Sewer or Drain Backup Endorsement leads to numerous claims being denied or underpaid.
Overview of Current Claim Trends
As a Public Adjusting firm assisting home and business owners throughout Florida, Georgia, and South Carolina, we see a lot of claims. Our unique position allows us to witness recurring nightmare stories and identify trends in how insurance companies handle claims. These trends can be specific to individual companies or common across multiple carriers. In this case, we are seeing the same trend with several different insurance companies.
Common Issues with Sewer Back-up Limited Endorsement
Understanding the Endorsement
This trend revolves around the differences between a sewer back-up claim and a simple water damage claim. Although the title of this endorsement may vary from one insurance carrier to another, the implications are generally consistent. Most endorsements specify a special limit of insurance, typically around $5,000 or a small percentage of the building’s coverage, activated under certain conditions.
Policy Coverage for Back-up of Sewer or Drain
Here is an example of how one insurance company policy describes this coverage:
“We will pay for accidental direct physical loss to the dwelling and covered personal property located within the dwelling, caused by the back-up of water or sewage, subject to the following: The back-up must be directly and immediately caused solely by water or sewage from outside the residence premises plumbing system that enters through a sewer or drain located inside the interior of the dwelling, or that enters into and overflows from within a sump pump, sump pump well, or any other system located inside the interior of the dwelling designed to remove subsurface water drained from the foundation area.”
For this endorsement to be properly applied, it would require that there was an issue with the sewer/drainage system off of the residence premises (beyond the property line) that then allowed water/sewage to back up into the property causing damage. This is typically due to some sort of problem with the sewer system at the street level or beyond. Not due to a blockage within the residence.
Initially, many adjusters, myself included, were trained to understand that it all depends if it is your own poopy water or your neighbors poopy water that entered your property. If it is your own water that was not able to drain properly due to a blockage or possibly a collapsed drain line and then the water overflows into the house, this endorsement would typically not apply as this is a standard water claim due to failed plumbing system. However, this endorsement would be properly applied in the event that there is an issue off of the property and other peoples poopy water is now backflowing into your property causing damage.
Misapplication of the Endorsement
Incorrect Claims Handling
The problem we observe is that this endorsement is frequently misapplied to nearly all types of water damage originating from the drain lines. The situation we often see is where there is a blockage or collapsed drain line which causes water to overflow into the property causing damage. This situation would not typically fall under the “Back-up of Sewer or Drain” endorsement. These are more accurately described as blockage or overflow claims and should be handled as a simple water damage claim.
Advocating for Fair Treatment in Insurance Claims
The Importance of Persistence and Knowledge
If your insurance claim is denied or underpaid, consider it a starting point rather than a final decision. Insurance policies are complex, and every word counts. If you believe you’re not being treated fairly, seek a second opinion from an experienced Public Adjuster or an attorney specializing in First Party Property claims. Remember, knowledge is power, and you deserve no less than what you are entitled to under your policy.
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Meet the Senior Public Adjusters at Claim Concepts
Our Commitment
Greg Roover, SPPA
Inspired by Personal Experience
Greg’s path to becoming a Public Adjuster was deeply personal. The Northridge Earthquake was a turning point, where his family’s experience with a public adjuster opened his eyes to the profound impact of this role. Greg embarked on a strategic career journey, motivated by a desire to help others as his family was helped. He honed his skills working for insurance companies as an independent insurance adjuster.
In 2006, Greg’s vision came to fruition with the founding of Claim Concepts. His insider knowledge, gained from years within the industry, and his passion for aiding others have been instrumental in the company’s success.
In 2025, Greg earned the Senior Professional Public Adjuster (SPPA) designation from The Institutes, the highest designation available to public adjusters. Awarded only to seasoned professionals who complete a rigorous course of study and examinations, the SPPA reflects Greg’s commitment to mastering every aspect of the claims process on behalf of the policyholders he serves.
Greg’s expertise is not just in his impressive resume but in the countless testimonials from those he has aided, reflecting his dedication to securing the rightful settlements for our clients.
Greg's Expertise Backed by Industry Accreditations
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Florida Public Adjuster -
Lic #P017831 -
Georgia Public Adjuster -
Lic #2790971 -
South Carolina Public Adjuster -
Lic #716585 -
Tennessee Public Adjuster -
Lic #716858 - SPPA - Senior Professional Public Adjuster Designation
- NFIP Certified Flood Adjuster
- Former Independent Adjuster working for the Insurance Companies
- Former ICC Certified Residential Building Inspector
- Former Licensed: Mold Inspector/ Home Inspector
- Member FAPIA - Florida Association of Public Adjusters
- Member GAPIA - Georgia Association of Public Adjusters
Morgan "Eric" Thomas
From Adjuster to Advocate
Eric’s journey in the insurance world began in 1989, marking the start of a career defined by expertise and dedication. Fresh out of college, he jumped into the role of an independent adjuster, swiftly advancing to a general adjuster position at a major firm. There, Eric specialized in complex homeowners and commercial property insurance claims, showcasing his skill in navigating intricate scenarios.
In 2001, his career took a pivotal turn towards the construction aspect of insurance. As the General Manager for a renowned Insurance Restoration Contractor, Eric oversaw everything from estimating to maintaining vital relationships with insurance companies. His profound understanding of insurance and construction led him to Claim Concepts, where he now thrives as a Public Adjuster. His unparalleled insight has been crucial in ensuring that our clients receive the settlements they genuinely deserve
Eric's Expertise Backed by Industry Accreditations
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Florida Public Adjuster -
Lic #A263869 -
Georgia Public Adjuster -
Lic #3233218 -
South Carolina Public Adjuster -
Lic #3607940 -
North Carolina Public Adjuster -
Lic #3607940 - Former Independent Adjuster working for Insurance Companies (Since 1989)
- Former Insurance Restoration Contractor (Working for the Insurance Companies)
- Member FAPIA - Florida Association of Public Adjusters
- AIC - Associates In Claims
- Vale Institute - Large Loss Estimating
THE PROCESS
Our Proven Process Built on Precision, Leverage, and the Art of Resolving Complex Claims
Over many years, our team of seasoned professional Public Adjuster have developed a proactive claim management process to ensure our clients receive the proper settlement for their losses. We understand that proving your claim can be a daunting and time-consuming task, and we are here to alleviate that burden for you. Our goal is to make this process as seamless and stress-free as possible for you while ensuring that you recover the full and proper settlement for your loss that you need and deserve.
Step 1 - THE DISCUSSION
Your Claim, Our Strategy – It all begins with a no-obligation, in-depth review of your claim. We know that by the time most clients reach us, they’ve already experienced confusion, frustration, or a settlement offer that simply didn’t feel right. We will review all claim documentation including estimates, letters, policy, photos, and any other relevant items. We will then work directly with you to map out the most effective path forward. Rest assured that we will only make an offer to work with you if we are confident that we will add value to your claim.
Step 2 - THE EVALUATION
Exhaustive Inspection & Document Review – Once we partner, our team immediately gets to work on your claim. We dive deep into your policy to ensure we fully understand how it applies to your specific loss, while carefully reviewing all existing estimates, photos and documentation. We then conduct an exhaustive, technology-driven inspection of the property using advanced field tools to document every aspect of your loss, ensuring nothing gets overlooked.
Step 3 - THE DEMAND
Estimate Preparation & Submission – We develop a comprehensive, line-item estimate utilizing industry-standard software, subjecting it to a rigorous three-tier review process covering field accuracy, technical precision, and compliance, to ensure nothing is missed. Once completed, we share it with you for your review, input and approval before submitting our entire claim package to the insurance company as The Demand.
Step 4 - THE NEGOTIATIONS
Expert Negotiation, Focused on Your Best Outcome – We stand strong on your behalf, skillfully negotiating for the resolution you need and deserve. When negotiations stall, we don’t back down, we guide you through your available dispute resolution options, to keep your claim moving toward the outcome you deserve.
Step 5 - THE RESOLUTION
Successful Resolution, Your Satisfaction is Key: The final step, this is what everything has been building toward. A fair resolution isn’t just our goal, it’s our standard. Our clients’ outcomes speak for themselves, and yours will too!
CLAIM QUESTIONS? WE HAVE ANSWERS
Peace of mind! We are here to represent you and your interest in the claim. Unfortunately, insurance companies often times deny claims that should be paid or do not pay enough money on a covered claim. This is not always the case and even when it is it may not be intentional. I know that most adjusters have the best of intentions but sometimes they may be inexperienced or simply trained to see things one way, the way the big insurance company wants it to be seen. As Public Adjusters our number one job is to get you the largest settlement available to you under your policy with the insurance company.
NO. Most states have laws stating that Public Adjusters are not allowed to represent the insurance companies. At Claim Concepts, we only represent the insuring public.
The public adjuster is employed by you, the insured. Their function is to represent your interests and ensure that you recover the proper settlement for all of your losses per the terms of your insurance policy. The insurance company’s adjuster works for the insurance company and is responsible to protect their interests throughout the claim.
Public Adjusters typically work on a contingency basis which equals a small percentage of any money recovered by the insurance company.
NO! This is NOT required under any policy that I have seen to date and I do not recommend it. In the event of a loss it is best to employ a Reputable Public Adjuster that knows what the policy will cover and what it takes to get your property back to its pre-loss condition. Many contractors will provide you with a competitive bid to make repairs but not necessarily get your property back to its pre-loss condition.
Yes! In most cases we can reopen your file with a supplemental claim. There are many factors involved. Give us a call and we will be happy to offer you a free claim consultation.
Not necessarily. It is not recommended to file a claim every time you spill a glass of water as you may become classified as a nuisance claim maker. Property insurance is typically rated based on your area which is why all homeowner rates increased in Florida after the hurricanes, whether you filed a claim or not. The risk is more related to the area where your property is located and in commercial situations the use of the property. However, it is known that there are databases where claim activity is logged and each insurance company may have their own stipulations based on claim activity of the individual or the property. Ultimately, you buy insurance to protect you in the time of a loss. If you are debating whether you should file a claim or not, please feel free to call and speak with one of our Public Adjusters about your particular situation, we are always happy to help.
Do not do anything before having a qualified Public Adjuster or Attorney take a look at your file. Depending on the way everything is written you may be agreeing to their offer by depositing the check. Please call our office and speak with one of our Public Adjusters about your particular situation, we are always happy to help in any way we can.