In home insurance documents, you may read about some situations called covered losses. In short, a covered loss is a type of incident in which the policy covers, or pays for, the loss or incident. It may sound complex. It does not have to be, though. Take a closer look at what it may mean to your insurance coverage.

What Happens When You File an Insurance Claim?

Take this scenario as an example.

You contact your home insurance agent because the roof has a leak. It was not large but did enough damage to your home’s interior that you want your policy to cover some of the costs.

The insurance company must determine if you have coverage through your policy. You may think this is an easy decision. Yet, there are various factors that play a role in determining if you, in fact, have insurance.

To be a covered loss, your policy must state that the incident meets the criteria set in your insurance plan. Consider the above scenario.

• The insurance agent determines that the roof leak was due to poor maintenance. The missing singles came off, exposing the underlayment. This created the leak. In this situation, the leak may not have coverage because it is due to poor maintenance and upkeep. You may not be able to file a claim. This is not a covered loss.

• The insurance agent determines the roof is leaking due to exterior damage after a hailstorm. The hail damaged the structure of the roof. You could not control that. This created a situation to the home that caused leaks that damaged the interior. This may be a covered loss. You could not predict the hail was going to occur and could not minimize it. Therefore, insurance might pay.

Many factors play a role in determining whether any type of damage is a covered loss. Some policies have very specific exclusions. For example, most policies do not cover flooding related to weather or river swells.

Other policies provide more comprehensive coverage for most needs. Covered loss may include things like fires, theft, and vandalism. Generally speaking, the loss must be something you could not predict would occur. Or, it must be something unavoidable.

Is Your Loss Covered?

This is perhaps the biggest question people have after an incident. The good news is there is no harm in calling your home insurance agent. Ask questions about your coverage. Find out if you have a covered loss. If you do, you can then decide if you wish to file a claim for the incident.