How Insurance Covers Ceiling Leaks: Everything You Need to Know About Ceiling Leak Claims

Keep reading to find out everything you need to know about ceiling leak insurance claims.

Homeowners Insurance Covers Sudden & Accidental Ceiling Leaks

A standard homeowners insurance policy covers ceiling leaks – but only if the ceiling leak is sudden and accidental and caused by a covered peril.

If a pipe suddenly burst in your ceiling, for example, and caused water damage, then insurance should cover it.

Insurance also covers other sudden plumbing issues, storm damage, appliance malfunctions, and other sources of sudden and unexpected damage that may have caused a leak on your roof or ceiling.

Insurance Doesn’t Cover Maintenance Issues

If you have a ceiling leak because of poor maintenance, then insurance may deny your claim.

Let’s say you ignored roof damage for years, leading to water damage on your ceiling, then insurance may deny your claim. As a homeowner, you have an obligation to maintain your property.

Insurance may also deny claims because of long-term, sustained damage. If a rodent made a nest in your ceiling over many months, for example, and you failed to notice the damage, then insurance could deny your claim.
Insurance is increasingly denying claims for “wind-driven” rain…meaning that the wind drove the rain into vents and under shingles, but did not make a hole in the roof. These claims get denied often and can be disputed with the proper information.

Does Homeowners Insurance Cover Cracked or Collapsed Ceilings?

Your home may develop a crack because of normal settling. Or, water damage could rapidly turn a ceiling crack into a ceiling collapse.
Generally, insurance covers cracked or collapsed ceilings when the damage occurred because of a covered peril – like a burst pipe.
Insurance is unlikely to cover cracked or collapsed ceilings, meanwhile, if it’s caused by maintenance issues or other excluded damages.

Types of Ceiling Damage Covered by Insurance

Generally, homeowners insurance covers ceiling damage caused by sudden and unexpected events – like a windstorm or burst pipe.

Types of ceiling damage covered by insurance include:

• Burst pipes
• Windstorm or rainstorms
• Appliance-related leaks or issues
• Roof leaks caused by a covered peril
• Unexpected plumbing issues
• Other sources of sudden, unexpected damage
• Types of Ceiling Damage Not Covered by Insurance

Types of Ceiling Damage Not Covered by Insurance

Insurance policies have different exclusions.

Some of the most common types of ceiling damage not covered by insurance, however, include:

• Damage caused by neglect or lack of maintenance
• Damage caused by an excluded peril – like flood damage
• Mold damage
• Intentional damage or neglect

A standard homeowners insurance policy excludes things like flood damage, mold damage, wear-and-tear, pest infestations, pet damage, nuclear accidents, foundation settling, and vandalism, among other perils. If your ceiling damage was caused by any of these exclusions, then your ceiling damage may not be covered by insurance.

How Insurance Covers a Leaky Roof

Your insurer may or may not cover a leaky roof. It depends on the damage, the status of the roof, and your policy.

Generally, homeowners insurance covers damage caused by a leaky roof if the damage was sudden and accidental. If a rainstorm suddenly caused water to pour into your house, for example, then insurance should cover the cost of repairing the damage.

Here’s how insurance typically covers a leaky roof:

• Your home is damaged by a covered peril – like rain from a recent storm causing damage through an old roof.
• You contact your insurer. Your insurer assesses the damage, then covers the cost of repairing and replacing the damage to pre-loss condition.
• Your insurer may compensate you for the value of the old roof – which isn’t worth much. Depending on the age and condition of your roof, your insurer may tell you to replace or repair the roof.
• Sometimes, however, your roof isn’t just old and worn down: it’s damaged and needs to be repaired.

In this case, your insurance could deny your leaky roof insurance claim. Your insurer could send a letter warning you that you need to repair or replace your roof. Otherwise, they’ll deny future claims.

Should You File a Ceiling Damage Insurance Claim?

It may or may not be in your best interest to file a ceiling damage insurance claim.

If you have extensive ceiling damage and a broken roof because of a sudden and unexpected event, then it’s generally worth filing a claim. Insurance covers the cost of repairing your property to pre-loss condition.

If you have minor ceiling damage, however, then it may not be worth filing a claim. You may be better off paying to repair damage out of pocket.

Things to consider when filing a ceiling damage insurance claim include:

• How much is your deductible?
• What’s the estimated cost of repairing the damage?
• Will your insurance cover the cost of a new roof?
• Can you repair your roof or does it need to be fully replaced?
• Does your homeowners insurance policy cover ceiling leaks?

Remember: insurance rates rise after a claim. Making an insurance claim for a leaky roof will cause you to pay higher insurance premiums if the damage is not a weather related claim. However, it may still be in your best financial interest to make a claim because of the cost of repairing your property to pre-loss condition.

Who Covers Ceiling Damage in a Condo or Apartment?

If you live in an apartment or condo and have a leak from an upstairs neighbor, then your water damage insurance claim could get complicated.

Some of the things to consider when ceiling damage occurs in a condo or apartment include:

• Where’s the source of the water damage? If the water damage came from an overflowing toilet from an upstairs neighbor, for example, then the upstairs neighbor’s insurance should cover this damage.
• Is there HOA coverage? Some HOAs or similar organizations provide coverage for leaks, shared roofs, plumbing issues, and other damages. If damage occurred in a shared area and spread to your home, for example, then the HOA’s insurance may cover it.
• Was the damage caused by a covered peril? As mentioned above, a standard homeowners insurance policy covers water damage from sudden and unexpected sources – like burst pipes and appliance malfunctions. However, it may not cover damage caused by lack of maintenance or wear and tear over a long period.

Consider contacting your insurer regardless of where damage occurred. In some cases, your insurer processes the claim, then works with the at-fault party’s insurer (via subrogation) to receive compensation.

How to Solve Ceiling Claim Disputes

Ceiling damage insurance claims can get messy.

Insurers may argue the roof damage occurred because of an excluded peril – like poor maintenance. You could argue it was a covered peril – like a windstorm causing significant damage.

In these situations, you have a few options for resolving the dispute:

• Contact your insurer and document all conversations. Ask for an explanation, in writing, of why your insurer is denying or reducing your claim.
• Check your policy for a dispute resolution clause to explore the next steps. Your insurer may reassign an adjuster to reevaluate your claim, for example.
  Check your insurance policy to verify coverage or lack of coverage. Check your insurance policy’s dispute resolution system.
• If the insurance company continues to deny your claim or provide unsatisfactory service, then schedule a no-cost consultation with a public adjuster. These claim professionals can explore your case, then advise on the next steps to take. It may be in your best interest to hire a public adjuster to help with your claim.

ClaimsMate’s public adjusters have years of experience resolving tricky insurance claim disputes.

Schedule a no-cost consultation with a ClaimsMate public adjuster today. ClaimsMate’s adjusters work hard to ensure you receive fair compensation for your roof or ceiling damage insurance claim.

Stephanie Corona

Stephanie is a property insurance claim expert with over 20 years of experience working as an insurance adjuster, expert witness, appraiser and umpire. She is passionate about sharing her expertise, knowledge, tips and training to help both property owners and Public Adjusters in their pursuit of effectively managing claims and recovering the claim settlement they deserve after a loss.