Insurance claims for damage restoration
Most restoration work is paid through a home insurance claim. Here is how that normally works in Ontario, in plain language.
Call 24/7A note before you read: this page is general information. Policies differ, and only your insurer can tell you what yours covers. Read your policy or call your broker.
The order things usually happen
- Stop the damage. Shut off water, protect the building, start emergency drying. Policies generally expect you to take reasonable steps to limit the loss.
- Document. Photos and video of everything before it is moved or removed.
- Report the claim. Call your insurer or broker. You will get a claim number and an adjuster.
- Assessment. The adjuster reviews the cause, the damage and your coverage.
- Scope and approval. The restoration contractor submits a written scope and estimate. The insurer approves what the policy covers.
- Repairs. The approved work is completed. You pay your deductible and for any upgrades.
What we give your adjuster
- Dated photos and video of each affected area
- The cause of loss as far as it can be determined on site
- Moisture readings and a drying log
- An itemised scope of work and estimate
- A list of contents that were damaged, where contents are involved
What is typically covered
How Ontario home policies commonly treat each type of loss. Your policy may differ.
| Type of loss | Common treatment |
|---|---|
| Burst pipe or sudden appliance leak | Commonly covered as sudden and accidental water damage. |
| Sewer backup | Usually an optional endorsement with its own limit. Not part of most basic policies. |
| Overland flooding from rain or rivers | Usually a separate optional coverage, and not available at every address. |
| Groundwater seepage through the foundation | Frequently excluded. |
| Slow leak over weeks or months | Frequently excluded as gradual damage or lack of maintenance. |
| Fire and smoke | A standard covered peril. |
| Wind and hail | Commonly covered. |
| Mold | Often excluded or limited unless it results from a covered loss reported promptly. |
What to keep
- Your photos and video
- Receipts for emergency work, hotel stays, meals and anything else you spend because of the loss
- Damaged items, until the adjuster has seen them or said they can go
- A note of who you spoke to at the insurer, and when
If you do not have coverage
You still get a written estimate before work begins, and the emergency steps are the same. We can separate the work into what must be done now to stop further damage and what can be scheduled.
Insurance questions
Do I have to use the restoration company my insurer recommends?
Generally no. In Ontario you can choose your own contractor. Insurers often have preferred vendors and may explain how the process differs if you use someone else. Ask your adjuster before work goes beyond emergency measures.
Should I start cleanup before the adjuster visits?
Emergency work that stops further damage should start right away, and policies generally expect it. Photograph everything first and keep damaged items until the adjuster has seen or released them.
What will I pay out of pocket?
On a covered claim you normally pay your deductible, plus the cost of any upgrades you choose beyond what was there before. Anything your policy excludes or limits is also yours to pay.
Will a claim raise my premium?
It can. Insurers look at claims history when setting premiums, and some policies carry a claims-free discount. Your broker can tell you how a claim would affect your policy before you decide to file.
What if my claim is denied?
Ask for the reason in writing and the policy wording relied on. Insurers must have a complaint process, and unresolved complaints about home insurance can be taken to the General Insurance OmbudService.
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