You pay Massachusetts homeowner’s insurance premiums and have for years – now you have a claim for property damage. Maybe your home and some of your things were damaged by wind driven rain, maybe water intrusion from ice dams, how to make your claim?

An insurance policy is a written agreement.

In order to make the carrier pay, you have to obey the rules set out in the policy.

Most Massachusetts homeowner insurance policies use standard forms of agreement found in M.G.L. c. 75, § 99. Your agent can get you the policy form and special coverages you  bought.

You have to cooperate

Insurers’ duty to issue payments to you is conditioned on your cooperation with their investigation of the claim.  This means prompt notice, protection from further damage, showing property, keeping accurate records and even giving a statement under oath.  If they want to come look, let them.

Exclusions are not covered

Even if blended with another covered cause, the list of exclusions shows what carriers do not have to answer for. Many policyholders are shocked to see that water damage from flood, surface water and even sewer backups are listed as excluded.

When to get a team to make your proof

If the insurer investigates your claim and then they offer a too low settlement figure, you might want to hire a public adjuster to speak for you and to make your proof. Public Adjusters are licensed and their contingent percentage agreements with homeowners are subject to laws M.G.L. c. 175 § 172.  They can help you format your claim in the categories that insurers expect to see. You may need to go out of pocket to get experts to describe the damage and cost to repair.  Actual, legitimate, market-based estimates of the repair costs of things such as linear feet of sheetrock will make your proof strongest.

When no agreement can be reached

If the carrier won’t pay fair money, the homeowner needs to demand, within two years of the incident – a reference to three referees.  Usually, referees are people with property damage claims experience. You pick one, they pick one, those two pick another, and the three of them view your property damage and hold hearings.

Reference Hearings 3 referees M.G.L. c. 175, § 99

Here, you probably should hire a lawyer, the insurer will have one.  While suing your own insurer in Court is still possible after the decision of two of the three referees, all efforts should be focused on making a tight, clear presentation before the expert referees.  Your case can be made best by your Public Adjuster and your Lawyer.