Restoration Insurance Claim Guide

What is normally covered

• Sudden and accidental discharge — burst supply lines, failed water heaters, appliance ruptures
• Fire and smoke damage, including suppression water
• Storm damage where the building envelope was breached by wind first
• Mold, but only when it results directly from a covered water loss, and usually capped

What is normally excluded

• Rising surface flood water — requires a separate NFIP or private flood policy
• Gradual seepage and long-term leaks classified as maintenance
• Sewer backup, unless you carry a specific rider
• Damage from failure to mitigate promptly after the initial loss
• Wear-and-tear failures on components at the end of their service life

Documenting the loss properly

1. 1Photograph and video every affected room before anything is moved
2. 2Photograph the failure point itself — the split hose, the corroded fitting
3. 3Keep a written log of dates, times, names and what was done
4. 4Retain damaged materials until the adjuster has inspected or released them
5. 5Keep receipts for emergency purchases, lodging and meals if displaced
6. 6Request daily moisture logs from your restoration contractor

Working with your adjuster

The adjuster is assessing what the policy owes, not what the repair costs. Those are usually similar and occasionally not. Your leverage is evidence: moisture readings that prove the affected area, photographs that prove the condition, and line-item pricing in the same format they use.

If your claim is underpaid

1. 1Request the adjuster's full line-item estimate in writing
2. 2Compare it against your contractor's scope line by line
3. 3Submit a supplement with photographs, readings and pricing for each missing item
4. 4Escalate to a claims supervisor if the supplement is not acknowledged in 10 business days
5. 5Engage a licensed public adjuster for genuine coverage disputes, not scope gaps
6. 6File a complaint with the Texas Department of Insurance if the carrier is unresponsive