A large tree falls on an insured’s roof due to strong winds. The cost to remove the tree was approximately $4,500, but the insurance carrier is limiting the amount of recovery to $1,000 due to Section III—Additional Coverages, Part A. Removal of Fallen Trees.
Q: I contend that the removal of the tree from the dwelling should be paid as part of the claim because the removal of fallen trees section of the policy is specifically for "removing any fallen tree from the grounds appurtenant to your principal residence." Should the carrier cover the entire cost of removing the fallen tree from the insured’s roof?
Response 1: To only pay $1,000 to remove the tree from the house would violate its own policy saying that it will pay all costs to make reasonable repairs to protect property from further damage. You can’t make repairs without removing the tree.
The policy pays whatever it takes to get the tree off the roof. The cost of removing the tree from the premises once on the ground would be subject to the $1,000 removal limit. Move this up the line to a supervisor.
Response 2: Something tells me this will end up as a question for a lawyer because the limitation does apply. But the question is: What does it apply to?
One interpretation is that the total repair bill consists of three elements: the cost of repairing the roof, the cost of removing the tree from the roof and the cost of disposing of the tree after it's been removed from contact with the roof. I would argue that the cost of removing the tree from the roof is part of the Coverage A loss, just like the cost of repairing the roof boards and shingles.
It’s comparable to ice or snow damage. In order to make repairs to the roof and prevent total collapse, it's necessary to shovel ice or snow off the roof. The cost is a necessary part of the roof repair and should be included in the Coverage A loss up to the Coverage A limit. Once the tree is off the house, the cost of cutting it up and hauling it away is subject to the sublimit.
If my argument holds up, somebody needs to parse the $4,500 bill for the tree removal into the roof repair and tree removal elements. The contractor or contractors involved should be able to allocate their time to these tasks to give the adjuster some numbers to work with. The sublimit for tree removal may not be large enough to cover that element, but at least a portion of the $4,500 cost should be included in the roof repair bill.
If the $4,500 bill includes the cost of grinding out the stump, that part belongs in the tree removal portion of the claim.
Response 3: An additional coverage that can apply is "Reasonable Repairs.” The cost to remove the tree from the house is a reasonable temporary measure to prevent further loss to the home from having the tree on it. This question has been litigated. If the insurer subscribes to Property Loss Research Bureau (PLRB), request they submit the question to them. The last PLRB opinion I saw confirmed the case law that supports this interpretation.
Response 4: I agree with you. If the tree fell on the roof, the cost to access the damaged roof and make repairs requires the tree to be moved from the roof first. That is not an additional coverage, it is an expense related to repairing the covered roof.
Most tree removal firms break down their bill into two parts: “lift and drop,” and two, “cut up and haul away.” The second part is subject to the additional coverage limit. And, by the way, if this was only one tree it is subject to a $500 limit, not $1000.
Response 5: The adjuster doesn’t appear to understand how the policy works. Here’s another article from the Big “I” Virtual University detailing answers to similar questions.
This question was originally submitted by an agent through the VU’s Ask an Expert Service, with responses curated from multiple VU faculty members. Answers to other coverage questions are available on the VU website. If you need help accessing the website, request login information.