loss, or
even a total loss. They can afford manageable monthly payments, and they can
usually afford their deductible, but just as people tend to buy homes using a
mortgage instead of paying cash, they use insurance to pay for repairs to the
home instead of paying for those repairs themselves.
Even those who could afford to pay cash for their home, or
who could pay cash to repair or replace their home in the event of a
catastrophic loss, tend to use insurance to spread and share the cost, as well
as avoiding liquidation of assets or conversion of investments in order to generate the needed
cash.
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You see, when people ask the question “Why do I even have
insurance anyway?” it’s more of a rhetorical question. They know why they have insurance,
they are merely complaining about paying higher and higher amounts of premiums
for lower and lower benefits. It should also be noted this question invariably
comes when a claim is not being covered, or not being paid completely. No one
ever asks this question after collecting $200,000 for a large loss just months
into their first year of insurance when they have paid less than $1,000 in
premiums. No, it usually comes after 10 years of paying premiums faithfully and
then having a relatively small claim declined.
It just goes to show, whether or not we have a mortgage, and
whether or not we’ve been paying premiums for a long or short time, we buy
insurance just in case, for peace of mind, to hedge our bets, to leverage
another financial tool at our disposal, and for any number of other reasons
based on our personalities, our risk tolerance, and our desire for stability. In other words, why ask why?
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.
This is why few people love their insurance company! :C
ReplyDeleteThey say the only two certainties in life are death and taxes. I think you just pointed out a third in your blog: Insurance.
ReplyDeleteBut aren't insurance rates and payouts based on actuarial tables? Insurance companies don't fail even in the worst of times. Just doesn't make sense.
ReplyDeleteInsurance companies regularly have "underwriting losses", which means they pay out more in claims than they take in as premiums - but they can still profit. Why? Investments. And insurance companies do fail, but usually only small or local companies, and usually only after a catastrophic event. Actually, State Farm Fire & Casualty Co. technically failed after hurricane Andrew in 1992, but State Farm Mutual Auto Co. "mother mutual" bailed them out, and few people ever knew.
DeleteA detailed and comprehensive explanation. Thanks for the post.
ReplyDeleteIf the event that damaged your property is a named peril, you still need to review the exclusions, but if the event is not one of the named perils, it doesn’t matter what the exclusions are – it’s just not covered.
ReplyDeleteInsurance loss