What is the Line-of-Sight rule and how does it apply to my insurance claim?
When repairing property that is partially damaged, you might find that you and your adjuster disagree on what type and/or how much replacement or repair of materials is required. In general, do not accept repairs that fail to restore the damaged item to its pre-loss condition, or which leave it non-uniform in appearance. Unfortunately, there is no hard and fast rule that strictly defines “what type” or “how much,” but an understanding of the standards can help you get your property back to its previous condition.
Uniform and Clear Line of Sight define the extent of repair. California Insurance Code §2695.9(a)(2) should be referred to when looking for guidance, as it states:
“When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace all items in the damaged area so as to conform to a reasonably uniform appearance.”
Uniform means repair work should not be unreasonably noticeable after completion. The results should be identical (and can even be better) than before the damage. For example, they can’t replace a few broken pink tiles with white tiles. Even if they were to find pink tile, it’s not uncommon for all of the tile to be replaced due to the natural variations in tile, the way in which colors and surfaces change over time, and the difficulty in matching new grouting to old. Having even slightly different colored tiles would make the area no longer “conform to a reasonably uniform appearance.”
Since “reasonable” is a subjective term, you will find yourself negotiating again with the adjuster. The adjuster’s idea of “reasonable” will be guided by company requirements. Your “reasonable” will be informed by the fact that you knew what your house looked like before the damage.
Clear Line of Sight, while not explicitly cited, can be inferred from “the insurer shall replace all items in the damaged area.” It is generally recognized that this means the insurance company will pay to replace all materials or surfaces that you can clearly see in your line of sight, i.e. that are in the same room and/or are contiguous. For example, if you have the same wall-to-wall carpet in your house and part of the carpet is damaged, they should replace all carpet that is not only in the same room, but all the way to a natural break where you no longer see the same carpet. Closing a door may not be a natural break as the door is generally open most of the time. Negotiating a “natural break” could prove to be a hot topic between you and your adjuster.
These two standards are closely related, but breaking them down might help you clarify the issues.
For example: Your house suffers water damage from a broken pipe requiring all of the drywall in your house to be removed two feet from floor. You want to make sure that once the damage has been fixed, the repair is not obvious. Should an adjuster convince you that furniture will cover any remaining distortions or non-uniform areas, the standard has not been met because you may decide later that you want to rearrange your furniture, which will reveal the substandard repair.
Also, if you had special drywall or an uncommon texture that is difficult to duplicate, additional measures would need to be implemented so the result is “reasonably uniform in appearance” throughout the room. The contractor would need to re-texture and re-paint all of the walls in the damaged room to completely remove the water line.
One last point: be certain that the reasonable uniform surface repair will be PERMANENT or at least continue to look similar to the adjoining unrepaired surfaces. Just because it looks good today does not mean it will be the same a year from now. If different materials are used, exposure to sun, rain, and general wear and tear can cause different materials to age quite differently.
For example, paint stores have computers which can match paint colors. However, if paint repairs are made just to a small patched area, over time the differences between the non-damages surface and the newly painted patch tends to stick out like a sore thumb. Our advice to avoid this is to negotiate repainting of the entire wall and/or room.
Another example is broken tile. Some homeowners maintain extra tiles in case of loss and offer the tile to maintain a reasonably uniform surface. Be careful. Sometimes the grout between tiles cannot be duplicated and the tile repair sticks out like a sore thumb. Beware too: a small tile repair can compromise the water barrier behind or beneath the tile. (This example invokes the “pre-loss condition” rule.)
Repairs typically associated with the clear line of sight rule are:
- Carpet (or other floor coverings)
- Paint (or other floor covering)
- Tile
- Doors (especially when the doors match throughout the house)
- Windows (remember they need to match inside and out)
- Trim and molding
- Roofing
- Fencing
More detail can be found in Chapter 5 of our free eBook “A Survivor’s Guide to Insurance”