Pest Damage and Home Insurance in Mississippi

The general pattern

Most homeowners policies cover sudden and accidental damage and leave out damage that builds up over time, and pest damage is usually in the excluded group.

A policy generally responds to a sudden event such as a fire or a burst pipe, and generally excludes wear, rot and damage caused by insects or animals over a period. Termite damage is one of the most common examples of an excluded peril, and a homeowner should not assume it is covered without reading the policy.

This page states the general pattern only. It does not describe the coverage of any particular policy, and it does not give any deadline, limit or deductible. The policy and the insurer decide those.

What an adjuster usually asks

The questions tend to be about when the damage started, how it was discovered, what was done once it was seen and whether a pest was the cause.

A household that can answer these questions from a record usually has an easier time than one that reconstructs them from memory. The inspection report is often the most useful single document.

• When the damage was first noticed, and whether it was sudden or has grown over time
• The photographs taken at the time, and the location of each one
• Whether a pest inspection was made, and what the report says
• What was done to stop further damage, such as drying a leak or moving wood
• Whether any repair was made before the adjuster saw the damage

Mitigation and why the insurer cares

Most policies expect the owner to limit further damage once it is found, and the steps taken are part of the claim record.

Mitigation means stopping the damage from getting worse: repairing a leak, moving the wood that is being attacked, or drying a wet area. It is usually the owner's duty to do so, and the insurer will want to know what was done and when.

A pest finding is a reason to take mitigation steps that are recorded. A household that ignores a finding and lets the damage grow is in a weaker position than one that acted on it and kept the record.

What to photograph and keep

Photographs with a scale, the inspection report, the readings and any receipts for the steps taken are the core of the file.

Keep the originals and a copy in a second place. The file is only useful if it can be found quickly, and a household that keeps it in one labeled folder has the simplest path to an answer.

• Photographs of each affected area, with a coin or a ruler for scale
• The inspection report, with its date and the technician's licence
• Moisture readings taken at the same spots as the photographs
• Receipts for any repair, drying or treatment, with the date and the work described
• A short written note of when the problem was first seen and what was done about it

If a claim is denied

A denied claim can be questioned with the insurer, and a complaint about an insurer can be made to the Mississippi Insurance Department.

Start by asking the insurer for the reason for the denial in writing and for the policy language relied on. Read the policy with the reason in hand. An agent can also explain the terms, though the policy text is what counts.

If the answer is still unsatisfactory, the Mississippi Insurance Department takes consumer complaints about insurers and has an online consumer portal and a PDF form. The Department's guidance is to contact the company or the agent first, and this page does not state any deadline for doing so. The Department's own pages set out the process.

Reading the policy before a claim

The policy is the document that decides a claim, and a household that reads its exclusions before a problem starts is in a stronger position.

Look for the section on exclusions, and read it for wear, rot, insects, animals and gradual damage. Look also for the section on water and for any endorsement that adds or removes cover. The words used in the policy are the ones the insurer will rely on, and a general sense of what the policy covers is not enough.

If a term is unclear, ask the insurer or the agent to explain it in writing. The explanation does not change the policy, but it is part of the record, and it shows what was understood at the time.

Working with the adjuster

An adjuster is the insurer's representative, and the household's best approach is to be accurate, organized and polite.

The adjuster will want to see the damage, ask about its history and take their own photographs. Show what was found, answer the questions directly, and say where the answer is not known. The household should not guess at dates. A date that is said to be an estimate should be marked as one.

Ask the adjuster for the reason for any conclusion that is not explained, and ask for the report in writing. The adjuster's report is the insurer's document, and the household is entitled to a copy of what is relied on.

Documenting before any repair

Repairs can destroy the evidence of damage, so the damage should be photographed and measured before anything is removed.

Before wood is removed, photograph it in place with a scale, record the moisture reading and keep any piece that is removed. A repair that is made before the adjuster or the technician has seen the damage can make the claim harder to prove. The mitigation step, such as drying a wet area, should also be recorded before it starts.

A household that cannot wait for an adjuster to see the damage should take the photographs and keep the removed material, and say so in the file. The insurer will decide what weight to give them, and the file will show that the evidence was preserved.

Why a pest finding is not a claim by itself

A pest inspection gives a record of what was found, but a pest finding is not a claim, and a claim depends on the policy and the damage.

A report that finds termites in a sill does not automatically mean a claim will be paid. The insurer will ask whether the policy covers the damage and whether the damage was sudden or gradual. A household should therefore treat the report as part of the file, not as a decision.

A household that finds a pest should not assume the insurer will cover the treatment or the repair. The cost of the pest work is usually the household's to bear, and the insurer's question is about the damage the policy covers. Asking the insurer for its position in writing is the clearest way to know where things stand.

Keeping the file in order over time

A claim file is built over time, and a household that keeps it in order from the first day has an easier time than one that gathers it in a rush.

Keep a single folder, paper or digital, for the house, with sections for the policy, the inspection reports, the photographs, the repairs and any correspondence with the insurer or the agent. Date each item and label it with what it shows. A file that is in order can be sent to an adjuster or a regulator in a few minutes, and a file that is not will take days to reconstruct.

Keep copies of the policy each year, and note any change to the coverage. A change that was made after a pest was found can matter, and the file should show when it was made and why.

Reading the exclusions for termites specifically

A household that wants to know how its own policy treats termites should find the exclusion wording, not rely on a general summary, because the wording is what decides the claim.

Look for the words termite, wood-destroying insects, insects, vermin and wear and tear in the exclusions section. Note whether the exclusion is for damage caused by the pest or for the cost of treating the pest, because those can be treated differently. Note also whether a separate endorsement exists for termite damage, which some policies offer and which changes what is covered.

If the wording is unclear after a careful reading, ask the agent or the insurer for an explanation in writing. The written explanation is part of the file, and it shows what was understood at the time the policy was reviewed.

Talking to the insurer before a repair

Calling the insurer before a repair is started can prevent a dispute about what was damaged and what was paid for.

A household that finds damage should tell the insurer what has been found, and ask what the insurer needs before the repair begins. The insurer may want to see the damage, may ask for a report or may say that the policy does not respond. Any of those answers is better known before the work than after.

The conversation should be recorded in the file, with the date, the name of the person spoken to and the substance of what was said. A short follow-up email that confirms the conversation is a sensible step.