<?xml version="1.0" encoding="UTF-8" ?><!-- generator=Zoho Sites --><rss version="2.0" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:content="http://purl.org/rss/1.0/modules/content/"><channel><atom:link href="https://www.claimattorney.com/blogs/tag/wear-and-tear/feed" rel="self" type="application/rss+xml"/><title>The Claim Attorney - Blog #Wear and Tear</title><description>The Claim Attorney - Blog #Wear and Tear</description><link>https://www.claimattorney.com/blogs/tag/wear-and-tear</link><lastBuildDate>Sat, 04 Apr 2026 16:37:58 -0700</lastBuildDate><generator>http://zoho.com/sites/</generator><item><title><![CDATA[Wear and Tear in Insurance Claims: What Carriers Don’t Want You to Know]]></title><link>https://www.claimattorney.com/blogs/post/wear-and-tear-in-insurance-claims-what-carriers-don-t-want-you-to-know</link><description><![CDATA[HERE IS THE SECRET. INSURANCE POLICIES ARE WRITTEN BY ATTORNEYS AND IF THEY ARE AMBIGUOUS, IT IS LIKELY INTENTIONAL! What “Wear &amp; Tear” Really Mean ]]></description><content:encoded><![CDATA[<div class="zpcontent-container blogpost-container "><div data-element-id="elm_MzjjtIbESUmzzsz1fVu3dQ" data-element-type="section" class="zpsection "><style type="text/css"></style><div class="zpcontainer-fluid zpcontainer"><div data-element-id="elm_KKfpMmJyS2GZS018o89g-g" data-element-type="row" class="zprow zprow-container zpalign-items-flex-start zpjustify-content- " data-equal-column="false"><style type="text/css"></style><div data-element-id="elm_FB5gzP2GTYelZcBAB6mNZQ" data-element-type="column" class="zpelem-col zpcol-12 zpcol-md-12 zpcol-sm-12 zpalign-self- "><style type="text/css"></style><div data-element-id="elm_U-OXOu7u-pg3g5eOrzST-Q" data-element-type="image" class="zpelement zpelem-image "><style> @media (min-width: 992px) { [data-element-id="elm_U-OXOu7u-pg3g5eOrzST-Q"] .zpimage-container figure img { width: 1240px !important ; height: 347px !important ; } } </style><div data-caption-color="" data-size-tablet="" data-size-mobile="" data-align="center" data-tablet-image-separate="false" data-mobile-image-separate="false" class="zpimage-container zpimage-align-center zpimage-tablet-align-center zpimage-mobile-align-center zpimage-size-custom zpimage-tablet-fallback-fit zpimage-mobile-fallback-fit hb-lightbox " data-lightbox-options="
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                theme:dark"><figure role="none" class="zpimage-data-ref"><span class="zpimage-anchor" role="link" tabindex="0" aria-label="Open Lightbox" style="cursor:pointer;"><picture><img class="zpimage zpimage-style-none zpimage-space-none " src="/Picture1.png" size="custom" alt="Storm-damaged roof with missing shingles – insurance claim wear and tear example" data-lightbox="true"/></picture></span></figure></div>
</div><div data-element-id="elm_uk2UGtdQIG3FqG16U4sB6Q" data-element-type="heading" class="zpelement zpelem-heading "><style></style><h2
 class="zpheading zpheading-style-none zpheading-align-left zpheading-align-mobile-left zpheading-align-tablet-left " data-editor="true"><strong>📘 The Policyholder’s Playbook: Wear and Tear in Real Claims</strong></h2></div>
<div data-element-id="elm_IFZa9aQWbDUUu85UAuKcBA" data-element-type="text" class="zpelement zpelem-text "><style></style><div class="zptext zptext-align-left zptext-align-mobile-left zptext-align-tablet-left " data-editor="true"><div style="line-height:1;"><div style="line-height:1.5;"><p style="text-align:justify;"><span style="font-size:18px;font-weight:700;">HERE IS THE SECRET. INSURANCE POLICIES ARE WRITTEN BY ATTORNEYS AND IF THEY ARE AMBIGUOUS, IT IS LIKELY INTENTIONAL!</span></p><p style="text-align:justify;"><span style="font-size:18px;"><strong>What “Wear &amp; Tear” Really Means</strong></span></p><div><h3><span style="font-size:18px;"><p style="text-align:justify;"><span>Insurance companies often deny claims by citing “wear and tear.” In plain English, that’s just the natural aging of your property. Think:</span></p><ul><li><p style="text-align:justify;"><span>Paint fading over time</span></p></li><li><p style="text-align:justify;"><span>Small cracks in walls from settling</span></p></li><li><p style="text-align:justify;"><span>Roof shingles naturally losing granules</span></p></li></ul><p style="text-align:justify;"><span>Most policies exclude normal wear and tear. That’s fair enough — insurance isn’t meant to be a maintenance contract.</span></p><p style="text-align:justify;">But here’s the catch: policies do cover sudden and accidental damage. If a storm rips shingles off, hail strikes your roof, or a pipe bursts, that’s new damage — <strong>even if your property is old.</strong></p><span><hr style="text-align:justify;"/></span></span></h3><h3 style="text-align:justify;"><span style="font-size:18px;"><strong>How Insurers Misuse the Exclusion</strong></span></h3><h3><span style="font-size:18px;"><p style="text-align:justify;line-height:1.5;"><span>In practice, insurance companies often stretch the “wear and tear” excuse to deny valid claims. They’ll look for any way to blame a problem on age, maintenance, or neglect.</span></p><p style="text-align:justify;"><span>From my own experience handling claims, I’ve seen:</span></p><ul><li><p style="text-align:justify;"><span>Creased shingles blamed on “high nailing”</span><span> instead of wind damage.</span></p></li><li><p style="text-align:justify;"><span>Obvious storm creasing written off as “vandalism” or “wear and tear.”</span></p></li><li><p style="text-align:justify;"><span>Broken windows blamed on anything but the actual storm</span><span> — I’ve heard excuses ranging from thermal stress to “pre-existing weakness.”</span></p></li></ul><p style="text-align:justify;"><span style="text-decoration-line:underline;">The reality: these denials aren’t always honest assessments. They’re tactics to save the carrier money.</span></p><span><hr style="text-align:justify;"/></span></span></h3><h3 style="text-align:justify;"><span style="font-size:18px;"><strong>What Denial Letters Look Like</strong></span></h3><h3><span style="font-size:18px;"><p style="text-align:justify;"><span>Most homeowners and business owners don’t know how to read a denial letter. Carriers use coded phrases like:</span></p><ul><li style="text-align:justify;"><span>“Long-term seepage”</span></li><li style="text-align:justify;">&quot;Normal wear and tear&quot;</li><li style="text-align:justify;">“Marring, deterioration, or defect”</li><li style="text-align:justify;">“No evidence of a storm-created opening”</li><li>&quot;Long term seepage&quot;</li><li>&quot;No storm created opening&quot;</li></ul><p style="text-align:justify;"><span>These are red flags. They signal the insurer is leaning on exclusions instead of acknowledging new, covered damage. Seek a professionally immediately.</span></p><span><hr style="text-align:justify;"/></span></span></h3><h3 style="text-align:justify;"><span style="font-size:18px;"><strong>Real-World Examples</strong></span></h3><h3 style="font-weight:bold;">1. <strong>Cheetham v. Southern Oak Ins. Co. (2013)</strong></h3><h3><span style="font-size:18px;"><div><span style="font-size:18px;"><div><ul><li><p><strong style="font-weight:bold;">What happened:</strong> The Cheethams’ home suffered water damage after a deteriorated pipe broke. The insurer denied coverage, pointing to the wear-and-tear and water damage exclusions.</p></li><li><p><strong style="font-weight:bold;">Court’s view:</strong> The appellate court said exclusions are interpreted strictly against insurers. It found the policy ambiguous and ruled that because the damage came from the home’s own plumbing system, the loss was covered</p><p>Cheetham v. Southern Oak Ins.</p></li><li><p><strong style="font-weight:bold;">Takeaway for homeowners:</strong> Even if damage starts with “deterioration” (wear and tear), if it causes an accidental water discharge, coverage may still exist. Don’t accept “pipe was old” as the final word.</p></li></ul><hr style="font-weight:bold;"/></div></span></div></span></h3><h3 style="font-weight:bold;">2. <strong>Dodge v. People’s Trust Ins. Co. (2021)</strong></h3><h3><span style="font-size:18px;"><div><span style="font-size:18px;"><div><ul><li><p><strong style="font-weight:bold;">What happened:</strong> The Dodges’ cast iron pipes corroded, causing water damage. The insurer said corrosion = “act of nature” and capped coverage at $10,000 under a water damage endorsement.</p></li><li><p><strong style="font-weight:bold;">Court’s view:</strong> The appellate court agreed — rust and corrosion were considered natural processes (an “act of nature”), so the $10,000 sub-limit applied</p><p>Dodge v. People's Trust Ins.</p></li><li><p><strong style="font-weight:bold;">Takeaway for homeowners:</strong> Corrosion and long-term deterioration are often limited by sub-limits, even if sudden water damage occurs. Watch out for endorsements that quietly cap your payout.</p></li></ul><hr style="font-weight:bold;"/></div></span></div></span></h3><h3 style="font-weight:bold;">3. <strong>Sebo v. American Home Assurance Co. (2016)</strong></h3><h3><span style="font-size:18px;"><div><span style="font-size:18px;"><div><ul><li><p><strong style="font-weight:bold;">What happened:</strong> Sebo’s $8 million Naples home was destroyed by a mix of defective construction, rain, and Hurricane Wilma. The insurer denied coverage, saying defective construction (excluded) caused much of the loss.</p></li><li><p><strong style="font-weight:bold;">Court’s view:</strong> The Florida Supreme Court applied the Concurrent Cause Doctrine (CCD). When multiple causes (some excluded, some covered) combine, coverage applies if at least one covered peril contributed — unless the policy clearly says otherwise</p><p>Sebo v. Am. Home Assur. Co.</p></li><li><p><strong style="font-weight:bold;">Takeaway for homeowners:</strong> If storm damage and wear and tear both play a role, you may still be covered. Insurers can’t automatically deny just because wear and tear was involved.</p></li></ul></div></span></div></span></h3><h3></h3><h3 style="text-align:justify;line-height:1.5;"><span style="font-size:20px;"><strong>Steps Policyholders Should Take</strong></span></h3><h3 style="text-align:justify;line-height:1.2;"><p><span style="font-size:18px;">1. Document Everything – Take photos, videos, and keep repair/maintenance records.</span></p><p><span style="font-size:18px;">2. Get a Second Opinion – Hire a contractor, public adjuster, or attorney to inspect.</span></p><p><span style="font-size:18px;">3. Request the Denial in Writing – Force the carrier to spell out their reasons.</span></p><p><span style="font-size:18px;">4. Challenge the Denial – Many claims denied under “wear and tear” are later overturned.</span></p><p><span style="font-size:18px;">5. Remember Burden of Proof</span><span style="font-size:18px;"> – Once you show a loss occurred, it’s the insurer’s job to prove an exclusion applies.</span></p><span style="font-size:18px;">Document Everything</span><span style="font-size:18px;"> – Take photos, videos, and keep repair/maintenance records.</span></h3><h3 style="text-align:justify;line-height:1.2;"><span style="font-size:18px;">Get a Second Opinion</span><span style="font-size:18px;"> – Hire a contractor, public adjuster, or attorney to inspect.</span></h3><h3 style="text-align:justify;line-height:1.2;"><span style="font-size:18px;">Request the Denial in Writing</span><span style="font-size:18px;"> – Force the carrier to spell out their reasons.</span></h3><h3 style="text-align:justify;line-height:1.2;"><span style="font-size:18px;">Challenge the Denial</span><span style="font-size:18px;"> – Many claims denied under “wear and tear” are later overturned.</span></h3><h3><span style="font-size:18px;"><div></div></span></h3><h3><span style="font-size:18px;"><div></div></span></h3><h3><span style="font-size:18px;"><div></div></span></h3><h3><span style="font-size:18px;"><div></div></span></h3><h3><span style="font-size:18px;"><div></div></span></h3><h3 style="text-align:justify;line-height:1.5;"><span style="font-size:18px;">👉 Bottom line: Don’t just take the carrier’s word for it. If they say “wear and tear,” you may still have a valid, covered claim.</span></h3></div></div></div></div>
</div><div data-element-id="elm_cqGGHujUSNSd7XL-AkxrmQ" data-element-type="heading" class="zpelement zpelem-heading "><style></style><h2
 class="zpheading zpheading-style-none zpheading-align-left zpheading-align-mobile-left zpheading-align-tablet-left " data-editor="true"><span><span><strong><span>⚖️ Legal Corner: Lessons on Wear and Tear</span></strong></span><span><strong><br/></strong></span></span></h2></div>
<div data-element-id="elm_vAvzNOyudJTUjQQp_cV3bA" data-element-type="text" class="zpelement zpelem-text "><style></style><div class="zptext zptext-align-left zptext-align-mobile-left zptext-align-tablet-left " data-editor="true"><p><br/></p></div>
</div><div data-element-id="elm_h4ktzKmgjBbSeM1PPxdYUQ" data-element-type="button" class="zpelement zpelem-button "><style></style><div class="zpbutton-container zpbutton-align-center zpbutton-align-mobile-center zpbutton-align-tablet-center"><style type="text/css"></style><a class="zpbutton-wrapper zpbutton zpbutton-type-primary zpbutton-size-md zpbutton-style-none " href="javascript:;"><span class="zpbutton-content">GET YOUR FREE CLAIM REVIEW</span></a></div>
</div><div data-element-id="elm_0OXPgWruGzgdMIR3wMlH8g" data-element-type="text" class="zpelement zpelem-text "><style></style><div class="zptext zptext-align-left zptext-align-mobile-left zptext-align-tablet-left " data-editor="true"><p></p><p style="text-align:center;"><strong><span style="font-size:24px;">⚖️Legal Corner</span></strong></p><div><h3><strong><span style="font-size:18px;">Cheetham v. Southern Oak Ins. Co., 114 So. 3d 257 (Fla. 3d DCA 2013)</span></strong></h3><span style="font-size:18px;"></span><ul><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Facts:</span></strong><span style="font-size:18px;"> The insureds’ home suffered water damage when a deteriorated pipe burst. The insurer denied coverage, citing wear-and-tear and water damage exclusions.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Issue:</span></strong><span style="font-size:18px;"> Does the wear-and-tear exclusion bar coverage for water damage from a burst pipe?</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Holding:</span></strong><span style="font-size:18px;"> The court found the exclusions ambiguous and ruled the policy covered the loss.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Reasoning:</span></strong><span style="font-size:18px;"> Exclusions are strictly construed against the insurer; ambiguities favor the policyholder.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Takeaway:</span></strong><span style="font-size:18px;"> Even if a pipe is old, a sudden break causing water damage may still be covered.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span></ul><span style="font-size:18px;"><hr/></span><h3><strong><span style="font-size:18px;">Dodge v. People’s Trust Ins. Co., 321 So. 3d 831 (Fla. 4th DCA 2021)</span></strong></h3><span style="font-size:18px;"></span><ul><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Facts:</span></strong><span style="font-size:18px;"> Corroded cast iron pipes caused water damage. The insurer applied a $10,000 sub-limit under a Water Damage Endorsement, arguing corrosion was an “act of nature.”</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Issue:</span></strong><span style="font-size:18px;"> Does corrosion-related water damage fall under the endorsement’s sub-limit?</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Holding:</span></strong><span style="font-size:18px;"> The court upheld the sub-limit. Corrosion was deemed a natural process and therefore subject to the endorsement.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Reasoning:</span></strong><span style="font-size:18px;"> Clear policy language limited the payout; courts enforce unambiguous sub-limits.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Takeaway:</span></strong><span style="font-size:18px;"> Corrosion and wear-and-tear losses may be limited by hidden policy endorsements.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span></ul><span style="font-size:18px;"><hr/></span><h3><strong><span style="font-size:18px;">Sebo v. Am. Home Assur. Co., 208 So. 3d 694 (Fla. 2016)</span></strong></h3><span style="font-size:18px;"></span><ul><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Facts:</span></strong><span style="font-size:18px;"> A luxury home suffered damage from defective construction, rain, and Hurricane Wilma. The insurer denied coverage, pointing to the construction defect exclusion.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Issue:</span></strong><span style="font-size:18px;"> When both covered and excluded causes contribute to a loss, does coverage exist?</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Holding:</span></strong><span style="font-size:18px;"> The Florida Supreme Court applied the <strong>Concurrent Cause Doctrine (CCD):</strong> coverage exists if a covered peril contributes, unless the policy clearly avoids CCD.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Reasoning:</span></strong><span style="font-size:18px;"> Many losses have multiple causes. Without clear anti-concurrent cause language, insurers cannot escape coverage.</span></p><span style="font-size:18px;"></span></li><span style="font-size:18px;"></span><li><span style="font-size:18px;"></span><p><strong><span style="font-size:18px;">Takeaway:</span></strong><span style="font-size:18px;"> Even if wear and tear contributed, coverage may still apply when a storm or other covered peril also caused the damage.</span></p></li></ul></div></div>
</div><div data-element-id="elm_avC-FQclbizhCVZkU1s2FQ" data-element-type="heading" class="zpelement zpelem-heading "><style></style><h2
 class="zpheading zpheading-style-none zpheading-align-left zpheading-align-mobile-left zpheading-align-tablet-left " data-editor="true"><span>👉 Final Takeaway</span></h2></div>
<div data-element-id="elm_8Hn4IXHIotCINhF7rTG_-g" data-element-type="text" class="zpelement zpelem-text "><style></style><div class="zptext zptext-align-left zptext-align-mobile-left zptext-align-tablet-left " data-editor="true"><p></p><div><p>Carriers often misuse “wear and tear” to avoid paying. But Florida law shows:</p><ul><li><p>Burst pipes may still be covered.</p></li><li><p>Corrosion may be capped, but only if endorsements clearly limit it.</p></li><li><p>Mixed causes (wear + storm) may still result in coverage under CCD.</p></li></ul><p><strong>If your claim was denied for “wear and tear,” contact The Claim Attorney today for a free claim review.</strong></p></div><p></p></div>
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