Home insurance claims

What should I do first after damage to my home?

Make sure everyone is safe, then stop the damage getting worse: shut off the water, kill the power to a flooded area, or board up an opening. Most Ontario policies require reasonable steps to prevent further loss. Photograph the damage before anything is moved or cleaned, and keep receipts for any emergency work.

The photographs are the part people skip, and the part that is impossible to recreate. Once a restoration crew has begun, the evidence of what the damage looked like is gone.

Emergency repairs to prevent further damage are usually covered, but they are not the same as permanent repairs. Keep the two separate in your records.

Do not throw damaged items away before the adjuster has seen them or agreed you can dispose of them. It feels like tidying up and it removes the evidence of what was lost. Photograph everything, set it aside if it is safe to do so, and ask before anything goes to the kerb.

Is water damage covered by home insurance in Ontario?

It depends entirely on where the water came from. A burst pipe is typically covered. Sewer backup and overland flooding are usually separate optional coverages that must be added. Gradual seepage and long-term leaks are generally excluded, because insurance responds to sudden and accidental events rather than to maintenance.

This is the single biggest source of surprise in Ontario property claims. Two homes with identical damage can have very different outcomes depending on the source of the water and on which endorsements each policy carries.

What does the adjuster do?

The adjuster is appointed by the insurer to assess the loss against the policy. They inspect the damage, review the coverage, request documentation, and determine what the policy responds to and at what value. They work for the insurer, not for you, which is why having a broker following the file matters.

Being organized helps more than being insistent. An inventory with photographs, dates and values moves faster than an argument about what was in the room.

What if my property is uninhabitable?

Most Ontario home policies include additional living expenses, which can cover reasonable extra costs of living elsewhere while the property is repaired: accommodation, meals above your normal spending, and similar. Limits and time periods vary by policy, so it is worth checking what yours carries before you commit to arrangements.

Keep every receipt. Additional living expenses are reimbursed against evidence of what was actually spent above normal costs, not estimated.

Additional living expenses cover the gap between normal household spending and what a displacement actually costs: temporary accommodation, meals above the usual grocery bill, pet boarding, extra travel to work. The limit is set in the policy and is commonly a percentage of the dwelling amount rather than an open budget, and it runs for a stated period. An in-house claims representative is available to every Sutherland Insurance client on a claim to confirm what the policy allows before the spending starts.

What is the difference between replacement cost and actual cash value?

Replacement cost pays what it costs to replace an item with a new equivalent today. Actual cash value pays that amount less depreciation for age and wear. Most Ontario home policies insure the building on a replacement cost basis, but contents coverage varies, and certain categories are commonly settled on actual cash value instead.

The difference is rarely noticed until a claim. A ten-year-old roof settled at actual cash value pays a fraction of a new roof; the same roof on replacement cost pays the new one, usually once the work is actually done.

Replacement cost settlements are often paid in two stages: actual cash value first, and the balance once the replacement is completed and evidenced. Knowing that in advance prevents an unwelcome surprise in the middle of a rebuild.

What if I disagree with the amount offered?

Start by asking how the figure was calculated and what it is based on. Most Ontario home policies also contain an appraisal clause, which allows each side to appoint an appraiser and, if they cannot agree, an umpire whose decision resolves the dispute over VALUE. It settles amount, not whether the loss is covered.

The appraisal route is for disagreements about how much. A disagreement about whether the policy responds at all is a coverage dispute and follows the complaints and ombudsman route instead.

Documentation moves these conversations more than argument does. Receipts, photographs, model numbers and independent quotes give an adjuster something to work from.

Will a claim affect my home insurance later?

Claims are recorded and form part of the history insurers consider at renewal and when quoting. The effect depends on the type of claim, its size, and how many have been made. A single weather-related claim is generally treated differently from a pattern of water losses at the same property.

This is worth weighing for small losses close to the deductible, where the benefit of claiming may be modest. It is a judgement about your own circumstances, and your broker can set out what a claim would and would not achieve before you decide.

What does a home insurance claim actually pay for?

A property claim can respond across several parts of the policy at once: the building itself, contents belonging to the household, additional living expenses if the home is uninhabitable, and liability if someone else was harmed. Each has its own limit, and a single incident can draw on more than one of them simultaneously.

Contents are usually insured as a percentage of the building amount rather than separately itemized, which works until something unusual is involved. Jewellery, art, bicycles, musical instruments and collections commonly carry sub-limits well below the overall contents figure.

Where an item is worth more than the sub-limit, it can normally be scheduled, listed individually with an agreed value, usually supported by an appraisal. That is a decision to make before a loss; after one, the sub-limit is the sub-limit.

Outbuildings, fences and detached structures are frequently covered under their own limit too, which is why a claim involving a garage or shed can settle differently from one involving the house.

What should I keep a record of while the claim is open?

Keep the claim number, the adjuster's name and contact details, and a dated note of every conversation and what was agreed. Keep receipts for emergency repairs, for additional living expenses, and for anything replaced. Photograph the damage before cleanup and photograph the repairs as they progress.

A claim that runs for months will outlast anyone's memory of a phone call in week two. A simple dated log costs nothing and settles disagreements that would otherwise come down to recollection.

It also helps the broker. When somebody advocates on your behalf, the quality of what they can say depends on the quality of what they have been given.

Sources

• Insurance Bureau of Canada: Home insurance basics