Exemptions to the Individual Mandate
There are some cases where there is no penalty to not having coverage.
Insurance companies typically pay a covered replacement-value loss by providing an initial payment based on the actual cash value (ACV).
The ACV is the replacement cost minus depreciation.
When you present your insurance company the final receipts or other proof that repair work is finished, you get the rest of the settlement. This guarantees that a covered loss has been paid in full.
Most insurance policies require that replacement/repair occur in a set time frame, such as 180 days.
If a damaged item can be repaired, the company has the right to pay based on repair rather than replacement.
However, you can often purchase insurance that provides these types of coverages.
Your insurance agent may be able to help you.
If your community has opted to participate in the National Flood Insurance Program (NFIP) - administered by the Federal Emergency Management Agency (FEMA) - you may be able to purchase coverage for those types of damage through that program.
If someone works on your home and other damage occur over time because the original work was faulty, your insurance company can deny the claim due to workmanship issues.
When this happens, it’s the responsibility of the company or individual who did the work to fix any damages caused by their faulty workmanship. This is not covered under most insurance policies.
Check your specific policy. Know what perils are covered.
The company owes repair or replacement only for the portion of the home that was damaged.
This is true whether it is covered damage to a roof, indoor carpeting or siding.
The company should provide a settlement sufficient to replace damaged materials with material that is similar and of "like kind and quality".
It does not owe for portions of the home that were not damaged.
Insurance policies cover negligence of a policyholder.
If there was no evidence that the tree was in danger of falling and causing damage before the storm, the neighbor’s insurance company may not be responsible.
However, this type of damage is typically covered under your own homeowners policy.
The basic homeowners policy usually does not.
However, this is a popular coverage for insurance companies to offer.
You may be able to buy this coverage for a small addition to the premium.
There is also the issue of where the power was lost.
Some policies are limited to coverage for electricity lost in the home or where the electricity enters the home.
Others limit coverage to a certain distance from the home.
Ask your agent about the availability and cost of this type of coverage.
Most insurance policies exclude water damage for water that backs up through sewers or drains.
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