By Insure City Insurance Brokers (Pty) Ltd
Body Corporate and Homeowners Association (HOA) insurance is designed to protect against sudden, accidental, and unforeseen physical loss or damage to insured property. However, it is important to understand that insurance is not intended to cover damage arising from normal wear and tear, gradual deterioration, poor maintenance, defective workmanship, or issues that develop over time.
Understanding where insurance cover ends and maintenance responsibilities begin can help avoid confusion when claims are submitted and subsequently declined.
Example: Misaligned Door Frame
Scenario:
An owner submits a claim for a door frame that has gradually shifted over time, causing the door to become misaligned and difficult to close properly.
Insurance Position
In most cases, this type of damage would not be covered by insurance because it did not result from a sudden and accidental event. Instead, the condition developed progressively over an extended period.
Even where a policy provides cover for subsidence or landslip, a claim may still be rejected if there is no evidence of a sudden and unforeseen insured occurrence. Gradual settlement, structural movement, ageing of the building, or general deterioration are typically regarded as maintenance-related matters rather than insurable losses.
Determining Responsibility for Repairs
When an insurance claim is repudiated, the next step is to establish whether responsibility for the repairs rests with the owner, the Body Corporate or HOA, or a combination of both.
The key consideration is identifying the root cause of the damage.
Body Corporate or HOA Responsibility
A Body Corporate or HOA is generally responsible for maintaining and repairing:
- common property;
- shared services and infrastructure; and
- structural components, where these fall within the responsibilities defined by the applicable rules, constitution, or management regulations.
Where damage to a door frame is caused by:
- a structural defect;
- building movement affecting common or structural elements;
- rising damp originating from common property;
- a leak from a shared pipe or service; or
- any defect for which the Body Corporate or HOA is responsible,
The obligation to repair may fall on the Body Corporate or HOA.
Owner Responsibility
Owners are generally responsible for:
- maintenance and repairs within their section, unit, or property;
- normal wear and tear;
- age-related deterioration; and
- cosmetic defects and routine upkeep.
If the door frame has become misaligned due to ordinary ageing, inadequate maintenance, wear and tear, or factors isolated to the owner’s property, the repair costs would typically be the owner’s responsibility.
Shared Responsibility
In some instances, the damage may result from a combination of structural and internal factors. Where responsibility is not clearly attributable to a single party, a shared-cost arrangement may be considered.
Depending on the circumstances, the owner and the Body Corporate or HOA may agree to a 50/50 cost-sharing arrangement or another mutually acceptable solution.
Best Practice
When a claim has been repudiated, owners should engage with the trustees, directors, managing agent, or HOA committee to investigate the cause of the damage before proceeding with repairs.
Obtaining an assessment from a qualified contractor, engineer, or building specialist helps to determine whether the issue stems from a maintenance obligation, a structural defect, or another underlying cause, enabling the parties to allocate responsibility fairly and correctly.
Key Takeaway
Insurance is designed to cover sudden and unforeseen events, not gradual deterioration or maintenance-related issues.
When a claim is declined, responsibility for repairs must be determined by examining the underlying cause of the damage. Depending on the circumstances, liability may rest with the owner, the Body Corporate, the Homeowners Association, or be shared between the parties involved.
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