{"id":904401,"date":"2025-05-21T14:49:45","date_gmt":"2025-05-21T20:49:45","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=904401"},"modified":"2025-05-21T14:49:49","modified_gmt":"2025-05-21T20:49:49","slug":"excluded-perils-clause-that-can-ruin-your-payout","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/excluded-perils-clause-that-can-ruin-your-payout\/","title":{"rendered":"Mold, Water Damage &amp; Fire Claims: The &#8216;Excluded Perils&#8217; Clause That Can Ruin Your Payout"},"content":{"rendered":"\n<p>Eduardo A. Maura | <a href=\"https:\/\/www.lawayala.com\/the-excluded-perils-clause\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Ayala Law<\/a><\/p>\n\n\n\n<p>Dealing with property damage is stressful enough. Whether it\u2019s mold creeping through your walls, water damage from a busted pipe, or the aftermath of a fire, homeowners and property owners turn to insurance to help them recover. But then comes the surprise: the insurance company denies your claim, citing something called the\u00a0<a href=\"https:\/\/doi.sc.gov\/957\/Understanding-Your-Insurance-Policy\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>\u201cExcluded Perils\u201d clause<\/strong><\/a>.<\/p>\n\n\n\n<p>At Ayala Law, we\u2019ve worked with clients across Florida who thought they were covered\u2014only to find out too late that the fine print in their policy left them with little or nothing. In this blog post, we break down what\u00a0<em><a href=\"https:\/\/www.myconstructionexpert.com\/blog\/tag\/excluded-perils\/\">Excluded Perils<\/a><\/em>\u00a0are, why they matter in mold, water damage, and fire claims, and how you can protect yourself.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>What Does \u2018Excluded Perils\u2019 Mean in a Property Insurance Policy?<\/strong><\/h4>\n\n\n\n<p>An Excluded Perils clause in your property insurance policy lists specific events or conditions that are not covered. If damage is caused by one of these \u201cexcluded\u201d perils, the insurance company can deny your claim\u2014even if the damage is real and significant.<\/p>\n\n\n\n<p>This clause is often buried in the middle of dense policy language. But it\u2019s one of the most important parts of your insurance contract.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Common Perils That Are Often Excluded From Coverage<\/strong><\/h4>\n\n\n\n<p>Here are some common causes of damage that may be excluded from your standard policy\u2014unless you\u2019ve purchased additional coverage:<\/p>\n\n\n\n<p><strong>Mold:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Often excluded or capped at low limits (like $10,000 or less)<\/li>\n\n\n\n<li>Insurance companies may argue mold was caused by \u201clong-term neglect\u201d or a \u201cmaintenance issue\u201d<\/li>\n<\/ul>\n\n\n\n<p><strong>Water Damage:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gradual leaks are often not covered<\/li>\n\n\n\n<li>Damage from flooding is typically excluded unless you have a separate flood insurance policy<\/li>\n\n\n\n<li>Sewer backups may also be excluded unless you have specific coverage<\/li>\n<\/ul>\n\n\n\n<p><strong>Fire:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Most fire damage is covered\u2014but claims can be denied if the insurer argues arson, neglect, or an excluded cause led to the fire<\/li>\n\n\n\n<li>If fire damage is the result of faulty wiring not disclosed to the insurer, they may reject the claim<\/li>\n<\/ul>\n\n\n\n<p>If your damage was caused by a combination of events\u2014some covered, some not\u2014this creates a coverage gray area, which is where many disputes arise.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How Insurance Companies Use \u2018Excluded Perils\u2019 to Deny Claims<\/strong><\/h4>\n\n\n\n<p>When a claim is filed, insurance adjusters may look for any justification to deny or limit the payout. The Excluded Perils clause is often the go-to tool.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Examples of Claim Denials We\u2019ve Seen:<\/strong><\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A homeowner suffers water damage from a broken A\/C unit, but the insurer says the damage was due to \u201cmaintenance failure,\u201d an excluded peril.<\/li>\n\n\n\n<li>A property owner discovers black mold in a rental unit. The insurer blames \u201congoing neglect\u201d rather than a covered sudden leak.<\/li>\n\n\n\n<li>A business experiences a fire caused by outdated wiring. The insurance company claims the damage isn\u2019t covered because of an undisclosed condition.<\/li>\n<\/ul>\n\n\n\n<p>These cases often require a legal fight to push back against narrow interpretations of what\u2019s covered and what\u2019s excluded.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Can You Still Get Paid If the Damage Falls Under an Excluded Peril?<\/strong><\/h4>\n\n\n\n<p>Yes\u2014but it depends. Here\u2019s where things get nuanced.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>When You Might Still Have a Claim:<\/strong><\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The \u201cexcluded\u201d peril contributed to the damage, but so did a covered peril<\/li>\n\n\n\n<li>The insurer misclassified the cause of damage<\/li>\n\n\n\n<li>You can show the damage was sudden and accidental, not long-term<\/li>\n\n\n\n<li>Your policy includes an endorsement (add-on) that covers what would otherwise be excluded<\/li>\n<\/ul>\n\n\n\n<p>This is where working with an\u00a0<a href=\"https:\/\/www.lawayala.com\/our-team\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>experienced insurance litigation attorney<\/strong><\/a>\u00a0can make the difference between getting nothing\u2014and getting compensated.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>What to Do if Your Property Damage Claim Was Denied<\/strong><\/h4>\n\n\n\n<p>If your mold, water, or fire claim was denied, here are steps you should take immediately:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Request the Denial in Writing:<\/strong>\u00a0Review the exact reason for denial<\/li>\n\n\n\n<li><strong>Get a Second Opinion<\/strong>: Bring in an independent contractor or expert to assess the cause of damage<\/li>\n\n\n\n<li><strong>Gather Documentation<\/strong>: Photos, videos, repair records, and inspection reports can help your case<\/li>\n\n\n\n<li><strong>Do Not Accept the Denial as Final:<\/strong>\u00a0You have a right to dispute the decision<\/li>\n\n\n\n<li><strong>Talk to An Attorney<\/strong>: Especially if the amount at stake is significant or the insurer is misrepresenting your coverage<\/li>\n<\/ol>\n\n\n\n<p>At Ayala Law, we represent policyholders in insurance litigation across Florida, and we understand how insurance companies think. We can assess whether the denial was valid, or if your case can be fought and won.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Can I Sue My Insurance Company for Denying My Claim?<\/strong><\/h4>\n\n\n\n<p>Yes. If your insurer wrongfully denied a valid claim or acted in bad faith, you may have grounds for a lawsuit against the insurance company.<\/p>\n\n\n\n<p>In Florida, insurers are legally required to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Properly investigate claims<\/li>\n\n\n\n<li>Act in\u00a0<a href=\"https:\/\/www.law.cornell.edu\/wex\/good_faith\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>good faith<\/strong><\/a><\/li>\n\n\n\n<li>Not misrepresent policy language<\/li>\n<\/ul>\n\n\n\n<p>If they fail to do this, they can be held financially responsible, sometimes beyond the original policy limits.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Final Thoughts: Don\u2019t Let the Fine Print Cost You<\/strong><\/h4>\n\n\n\n<p>Insurance policies are complicated and insurance companies count on that. The Excluded Perils clause can significantly impact your claim, but it\u2019s not always the last word.&nbsp;<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes &#8211; please call Advise &amp; Consult, Inc. at 888.684.8305, or email <a href=\"mailto:experts@adviseandconsult.net\">experts@adviseandconsult.net<\/a>.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Eduardo A. Maura | Ayala Law Dealing with property damage is stressful enough. Whether it\u2019s mold creeping through your walls, water damage from a busted pipe, or the aftermath of a fire, homeowners and property owners turn to insurance to help them recover. But then comes the surprise: the insurance company denies your claim, citing&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/excluded-perils-clause-that-can-ruin-your-payout\/\">Continue reading <span class=\"screen-reader-text\">Mold, Water Damage &amp; Fire Claims: The &#8216;Excluded Perils&#8217; Clause That Can Ruin Your Payout<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[10721],"tags":[9895,11329,22],"class_list":["post-904401","post","type-post","status-publish","format-standard","hentry","category-insurance","tag-advise-consult","tag-excluded-perils","tag-insurance","entry"],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Mold, Water Damage &amp; 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