Author: VU Faculty
Your insured discovers that the toilets, sinks and tubs won't drain. The plumber discovers a blockage in the main sewer line running from the house to the street caused by tree roots. Is any "backup" damage covered by the HO policy? Is the cost to replace or re-run the sewer line covered?
"Our insured with an HO 00 03 10 00 has a sewer line that runs from his house to the main line in the street. The composition of the line is unknown. A large tree in the front yard wraps its root system around the line to the extent that the line is damaged and is shut down. The insured asked us if the cost to repair/replace the line is covered. The insurer says, “Submit it and we will see.” My gut said there isn’t any coverage, but I can’t find an exclusion to kill coverage. Maybe it’s Friday and I just need to leave for the weekend and my mind is blank. Thoughts?"
"I have an insured covered by an HO policy form. Her plumber advised her that she has plant growth getting into her underground sewer pipe through the seams in the terracotta, which is causing water backup into her basement.There was no damage to the interior of the house, but would replacement of the sewer line be covered?"
"I have a claim where the roots from a neighbors tree have grown up through the wall of the shower stall in the master bedroom. This was unknown to the insured until the tiles fell off the wall due to the roots loosening them. At this same time the insured started having a problem with his toilet flushing and he called a plumber to repair it. The plumber ran a snake and pulled out roots. He advised the insured that there appeared to be roots growing into his underground pipes and these pipes will have to be replaced. The tree is at the front of a neighbors home and is in the process of being cut down. I was advised by my supervisor that the tile in the bathroom was covered since this is an HO 3 policy but I am unsure about the excavation of the damaged pipe. I would appreciate your input so that when I go again to my supervisor I can at least ask intelligent questions."
"Our insured had water backup from an overflowing toilet. The plumber discovered extensive tree roots in the sewer line. He said it is cheaper to lay a new line than to try and repair the existing one. He said the old line is some kind of fiber piping no longer allowed by codes and roots would just grow back into the area not damaged if it's just repaired. The adjuster says this is a 'maintenance' problem and the cost of owning a home but didn't cite a policy exclusion. I can't find one, can you?"
"We have had several HO claims to replace sewer lines due to tree root damage. Some insurers cover this and some refuse to. Do you think it's covered or is it normal wear and tear and excluded?"
"I have a customer that has had tree roots punch through the sewer lines buried in her yard leading to/from the house. This has interrupted her water and sewer service and will be quite an expense to replace the piping. The problem, however, has not caused any resultant water or sewer damage to her home. She has called and asked if this is covered under her homeowners policy. I have looked through the forms and do not see a specific exclusion, however, I may be missing something. If it is not specifically excluded, the question I have is if the sewer line is considered a part of the dwelling."
This is a very common type of question we receive fairly regularly. As for actual damage to the home itself, we have addressed that in another article called "Accidental Discharge vs. Sewer Backup." In this article we'll examine damage to the sewer line itself caused by tree root intrusion. As you will see, the key issue revolves around the facts of the claim...did the tree roots cause the damage? If so, the consensus is that there is no exclusion in the ISO HO form that precludes coverage. However, if the roots simply enter through a joint or through a break caused by pressure/earth movement, then there probably is not coverage.
This is clearly an "all risk" type exposure and the closest thing to an exclusion in the HO-3 is "wear and tear," though that doesn't appear to apply here since that usually involves gradual deterioration through use. There is no other exclusion for damage to covered property by tree roots that I can see. At best, it's clearly covered...at worst, it's ambiguous. I'd be interested in knowing how the carrier considers the claim and, if denied, on what basis. I think also that if there is damage, the Reasonable Repairs provision hooks the insurer into pay to prevent further damage.
Remember that the HO-3 provides “all risk” coverage for building items. In my view this would include pipes, drains, and sewer lines too. The homeowners program does not have an exclusion for items like “underground pipes, flues, and drains” like the commercial property program does. If you’re not going to cover the lines then you have to cite an exclusion…you can’t simply tell the insured, “The pipes and lines aren’t covered.” Reading the form, I don’t see an exclusion that applies. Have the pipes and lines actually been damaged, or is replacing them just a maintenance item? Remember that the HO policy covers “…risk of direct loss…” meaning there must be actual damage. If the lines are just clogged up and are not damaged then there may be a question of coverage there.
There is no specific exclusion in the HO-3 to exclude the damage to the sewer line in most cases. The closest thing would be "wear and tear," but that exclusion generally applies to nonfortuitous and relatively gradual degradation and deterioration of property through normal use. If the tree roots actually caused the damage to the pipe, then I see no basis for denying the claim. As a practical matter, I don't think tree tap roots are likely to damage most sewer lines except perhaps for terracotta or paper fiber type lines. More likely the roots enter breaks caused by settling.
If it is an "all risk" or "direct risk of physical loss" policy that does not specifically exclude the actions of tree roots, there is coverage for the loss as long as it is fortuitous. The problem with root claims is that they take so long to occur and most insurers believe that there is a sudden requirement. That requirement does not appear in a Homeowners policy, so the only exclusion that might apply is the unwritten fortuity (accidental) exclusion.
To determine coverage on an HO-3, you need to check the exclusions for Coverages A and B and the section I general exclusions. There is a Coverage A exclusion for "settling, shrinking, bulging or expansion, including resultant cracking, of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs or ceilings." The purpose of this exclusion is to exclude the type of normal settling and shrinking, etc. that occurs to most houses over time. I don't believe this exclusion applies in this case because the tree root caused the damage.
There is a Section I exclusion for "earth movement." In addition to several other items, the exclusion excludes "any other earth movement including earth sinking, rising or shifting." This exclusion normally applies to naturally occurring earth movement such as earthquake, landslide, subsidence, etc. The insurer might refer to this exclusion. I don't think it applies to this situation. The 2000 form added wording that states that the exclusion applies if the earth movement is "caused by or resulting from human or animal forces or any act of nature unless direct loss by fire or explosion ensues, and then we will pay only for the ensuing loss." This wording does not appear in the 1991 form but was added to clarify that this is not and never had been the intent of the policy.
I believe there is coverage in this case, including the cost to dig out the dirt, remove the roots, and repair or replace the pipe.
If there is no specific exclusion in the policy regarding damage by roots (from trees, bushes, etc), then the loss is covered, i.e. excavation to access and repair the damaged area; straightening or replacing the damaged part of the wall; and filling and grading the area of disturbance. I have seen (8-9 years ago) a few insurers that have a specific tree root exclusion, some applying only to sidewalks, patios, pavement, etc. I believe ISO considered such an exclusion at the time, but never proceeded.
I've heard of claim denials based on "wear and tear" and lack of maintenance, but I've never had a successful claim denial. How do you "maintain" a sewer line? Wear and tear is the natural deterioration of property by use. The Grand Canyon is evidence of wear and tear, not tree roots that puncture and damage a sewer line. The insurer's best bet would be the Neglect exclusion if they can demonstrate that this has been a long-term known problem not addressed by the insured, which is highly unlikely.
If the sewer line has actually been damaged, then I don't know of any legitimate basis for denying the cost to repair or replace the line. I suppose it's possible for roots to penetrate joints without damaging them, but I would think enough separation in the joint to allow the roots might be sufficient to constitute damage. If there's no damage, then there's no coverage.
The wear and tear exclusion does not apply. This is not the same as an appliance wear out or something becoming worthless in value through normal use. The sewer line was damaged by an external agent, tree roots. There is no exclusion for this. I can understand the insurer not wanting to pay for this common claim but, if so, they need an exclusion. We used to represent a nonstandard carrier some years ago that had a tree root exclusion. The ISO form doesn't.
Last Updated: June 18, 2009