California E&S Insurance

Is my homeowners insurance claim legitimate? I own a rental condo insured by State Farm. On one specific day at one specific time I received a call from our HOA association manager that the owner of the unit below suddenly reported water coming through a light directly below our tub (there was zero history of any previous leak or seepage). A diagnostic investigation by the HOA manager and a licensed plumber determined the issue was from a sudden and accidental detachment of the waste overflow drain under my tub and the tub would need to be torn out to access and repair the drain. I called my agent to see if this would be a covered loss. He put in writing it would be a covered loss. I filed claim. State Farm originally said they would send someone to investigate the claim but never did. State Farm outsourced the claim handling to a 3rd party company. The 3rd party denied the claim with zero physical evidence. They cited speculation of seepage (despite evidence this leak only happened one specific time), maintenance issues, and that there was no damage to my property. They also claimed I did not have tear out coverage in my policy. I pushed back and cited that I do have tear out coverage, cut and pasted from policy: "If a loss insured to Coverage A property is caused by water, steam, or sewage escaping from a system or appliance, we will also pay the reasonable cost you incur to tear out and replace only that particular part of the building structure or condominium unit owned by you necessary to gain access to the specific point of that system or appliance from which the water, steam, or sewage escaped. We will not pay for the cost of repairing or replacing the system or appliance itself. This coverage does not increase the limit applying to Coverage A property" After pushing back, the 3rd party company said they were going to send someone to investigate and never did. The 3rd party again denied the claim saying there was no damage to my property (again with no investigation). I cited industry standards that remediation is necessary after a leak this level that would infer a loss and they stonewalled and wouldn't acknowledge this point. They did say I could send new evidence after tear-out. I self-funded the tear-out and sent new evidence: A video of the detached drain and description of damage to my property by a licensed plumber. They said they would not review the claim further without reviewing the new evidence they promised they would look at. I filed a DOI complaint. After the DOI complaint, the claim was re-opened but it was still being investigated by the 3rd party (not State Farm). I asked a questions to the adjuster about the 3rd party's relationship with state Farm and he said: \-He would be fired if he approved my claim and State Farm later decided it was invalid. \-He would be fired if my DOI complaint prevailed. In other words, the adjuster didn't evaluate the claim objectively based on facts, evidence, and policy language. Instead he decided the claim outcome based on what would be best for his job security and his company's relationship with State Farm (the 3rd party's best customer). He verbally said he is going to deny the claim again based on no damage to my property (written denial letter pending - no new denial received letter yet). He said he didn't believe the licensed plumbers list of damage, couldn't see obvious damage in the video, and fabricated a narrative that the water leaking from the drain wouldn't have flowed in a way that justifies the damage the plumber listed. He said I should have ordered forensic plumbing and remediation tests. Keep in mind the property is in a rural area with no sophisticated forensic plumbing services available. Furthermore, State Farm could have simply sent someone to review the claim like they had promised in writing. Is this claim valid? Questions to adjusters: \-Would a leak severe enough to go through a concrete floor constitute an implied loss to my property due to remediation necessary per my above policy language? (this was advice I got from a public adjuster I talked with). \-Should the plumber's list of the damages be enough to trigger tear out coverage and pay the claim, especially considering State Farm didn't send anyone? \-Why was my claim outsourced in the first place? I was put in a position in which I am no longer the customer/consumer and now State Farm is the customer/consumer. Any thoughts? Is the claim valid or should I just give up trying to get paid (even if my DOI complaint prevails )?

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  "score": 0,
  "title": "Is my homeowners insurance claim legitimate?",
  "subreddit": "InsuranceClaims",
  "num_comments": 30,
  "scrape_method": "apify_targeted"
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