Denied Due to Wear and Tear Exclusions?

How Wear and Tear Exclusions Affect Florida Policyholders

Regarding homeowners’ insurance in Florida, policyholders need to be aware of the fine print in their insurance policies. One of the most common clauses that can catch homeowners off guard is the “wear and tear” exclusion. Understanding what this exclusion means and its impact on your coverage is crucial for protecting your property and finances.

Wear and tear exclusions in insurance policies refer to the natural deterioration of a property or its components due to regular use and aging. Insurance companies often include these exclusions to avoid covering damages that occur gradually over time rather than from sudden, accidental events. Examples of wear and tear include aging roof shingles, rust on metal pipes, or fading paint.

Why Do Insurance Companies Include Wear and Tear Exclusions?

Insurance companies use wear and tear exclusions to limit their liability for claims. The reasoning is straightforward: Insurance is designed to cover unforeseen and accidental damages, not predictable and inevitable wear and tear. By excluding wear and tear, insurers can keep premiums lower and reduce the risk of paying for damages that could have been prevented with regular maintenance.

Common Examples of Wear and Tear Exclusions:

• Roof Deterioration: Gradual wear and tear on a roof, such as aging shingles, may not be covered. However, sudden damage caused by a storm or other covered peril typically falls within the realm of insurance coverage.
• Plumbing and Appliances: The gradual breakdown of plumbing systems or household appliances due to normal wear and tear may not be covered. Insurance is designed to address sudden and accidental events that cause damage.
• Mold and Mildew: Damages caused by long-term exposure to moisture, leading to mold and mildew growth, may be excluded. Preventive measures and prompt maintenance are essential to avoid such exclusions.
• Gradual Foundation Shifts: Some policies may exclude coverage for damages resulting from gradually shifting or settling a home’s foundation. While sudden events like earthquakes may be covered under a separate policy, gradual changes often are not covered under a homeowner’s insurance policy.
• General Aging of Materials: The aging of materials in your home, such as paint, wood, or other structural elements, may not be covered by insurance. Policies typically focus on sudden and unforeseen events rather than the natural aging process.

Why Insurers Rely on Wear and Tear to Deny Claims

The impact of wear and tear exclusions on your insurance claim can be significant. When you file a claim for damage to your property, the insurance company will likely send an adjuster to assess the situation. If the adjuster determines that the damage resulted from wear and tear, your claim may be partially or entirely denied.

For example, if your roof leaks during a hurricane, the insurance company may deny the claim, arguing that the damage was caused by the roof’s deterioration over time rather than the storm itself. Similarly, if your plumbing system fails and causes water damage, the insurer may refuse coverage if it believes the pipes were already compromised by age or neglect.

This leaves many Florida homeowners in a difficult position. You may have paid premiums for years, believing you were covered, only to discover that the insurance company refuses to pay when needed.

Understanding the Wear and Tear Excuse

Insurance companies often choose wear and tear as a default denial strategy because it:

• Places the burden of proof on the policyholder
• Minimizes financial exposure for long-term damage
• Leverages ambiguous policy language
• Can be supported by biased “expert” inspections

Insurers may send engineers or third-party inspectors who conclude that the damage was due to long-term degradation, even when a triggering event, like wind-driven rain or a storm, was involved.

Reopening a Previously Denied Claim in Florida

Florida law allows homeowners to reopen insurance claims, mainly when new evidence arises or the insurer acted improperly. You may reopen a claim:

• Within 1 year of denial (per Florida statute)
• If the insurer failed to investigate properly
• If new documentation proves the actual cause of damage

Don’t assume a denial is final.

Why Wear and Tear Is a Convenient Excuse for Insurers

The wear and tear exclusion is a catch-all defense. It gives insurers a broad loophole to avoid paying legitimate claims.

Insurers bank on the idea that most policyholders won’t challenge them. That’s why it’s vital to fight back professionally and legally.

Don’t Let Wear and Tear Exclusions Define Your Outcome

As a Florida homeowner, understanding the implications of wear and tear exclusions is crucial to protecting your investment. While these exclusions are a standard part of many insurance policies, they don’t have to leave you unprotected. With the right legal help, you can challenge unfair claim denials and ensure that your insurance policy provides the coverage you deserve.

Don’t let wear and tear exclusions prevent you from getting the coverage you need—seek legal assistance today to protect your rights and property. We’re here to help you navigate the complexities of your insurance policy and ensure you receive the compensation you deserve. Contact us at 1-800-451-6786 or complete our online contact form.