Homeowners policies generally exclude termite and vermin damage, and that is the most useful thing a homeowner can know before a claim. What a particular policy covers is decided by the policy and the insurer, not by this page. This guide sets out the general pattern, what to photograph and keep, and where to take a denied claim.
Key takeaways
- Termite and vermin damage is usually excluded from a standard homeowners policy, so a pest-damage claim often needs a close look at the policy wording.
- Coverage for sudden damage and for gradual damage differs, and most policies treat gradual deterioration and wear as outside what they cover.
- Endorsements sit outside a standard policy and can change what is covered; this guide does not describe any specific endorsement.
- Photographs, dates, invoices and the inspection record are the evidence a claim depends on, so keep them from the first day.
- A denied claim is answered in writing: ask for the reason in writing, read the policy and contact the North Dakota Insurance Department, the state regulator that oversees insurers licensed in North Dakota.
What do homeowners policies generally cover?
A standard homeowners policy generally responds to sudden and accidental damage from a covered peril and generally excludes damage from wear, gradual deterioration and certain animals and insects. The exact list is in the policy, and the policy decides each claim.
Most homeowners policies are built around a list of perils, which are the events the insurer agrees to cover. They generally respond to sudden and accidental damage of the kind the policy names. A policy will usually list which damage it covers and which it excludes, and the exclusions are as important as the cover.
Gradual damage, wear and tear and deterioration are generally outside the cover. A seal that has worn through over years, a sill that has rotted slowly and a foundation that has settled over time are the kinds of damage a policy usually treats as maintenance rather than an insured event. The line between a sudden event and gradual damage is often the first thing an insurer looks at.
This guide describes the general pattern only. Policies differ in their wording, and a homeowner should read the actual document rather than rely on any summary, including this one.
Why is pest and termite damage usually excluded?
Termite and vermin damage is usually excluded outright by a standard homeowners policy. That is the single most useful thing a homeowner can know before deciding how to pursue a pest-damage claim.
Pest damage is generally excluded because it is treated as a matter of maintenance and prevention rather than as a sudden event. Termites and rodents damage a building over time, and most policies name them specifically. A homeowner who has pest damage should not assume the policy covers it without reading the wording.
The exclusion is usually stated in general terms, and the exact wording varies. Some policies name termites or vermin directly, and others describe damage by insects or animals in similar terms. The homeowner's job is to find the clause and read it, not to guess from the name of the policy.
Where the policy excludes the pest, the damage the pest caused may still be looked at in a different way. An insurer may consider whether a sudden event caused the damage, and that is a question for the policy and the claims process, not for this page.
What do endorsements change?
Endorsements are additions to a standard policy that can change what it covers. This guide does not describe any particular endorsement, because the wording varies and only the policy can say what applies.
An endorsement is a written addition to the policy, and it can add cover for a peril the standard policy excludes or it can restrict what the policy covers. A homeowner who believes an endorsement applies should check the schedule of the policy and the wording of the endorsement.
This guide does not name or describe any endorsement, because the research behind it did not confirm the wording of those that exist. A homeowner should ask the insurer or the agent which endorsements the policy includes and what each one covers.
The policy and the insurer decide. No general page can settle whether an endorsement applies to a specific loss, and this guide does not try to.
What should a homeowner photograph and keep?
Keep photographs with dates, the location of each sign, invoices from any inspection or repair, the inspection record and any correspondence with the insurer. These records are the evidence a claim depends on.
Photograph the damage as soon as it is found, from more than one angle, with a scale or a known object in the picture where that helps. Note the date and the room. A photograph taken on the day is more persuasive than a description given weeks later.
Keep the inspection record. The technician's written plan and the list of findings are the evidence of what was seen and when. Keep the invoices for any repair or treatment, and keep the correspondence with the insurer in one folder with the dates.
Keep the policy document itself, and note the date of the most recent renewal. A homeowner who knows what the policy says is better able to decide how to present a claim.
What is mitigation, and why does the insurer care?
Mitigation means taking reasonable steps to stop further damage once a problem is found. Policies generally expect the homeowner to act reasonably to limit the damage, and an insurer may ask what was done and when.
Once a problem is found, the homeowner is generally expected to take reasonable steps to stop it getting worse. For a pest problem that means sealing the openings and clearing the harbourage, which is the same work this site describes in its services. The insurer may ask what was done and when, so the record of the sealing matters.
Mitigation is not the same as repairing the building. A homeowner who seals an opening is limiting further damage, and the repair of the damage already done is a separate question for the policy and the insurer.
Keep the record of each step taken, with the date. The record shows the insurer that the homeowner acted reasonably, and it gives the technician and the homeowner a clear basis for any later decision.
What does the adjuster ask, and what if the claim is denied?
An adjuster usually asks when the damage was found, how it happened, what was done about it and whether there was earlier damage. A denied claim should be answered in writing: ask for the reason in writing, read the policy and contact the North Dakota Insurance Department, the state regulator that oversees insurers licensed in North Dakota.
An adjuster will ask when the damage was first seen, what caused it as far as the household knows, what was done about it and whether the damage has been seen before. The answers should be accurate, and the photographs and records support them. A homeowner who does not know an answer should say so rather than guess.
If a claim is denied, ask for the reason in writing and read the policy wording that the insurer relies on. A denial that is not explained in writing is hard to challenge, and the written reason is the thing the homeowner needs to compare with the policy.
If the homeowner is not satisfied, the next step is to contact the North Dakota Insurance Department, the state regulator that oversees insurers licensed in North Dakota. The department publishes its complaint process and a consumer complaint form at insurance.nd.gov.
How should a homeowner describe the damage on a claim form?
Describe the damage as it was seen: where, when, how it was found and what was done about it. Stick to the facts, avoid guessing at a cause that the inspection did not confirm and say when a cause is not known.
A claim form asks the homeowner to describe the damage and its cause. The best description is the one the record supports: the room, the wall or the floor, the date the damage was first seen and the signs found on the inspection. Where the cause is not known, the form should say so, rather than guessing.
A homeowner should avoid describing the cause in a way the inspection did not confirm. A statement that the damage was caused by a sudden event, when the inspection found gradual damage, is a mistake that can hurt the claim. A statement that the cause is not known is accurate and better than a guess.
Attach the photographs and the inspection record to the form. The written plan lists the findings and their places, and it is the most useful support a homeowner can provide. A claim that is backed by the record is easier to assess than one that rests on a description alone.
What happens between the claim and the decision?
The insurer may send an adjuster, ask for more records or ask questions in writing. The homeowner should respond promptly, keep copies of everything and note each contact with its date.
After a claim is filed, the insurer may visit the house, ask for records or send questions in writing. Each step is a point at which the homeowner should respond promptly and accurately. A delayed reply can slow the decision, and a reply without the records can leave questions open.
The homeowner should keep copies of everything sent and received, and should note each phone call with its date, the name of the person spoken to and what was said. That record is useful if the decision is disputed.
Ask the insurer to confirm in writing any decision it makes by phone. A written decision gives the homeowner the reasons to compare with the policy, and it is the document the state regulator will ask to see if a complaint is made.
Frequently asked questions
Will my policy pay for termite damage?
Termite damage is usually excluded by a standard homeowners policy. The policy wording decides the question, and a homeowner should read the exclusion rather than assume either way.
Does a pest sign mean I should file a claim?
A sign is a reason to call an inspection and to record the findings. Whether a claim is worth filing depends on the policy and on the damage found, and the decision is best made after reading the policy.
How long do I have to file a claim?
This guide does not give a deadline, because the time limit is set by the policy and by state law and can vary. Read the policy and ask the insurer for the time limit in writing as soon as a loss is found.
Can this page tell me what my policy covers?
No. The policy and the insurer decide what is covered. This page describes the general pattern and the steps that help a homeowner present a claim, and nothing here replaces the policy.
Can I hire my own contractor before the adjuster visits?
A homeowner can take reasonable steps to limit damage while the claim is open, such as sealing an opening or drying a damp area, and should keep the record. It is wise to ask the insurer how it wants the work documented before major repairs are started.
This guide is general information for Cass County homeowners, not a substitute for an on-site inspection. Prices are estimates. See our disclaimer.