Understanding water damage claims

After a long, cold winter, many of us yearn for the transition to spring. More daylight, chirping birds, increased outdoor activity, and the start of Major League Baseball are all signs that we’re getting closer to warmer days.
Unfortunately, as we make the transition, melting snow and spring rains have led to serious flooding in many parts of the country. While many people worry about losing their home to fire, water damage is one of the most common homeowner claims.
If a flood consumes your neighborhood or your sump pump fails and your home fills with water, do you have the right insurance coverage in place to fix the damage?
Below are some water damage claims that may impact your home. It’s important to understand each one so you can make sure you have the right insurance coverage in place.


Spring thaws combined with several inches of rain can cause your community to flood quickly. If you have a river nearby, the situation can escalate even more. According to the Federal Emergency Management Agency (FEMA), flooding is the most common and expensive natural disaster in the United States.

A standard home insurance policy doesn’t provide coverage for damage caused by a flood. If your home is in a community that participates in the National Flood Insurance Program (NFIP) you may be eligible for flood insurance through the federal government. Some private insurers may also provide coverage.

NFIP coverage for a single-family home can provide coverage limits up to $250,000 dwelling coverage and $100,000 on contents. If you’re a renter, you an get coverage for up to $100,000 on contents.

The waiting period for an NFIP policy is 30 days. So, trying to buy a policy just before a big storm hits your neighborhood won’t provide you with coverage.

*Sump pump overflow

In March, April, and May, West Bend’s Claims department sees an influx in sump pump claims. Because our sump pumps work hard this time of year, it’s important to make sure they’re in proper working order. While I’m always thankful when I hear my sump pump run, I’m also always a bit nervous because I know water is an issue.

A standard insurance policy may not provide coverage for sump pump overflow. A West Bend policy provides coverage only if you choose it. It’s not automatically provided.

*Sewer backup

Sewer backups can occur in your home due to:

Tree roots growing in sewer pipes;
Deteriorated sewer pipers; and
Problems with your municipal sewer system.
Depending on how your city sewer system works, too much rain water can overload the system causing the water to backup into your home. The backup may not occur just at the drain in your basement, it can come through your sinks, toilets, or bathtubs. If you have a black stinky water coming from these areas in your home, contact your local municipality and your insurance agent or company. If you have insurance coverage, a restoration company should clean up the mess. Black water is contaminated and can contain fecal matter and bacteria.

Like sump pump overflow, a standard insurance policy may not provide coverage.

*Household leaks

Common household leaks include a burst water pipe or leaking appliance. If you have a water leak in your home, find and close the shutoff valve immediately to prevent further damage. If the shutoff valve near your appliance or plumbing fixture doesn’t work, shut off your water main coming into your house. Depending on your situation, timing is crucial. To find your water main quickly, consider attaching a West Bend Water main tag. To request yours, click here.

Coverage for this type of damage is usually provided in a standard homeowners policy.

Insurance isn’t fun to buy and can be difficult to understand. Focusing and buying a policy simply on price may leave you with serious coverage gaps. It’s up to you to talk to your independent agent to determine if your policy has any coverage gaps and what’s the appropriate amount of coverage for your home. Finding out during the claim process that you don’t have proper or adequate insurance coverage isn’t a good situation for you or your insurance company.
Posted by West Bend Cares Scott Stueber April 2, 2019

Don’t fall victim to Fraud with the new Medicare card

By: Judith Graham, Kaiser Health News March 16, 2018
Everything you need to know about the new Medicare card.

Historically, Medicare ID cards have been stamped with the Social Security numbers of members — currently, about 50 million seniors and 9 million people with serious disabilities. But that’s been problematic: If a wallet or purse were stolen, a thief could use that information, along with an address or birthdate on a driver’s license, to steal someone’s identity.

For years, phone scammers have preyed on older adults by requesting their Medicare numbers, giving various reasons for doing so. People who fall for these ruses have found bank accounts emptied, Social Security payments diverted or bills in their mailboxes for medical services or equipment never received.
Related: The growing need for identity management services

The new cards address these concerns by removing each member’s Social Security number and replacing it with a new, randomly generated 11-digit “Medicare number” (some capital letters are included). This will be used to verify eligibility for services and for billing purposes going forward.

Such a major change can involve bumps along the way, so there will be a transition period during which you can use either your new Medicare card or your old card at doctors’ offices and hospitals. Both should work until Dec. 31, 2019.

If you forget your new card at home, your doctor’s staff should be able to look up your new Medicare number up at a secure computer site. Or, they can use information that’s already on file during the transition period.

“We’ve had a few people contact us and ask ‘If I don’t have the new card at a doctor’s appointment, does that mean my provider won’t see me?’” said Casey Schwartz, senior counsel for education and federal policy at the Medicare Rights Center. “That shouldn’t be an issue.”

Cards will be sent to people covered by Medicare on a rolling basis over a 12-month period ending in April 2019. Older adults in Alaska, California, Delaware, the District of Columbia, Hawaii, Oregon, Pennsylvania, Virginia and West Virginia will be the first to receive the mailings, between April and June, along with several U.S. territories — American Samoa, Guam and the Northern Mariana Islands.

The last wave of states will be Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio and Tennessee, along with Puerto Rico and the Virgin Islands.

“If your sister who lives in another state gets her card before you, don’t fret,” the Federal Trade Commission explained in a new alert. Since the cards are going out in waves, “your card may arrive at a different time than hers.”

If you think Social Security might not have your current address, call 1-800-772-1213 or check your online Social Security account at https://www.ssa.gov/myaccount/, the FTC advised.

When you get your new Medicare card, don’t throw your old one in the trash. Instead, put it through a shredder or “spend time cutting it up with a pair of scissors” to make sure the part showing your Social Security number is destroyed, said Amy Nofziger, a fraud expert for AARP.

Those numbers remain sought-after by scammers, and AARP and Senior Medicare Patrol groups tell of receiving fraud reports related to Medicare cards since last year.

In one scam, reported by California’s Area 1 Agency on Aging, a caller purporting to represent Medicare or another government agency claims to need your bank account information so Medicare can arrange a direct deposit of funds into your account. The new Medicare cards are used as an excuse for the call.

In another, circulating in Iowa, scammers are threatening to cancel seniors’ health insurance if they don’t give out their current Medicare card numbers. “We’re telling people, don’t ever give someone this number — just hang up,” said Nancy Ketcham, elder rights specialist at the Elderbridge Agency on Aging, which serves 29 counties in northwestern Iowa.

A month ago, Alfonso Hernandez, 65, who lives in Moreno Valley, Calif., received a call from a man who told him, in Spanish, that Medicare was going to issue new cards and that he needed to verify some information, including Hernandez’s name, address and Social Security number.

“I said no, normally, I don’t give my Social Security number to anyone,” Hernandez said. At that point, the caller put his “supervisor” on the phone, who said the government needed to make sure it had correct information. Caught off guard, Hernandez recited his Social Security number and, “as soon as I did that, they hung up.”

“Immediately, I’m like ‘oh my God, what did I do,’” said Hernandez, who quickly contacted credit agencies to have them put an alert on his account. “I just keep praying that nothing happens.”

Just last week, California’s Senior Medicare Patrol program received a report of another scam detected in Riverside County: a caller claiming that before a senior can get a new Medicare card, he or she has to pay $5 to $50 for a new “temporary” card, according to Sandy Morales, a case manager with the program.

Nofziger of AARP said a Medicare representative will never contact an older adult by phone or email about the new cards and will certainly “never ask for money or personal information or threaten to cancel your health benefits.” The new Medicare cards are free and you don’t need to do anything to receive one: They’re being sent automatically to everyone enrolled in the program. Don’t give out any information to callers who contact you by phone, she advised.

If you suspect fraud, report it to the FTC , AARP’s fraud help line, 1-877-908-3360, or your local Senior Medicare Patrol program.

If you’re among nearly 18 million seniors and people with serious disabilities who have coverage through a Medicare Advantage plan, keep the card that your plan issued you. Medicare Advantage plans are offered by private insurance companies, which have their own way of identifying members. Similarly, if you have prescription drug coverage through Medicare — another benefit offered through private insurance companies – keep your card for that plan as well.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.