The fact is, your insurance can refuse to pay for damage caused by any ongoing problems you should have attended to. "Insurance policies are not home maintenance contracts," said Christelle Fourie, MD of MUA Insurance Acceptances.

"Most policies will have a clause that says the homeowner must keep the property in an insurable condition. Leaks in roofs, the wood in windows, pool maintenance and paving must be attended to," she said.

Tough economic times have led many homeowners to neglect maintenance. Fourie said the claims pattern over the last 36 months showed this clearly.

"Policyholders during the recession have fought tooth and nail to get claims paid because they don't have the money to spend on the maintenance.

"Some insurers do a risk inspection when a policy is taken out, but years later things will have changed, and it's the policyholder's responsibility to keep the property in the same state," she said.

Fourie cited a second-quarter FNB Home Loans estate agent survey, which claimed the percentage of homeowners actively maintaining their homes has fallen from 79.5% in 2004 to just 41.5% in 2011. "Insurance claims must be for events and losses that were sudden and unforeseen. A cause behind a claim cannot be pre-existing. Any further damage from that problem won't be accepted by the insurer, which means subsequent damage will be a private loss."

It is up to the insurer to prove the condition pre-existed. Fourie said insurers use loss adjusters to evaluate any claims that are red-flagged.

"A loss adjuster takes photos and calls in an expert, like an engineer or pool repairer, to prepare a report. Independent assessors can be brought in for all claims over a certain amount. The insurer is likely to look at claims frequency too."

Insurers try to resolve the issue, but attempts to pull the wool over the assessor's eyes are likely to fail. "It's best for the policyholder to be proactive. We would have far fewer unhappy clients if they were proactive about the upkeep of their properties."