We have a Homeowners 3 policy issued on January 23, 2019. A claim came in on February 11, 2019 for freezing and water discharge discovered on February 9, 2019. Basement has standing water with about 2″ of ice formed over it. The house was vacant and unoccupied at the time of loss. We were unaware of this when writing the policy. Insured claims a basement window blew open causing the freezing pipes. There is no heat in the basement area and the main floor heat was on at the time of loss. Insured also indicated they had not been to the dwelling for about 2 weeks prior to discovering the flooded basement. There is extensive damage to the drywall etc. My question is: Do you feel this is a covered loss.

Kentucky Subscriber

You have a number of things going on here. First, I'm looking at the ISO HO 00 03 05 11; your policy may have different language. Your policy begins January 23, so you're limited to that time frame. If the insured lied on the application and the property had been vacant before the start of the policy then you have may misrepresentation and reason to deny the claim and cancel the policy.

Otherwise, the policy was put in force January 23. Even if the property became vacant and unoccupied the next day, it is not an issue unless the property was vandalized after it had been vacant 60 days. Freezing of pipes is excluded unless the insured used reasonable care to maintain heat in the building. While not stated in the policy, reasonable care to maintain heat is considered keeping the heat set at 55 degrees. If the heat is for the entire house and there is not separate heat for the basement, and the heat was set to at least 55 degrees, then the insured used reasonable care to maintain heat.  Therefore, the loss would be covered.

If the heat was set below 55 degrees or the basement runs on a different system which was not on, then the insured did not maintain heat in that part of the building and there is no coverage for the loss. If you believe that fraud is involved then an investigation would be warranted.

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