The water damage insurance claim process in Ontario

This is general information. Policies and insurers differ, so check the details with your adjuster or broker.

Step 1: Stop the damage

• Shut off the water
• Make the area safe, particularly around electricity
• Move belongings out of the way

Your policy requires you to take reasonable steps to prevent further damage. You do not need permission to do so, and the reasonable cost is normally part of the claim.

Step 2: Record everything

Before cleaning up:

• Photograph and video each affected room, wide shots and close-ups
• Capture the source: the split hose, the failed fitting, the overflowing fixture
• Photograph damaged belongings
• Note the date and time you found it, and what you did

Keep the failed part. Do not throw away damaged items until the adjuster has seen them or agreed, apart from things that are a health hazard, which you should photograph and list first.

Step 3: Report the claim

Call your insurer’s claims line or your broker as soon as you can. Most have a 24-hour number. You will be asked:

• Your policy number
• What happened, when and where
• What is damaged
• Whether the home is liveable
• What you have done so far

You will be given a claim number and the name of an adjuster. Write down the name of everyone you speak to and when.

If you are not sure whether to claim, you can ask your broker about coverage, your deductible and the possible effect on your premium first. A reported claim, even one that is not paid, may be recorded.

Step 4: Emergency mitigation

A restoration contractor extracts the water, removes what cannot be saved and sets up drying equipment. The insurer may offer to send one of its preferred contractors, or you can call your own. Either way:

• The contractor should document the source, the extent and the category of water
• Moisture readings are taken daily
• You will be asked to sign an authorisation for the work. Read it.

This phase usually takes three to five days for clean water.

Step 5: The adjuster’s assessment

The adjuster’s job is to establish what happened, decide whether the policy covers it, and determine the amount. Expect:

• A visit, or a review of photographs and the contractor’s report for smaller claims
• Questions about the cause and timing
• A review of your policy’s coverages, limits, endorsements and deductible
• Sometimes an independent adjuster, engineer or other specialist, where the cause is unclear

The key coverage questions for water are:

• Was it sudden and accidental? Gradual leaks and seepage are generally excluded.
• Where did the water come from? Plumbing and appliance failures fall under standard coverage. Sewer backup, overland water and ground water each need their own endorsement.
• Were policy conditions met? For example, the freezing and vacancy conditions.

Step 6: Scope and estimate

The contractor prepares a detailed estimate for the repairs. The adjuster reviews it and they agree a scope and a price. Ask for a copy and read it room by room. If something is missing, say so now. If further damage is found once work starts, the contractor requests a supplement.

Step 7: Your contents

For damaged belongings you prepare a list with descriptions, ages and replacement costs, supported by photographs and receipts where you have them. See home inventory for insurance. Restorable items are cleaned. Others are paid for according to your policy.

Step 8: Proof of loss

For larger claims, the insurer asks you to complete a proof of loss form: a sworn statement of what was lost and the amount claimed. Policies and Ontario’s Insurance Act set out requirements and time limits for filing it. Ask your adjuster when it is due, complete it carefully, and keep a copy. Accuracy matters. A deliberately false statement can void a claim.

Step 9: Payment

• The deductible is your share of the loss. It is usually deducted from the payment, or paid by you to the contractor.
• Building repairs are often paid directly to the contractor with your authorisation, or to you. If you have a mortgage, the lender may be named on the cheque.
• Replacement cost and depreciation. Many policies pay the actual cash value first and the balance once repairs are done or items are replaced.
• Contents are paid to you.
• Additional living expenses, if you had to move out, are paid against receipts. See additional living expenses explained.
• Advances are often available on larger claims. Ask.

Step 10: Repairs and closing

Reconstruction follows the agreed scope. At the end you are asked to confirm the work is complete. Do not sign until it is. The insurer then pays any recoverable depreciation and closes the file.

How long does it take?

A small, straightforward claim can be settled in a few weeks. Larger ones take months, driven mainly by the repair schedule. Insurers in Ontario are expected to handle claims fairly and promptly under the rules overseen by the Financial Services Regulatory Authority of Ontario.

Tips that make a difference

• Report promptly
• Keep a claim diary: dates, names, what was said
• Follow up phone calls with an email
• Keep every receipt
• Read your policy, including the endorsements
• Ask for explanations in writing
• Do not exaggerate. It puts the whole claim at risk.
• Do not authorise permanent repairs before the scope is agreed

If you disagree

Start with the adjuster, then their manager, then the insurer’s complaint officer. Beyond that, the General Insurance OmbudService offers free, independent help. Disputes about the amount can go to appraisal under the Insurance Act. Time limits apply to legal action, so get advice early. See water damage claim denied.

Will my premium go up?

It may. Insurers consider claims history, and water claims are among those they watch most closely. Some policies have a claims-free discount that a claim removes. Ask your broker how a claim is likely to affect you before deciding whether to claim for a small loss close to your deductible.

More: water damage restoration.