After one of our nonprofit clients submitted a property claim based on significant water damage, the insurer denied the claim on the basis that the cause of loss was determined to be within the flood exclusion. The insurance company’s expert engineer produced a report supporting their denial.

As G2’s in-house Director of Claims, I investigated the damaged property with the client. On a day the weather conditions were similar to the date the loss occurred, I called the client to ask that they video the property. This would disprove the insurer’s expert’s theory that the damage came from roof gutter overflow. In addition, I pushed the carrier to appoint a new expert whom he knew was independent and objective. The new engineer’s report concluded that the cause of loss was a backup from the sewer.

The carrier agreed to cover the entire claim on the basis that this was a covered claim due to the engineer’s report. The claim concluded with a loss of more than $300,000 paid out to the client. The client was able to restore a treasured part of their local community and would have accepted the denial if G2 had not taken a critical eye to the insurer’s report.

Property