Recently a failed toilet supply line flooded the 2nd floor master bedroom of my townhouse and damaged the ceiling of my living room beneath it. I immediately filed a claimed to my individual condo policy insurer, and the adjuster, after reviewing CC&Rs, refused to provide coverage for property damage and insisted that the HOA's master policy should be the primary. My adjuster was firm that my condo policy primarily covered personal possession loss and loss of use. He also estimated that it would cost about $40k for our repairs. My HOA initially said that water damage was our own responsibility and should be handled by my own insurance. After my adjuster pushed back, the HOA said that they could file a claim but the deductible would be $50k. My adjuster said that in this event, he would advise us not issuing the claim to HOA's insurer (since the deductible is more than our repair costs) and that in this situation my condo policy could provide a coverage of $10k or HOA deductible, whichever is lesser.
That is, I am now in a situation having to pay ~$30k out of pocket despite having a HOA master policy and my individual condo policy....
Has anyone encountered a similar situation (individual policy insurer refuses to be the primary and whatever is covered by the individual policy is less than the deductible of the HOA master policy? Any advice?
Update
“Insurance. The Board shall procure and maintain liability insurance and property insurance as it shall deem proper and as more particularly set forth in the By-Laws.
Damage to Single Residence. If the Development is damaged by fire or other casualty which it is insured against, and said damage is limited to a single Residence on a Lot, the insurance proceeds shall be paid to the Owner or Owners of such Lot, or the Mortgagees thereof as their respective interests appear, and such Owner or Mortgagees shall use the same to rebuild or repair such Residence. In the event there is a deductible or the insurance proceeds are insufficient to complete such work, the Lot Owner shall pay and advance the deductible and such additional sums as may be necessary to complete such rebuilding and repair.”
These are the languages from our HOA CCRs that my own policy adjuster pointed to when he insisted that the HOA master plan should be our primary. My policy adjuster advised against filing a claim to HOA’s insurer as the deductible would be higher than the cost of our repairs. We are still deciding if we would like HOA to file a claim regardless and have the two companies fight over responsibility….I told me my own policy agent and she was taking the same position as the adjuster. What should we do if we do not agree with my own policy’s reps? File a complaint on the Department of Insurance website? Consult with a lawyer?
**latest update**
I think I found more clarification in the by-laws:
Within a section that describes the Board Directors' duties it mentions "Each Owner shall be solely responsible for obtaining and maintaining liability insurance covering his or her Lot and adequate property insurance covering the contents, any internal damage and any upgrades or enhancement of the improvements located upon his or her Lot. In the event that Association shall obtain insurance which provides broader coverage than is required under the provisions of these By Laws and a particular loss may be covered both by a policy of insurance obtained by the Association and one obtained by an Owner, the Association’s insurance policy shall provide primary coverage only upon express approval by the Board; provided that in al events, should a loss result from a cause originating within an Owner’s Lot, the policy obtained by such Owner shall provide primary coverage."
I think now I have a leverage to ask the adjuster to reassess my claim!