Wear and Tear Exclusion

The wear and tear exclusion denies coverage for loss caused by normal age, use, or deterioration. This is a Policy Language denial reason found in standard policy language.

However, the exclusion is often applied incorrectly. Wear and tear typically does not include sudden, accidental damage—even if the item was already showing signs of age.

1. Damage occurs to a home component (roof, HVAC, water heater, etc.)
2. Policyholder files a claim
3. Adjuster investigates and finds the item has age or visible deterioration
4. Adjuster concludes the item failed due to wear and tear, not a covered peril
5. Claim is denied under wear and tear exclusion

• Sudden loss, not gradual failure: If a roof is damaged in a wind storm, age does not prevent coverage—even if the roof was already 20+ years old.
• Damage from a specific cause: If water entered because a storm knocked a tree limb through the roof, the coverage is for the storm damage, not the age of the roof.
• Coverage applies despite age: If the policy covers "accidental loss," an accident remains an accident even if the item was old or showing wear.

• Was there a specific event (storm, water leak, fire) that caused the loss?
• Does your policy define the exact coverage trigger (e.g., "sudden and accidental" damage)?
• Did the adjuster confuse the age of the item with the cause of the loss?
• Is there documentation of the triggering event (storm report, water damage evidence)?