After a burst pipe, two metres of the laminate floor have buckled, and the insurer's calculation pays for those two metres – except that the floor pattern is no longer available, and a mismatched strip remains in the middle of the living room. The same goes for tiles, one row in the bathroom, or a dozen tiles on the roof: the damage is small, the aesthetic consequence large. This is one of the most common points of dispute in settling home insurance claims, because two truths collide: the contract pays for the damage, not for a renovation; and the client did not buy a patchy floor. As a broker, I see that the outcome of the dispute depends not on how loudly you argue but on one or two paragraphs of the policy conditions and on the documentation. This article shows these two things.
Home insurance pays for the damage caused by the insured event, in the manner and to the extent set out in the contract. The Home Insurance Guide of MABISZ (the Hungarian insurers' association) defines new value as the new rebuilding or replacement value of the insured property, “or, in the case of partial damage, we mean the cost of restoration and repair” with which the damaged part can be brought back to its original condition. The insurer therefore pays for the ruined strip, the row of tiles that came away, the broken roof tiles – materials, labour, the related removal work and the necessary ancillary work –, but, as a basic rule, not for replacing undamaged flooring that the damage did not affect. This is not stinginess but the essence of indemnity insurance: the aim of the payment is the condition before the damage, not a better or more uniform one. The article on loss assessment and settlement describes how the calculation works; here I narrow the focus to the specifics of partial damage.
In the language of policy conditions, the “it must not clash” demand is aesthetic damage or loss of value. Hungarian conditions typically exclude it: one MFO product information document, for example, excludes changes in colour or shape caused by heat (scorching) if these are not the result of fire damage as defined in the conditions. At the same time, many conditions themselves resolve the most painful situations with a room or surface rule. One Generali condition, for example, provides that if the painting, wallpapering or varnishing of the ceiling or of one of the side walls of a room is damaged to the extent of at least 40%, or if the surfaces of the ceiling and at least one side wall, or of two side walls, are damaged, “the insurer reimburses the cost of restoring the entire surface of the room”. The threshold and the scope differ from insurer to insurer – in some, the room-by-room unity applies to floor coverings and tiles too, in others only to paintwork –, so you need to check the “insurer's benefits” chapter of your own conditions; the guide to reading policy conditions highlights this chapter separately.
For roofs the logic is the same, with different proportions: replacing the broken roof tiles is covered; replacing the entire roof covering is covered if the extent of the damage reaches the threshold set in the conditions, or if the damaged tile type can no longer be obtained and partial repair is not technically possible – the latter is no longer an aesthetic but a technical question, and the loss adjuster treats it differently, too. The documentation described in the storm-damage article – keeping the damaged elements until the inspection – is worth real money here.
“No longer available” is the most common argument, and also the one most often misused. On its own it does not bring full replacement: the conditions allow restoration with material of the same or similar quality, and the insurer may rightly say that flooring of a similar shade restores the condition before the damage. What “no longer available” really does support comes down to three things. First: the room boundary – if the flooring runs continuously within a room and the damaged part cannot be separated off by a door threshold or another natural boundary, replacing the strip is also technically difficult to carry out (the click system of laminate flooring can often only be taken apart from the edge), and this affects the cost of the repair, not the aesthetics. Second: a supplier's or manufacturer's certificate that the product has been discontinued and stating what the closest similar product is; with this, the insurer is not deciding between “nice” and “ugly” but receives technical facts. Third: a contractor's quote showing item by item how much it costs to replace the strip with the necessary removal work and how much to do the whole room – the difference is often smaller than the calculation suggests at first glance, and this is the basis for a settlement.
The first step is to request the insurer's calculation in writing and itemised: which items it calculated, with what quantities and unit prices, and on the basis of which clause of the conditions. The second is your own material: photos of the condition before the damage (the floor is visible in many family photos), the size of the damaged area in metres, the floor plan of the room with the continuous flooring, a supplier's certificate, a contractor's quote. The third is the conditions: if there is a surface or room rule, refer to it precisely; if there is none, the argument is technical repairability and the cost difference. The fourth is the settlement proposal: often the realistic request is not full replacement but an intermediate solution – laying new flooring across the whole room at a compromise unit price, or fuller recognition of the removal and ancillary work. The insurer is not obliged to pay beyond the conditions, but a settlement can take many forms even within your own conditions.
If no settlement is reached, the order is: a written complaint to the insurer's complaints handling, with a precise reference to the clause of the conditions, then the Financial Arbitration Board (PBT), and ultimately the court; the MNB does not decide individual claim disputes. Where the stakes are high, the opinion of a forensic or construction expert commissioned at your own expense is the strongest document. As a broker I do not represent you in a claim and I do not hold talks with the insurer; if a case gets stuck or disputed, I help where I can: in comparing the calculation with the conditions and in structuring the complaint. The article on stuck and disputed claims describes this division of roles precisely.
Before any damage: check whether your own conditions contain a surface or room rule, and what it covers – painting, wallpaper, flooring, tiles, roof. Keep the invoices and the manufacturer's data sheets for your floor and wall coverings and, if any are left over, a few spare pieces: against the “no longer available” argument, half a box of tiles kept in the garage is the most obvious safeguard. After damage: documentation following the schedule after water damage, keeping the damaged elements until the inspection, and requesting the itemised calculation are the first steps – the settlement starts from there.
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