Claims Process

Policy Limits

Policy limits are the maximum amounts an insurance policy will pay for a covered loss. Dwelling coverage, contents, other structures, and loss of use each have separate, independent limits listed on the declarations page.

The Ceiling on Every Claim

Policy limits are the maximum amounts an insurance policy will pay for a covered loss - no supplement, no appraisal, and no negotiation gets a claim above the policy limit. No supplement, no appraisal, no negotiation changes this ceiling. Each coverage type - dwelling, contents, other structures, liability - has its own independent cap. On residential property claims, the dwelling coverage limit is the number that matters most because it governs how much the carrier will pay for structural repairs to the home itself.

Coverage Types and Their Limits

Each section of the policy operates independently. Damage to the house pulls from dwelling coverage. A destroyed fence pulls from other structures. Ruined furniture pulls from contents. They do not cross over.

Coverage TypeWhat It CoversTypical Limit
Dwelling (Coverage A)The house structureBased on rebuild cost
Other Structures (Coverage B)Detached garage, fence, shedUsually 10% of dwelling
Contents (Coverage C)Personal property insideUsually 50-70% of dwelling
Loss of Use (Coverage D)Additional living expensesUsually 20-30% of dwelling

Check the Dec Page Before You Scope

The declarations page tells you everything you need to know about a homeowner's coverage limits. On older homes with outdated policies, the dwelling coverage limit may be significantly below the actual rebuild cost. If the replacement cost value of the repairs exceeds the dwelling limit, the homeowner is responsible for the difference - and that gap can be tens of thousands of dollars.

Ask to see the dec page during your first meeting with the policyholder. If dwelling coverage is $180,000 but the home would cost $260,000 to rebuild, you are looking at a potential $80,000 gap. That is information you need before committing to the job, not after you have ordered materials.

When Policy Limits Become the Battleground

On large storm damage claims, the initial scope of loss may already approach the policy limit. When that happens, the carrier has zero incentive to approve supplements - they are already near the cap. This is where documentation becomes critical. If the actual repair cost exceeds the limit, the homeowner may need to file a separate claim for contents or other structures, or explore whether their policy includes an extended replacement cost endorsement that adds 20-50% above the dwelling limit.

Some policies also include ordinance or law coverage, which pays for code upgrades required by current building codes. This is a separate limit from dwelling coverage and is frequently overlooked on older homes where code compliance adds significant cost to the rebuild.

Frequently asked questions

If the repair cost exceeds the dwelling coverage limit, the homeowner is responsible for the difference. On older homes with outdated coverage, this gap can be significant. Always check the declarations page before scoping a large job.

No. Dwelling coverage has its own limit, contents have a separate limit, and other structures (detached garage, fence, shed) have another. Each type of coverage has an independent cap.

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