Why is the cause of a loss not always covered?

You may have heard these words before when filing an insurance claim: this is not covered by your insurance policy. Why is this?

Whether for your home or your car, insurance provides compensation for damages resulting from a covered loss. If you check your policy, you will see that various exclusions apply, one of which deals with excluded property. This section states that the property or parts thereof that caused the loss are not covered (for example, when the damage is caused by the breakdown, inherent vice or nature of the property).

Here is an example to better illustrate this situation. When you return home from vacation, you see that your basement has flooded. Afterwards, you notice that the loss was caused by your water heater, which has broken down. Your first instinct is to call your insurer to file a claim. You explain the situation, and to your surprise, the claims adjuster tells you that you are responsible for the replacement cost of the appliance. The insurer will cover the damages resulting from the covered loss, but will not cover the water heater itself due to the exclusion in the policy.

This exclusion also applies to car insurance. If you get a flat tire, the insurer will not reimburse you for the tire. However, if the flat tire caused an accident, the insurer will cover the resulting damages if you have “Collision” coverage on your policy.

What are your options?

If you ever find yourself in this situation, the Civil Code of Québec allows you to seek compensation for your property that caused the loss. The seller or manufacturer may be liable for the damages caused. Most of the time, to prove that the seller or manufacturer has been negligent, you will need to demonstrate the damage, fault and causation between the two.

A Few Preventive Measures

Most home insurance claims are related to water damage. Since this can occur at any moment, here are some tips to prevent any unforeseen issues:

  • Have your plumbing checked regularly by a specialist.
  • Don’t wait too long to replace your flexible hoses (washing machine, dishwasher, toilet tank).
  • When purchasing a home, have it inspected by a certified building inspector, who will recommend a plumber if there is any doubt.
  • Check your foundations each year to make sure there are no visible cracks.
  • Clean your French drains regularly to avoid clogging.
  • Alarm systems with sensors and automatic water main shutoff are a great investment and may qualify you for a discount on your insurance premium with some insurers.

To conclude, a loss, no matter its nature, can happen quickly and at any moment. If you find yourself in this situation, or if you have any questions, you can always contact your Lareau broker, who will be able to assist you and direct you to our claims team to ensure that everything is in order.

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