Wear and Tear Is a Cause of Loss Exclusion — Not a Condition of Property Exclusion

If you've filed a property insurance claim — especially a roof claim — there is a good chance the insurance company told you that your damage is “wear and tear” and therefore not covered. This is the single most common basis for denying or reducing property claims in California, and it is based on a fundamental misreading of the policy.

Here is what the insurance company does not want you to understand: your policy excludes wear and tear as a cause of loss. It does not exclude coverage for property that happens to be in a worn condition.These are two completely different things, and the distinction is the key to defeating most “wear and tear” denials.

The Distinction That Changes Everything

Consider a simple example. You have a 15-year-old roof. The shingles are aged — some granule loss, some minor curling at the edges. Then a windstorm with 60 mph gusts hits your area. Shingles are torn off. The roof is leaking.

The insurance company sends an engineer who writes: “The shingles were in a deteriorated condition consistent with their age. The damage observed is consistent with wear and tear.” Claim denied.

But ask the right question: What was the cause of the loss?

• Did the shingles spontaneously fall off because they were old? No.They were on the roof the day before the storm. They were functioning — keeping water out. They weren't pretty, but they were doing their job.
• Did the wind blow them off? Yes. The shingles were on the roof before the wind. After the wind, they were gone. The wind caused the loss.
• Were the shingles more vulnerable to wind because of their age? Probably. A brand-new shingle might have survived the same gusts. But that doesn't change the cause. The shingles didn't fail on their own. They failed because of wind.

This is the “but for” test: But for the wind, would the shingles have been damaged at that time?If the answer is no — the shingles would still be on the roof if the wind hadn't blown — then wind is the cause of loss, not wear and tear. The condition of the shingles may have made them more susceptible to wind, but susceptibility is not causation.

What the Policy Actually Says

Let's look at the actual exclusion language. A standard HO-3 policy (ISO form) reads:

Notice the structure: “We do not insure for loss caused... by ... wear and tear.” The exclusion is about what causedthe loss. It is not about the condition of the property. The policy doesn't say “We do not insure property that has experienced wear and tear.” It doesn't say “We do not insure property that is old.” It doesn't say “We do not insure property that is in less than perfect condition.”

If it did say those things, no one would buy insurance — because every property experiences some degree of wear from the moment it is built. The exclusion would swallow the entire policy.

Wear and Tear as a Cause vs. Wear and Tear as a Condition

The distinction is straightforward once you see it:

In every “covered” scenario above, the property was in a worn condition — but wear and tear was not the cause of the loss. Something else — wind, hail, freezing — was the event that caused the damage. The worn condition may have made the property more vulnerable to the peril, but vulnerability is not causation.

The “But For” Test

The simplest way to identify the cause of loss is the “but for” test:

If the answer is “no — the damage would not have happened without the covered event” — then the covered event is the cause of loss, regardless of the condition of the property. The wear and tear exclusion does not apply.

California Law Supports This Reading

California's efficient proximate cause doctrine reinforces this analysis. Under California law, when a loss involves both a covered cause and an excluded cause, the court looks to the efficient proximate cause — the predominant cause that set the loss in motion.

• In Garvey v. State Farm (1989) 48 Cal.3d 395, the California Supreme Court held that coverage cannot be denied when a covered peril is the efficient proximate cause, even if an excluded condition contributed.
• In Julian v. Hartford Underwriters Ins. Co. (2005) 35 Cal.4th 747, the Court reaffirmed that the efficient proximate cause doctrine applies even when the policy contains anti-concurrent causation language, where a covered peril is the predominant cause.
• The California Insurance Code § 530 defines proximate cause as “the cause which, in a natural and continuous sequence, unbroken by any new independent cause, produces the event, and without which that event would not have occurred.” This is essentially the “but for” test codified.

Under this framework, a windstorm that blows off aged shingles is straightforward: wind is the efficient proximate cause. The age of the shingles is a pre-existing condition, not a competing cause. The carrier cannot use the wear and tear exclusion to deny a wind loss simply because the wind happened to damage old materials.

How Carriers Misapply the Exclusion

Insurance companies and their engineers routinely conflate the condition of the property with the cause of the loss. Here are the most common misapplications:

1. “The shingles were in a deteriorated condition.” — This describes the condition of the property, not the cause of the loss. The question is not whether the shingles were deteriorated. The question is what caused them to fail now.
2. “The damage is consistent with age-related wear.”— Even if some damage on the roof is attributable to age, that doesn't mean the specific damage being claimed was caused by age. Storm damage can exist on the same roof as pre-existing wear. See our guide on distinguishing pre-existing damage from storm damage.
3. “The shingles had reached the end of their useful life.” — An opinion about remaining useful life is not a finding about the cause of the current loss. A shingle at the end of its useful life can still be damaged by a storm, and that storm damage is still covered.
4. “The sealant strip had failed due to aging.”— Sealant strip adhesion weakens over time on all shingles. But a shingle with weak sealant doesn't blow off in calm conditions — it blows off when wind acts on it. The cause of loss is still wind.
5. “A new roof would have withstood this wind event.” — This is irrelevant. Your policy insures your roof, not a hypothetical new roof. The carrier collected premiums to cover your actual property in its actual condition.

Depreciation Is the Right Tool — Not Denial

If the carrier wants to account for the age and condition of the roof, the appropriate mechanism is depreciation — not denial. Depreciation reduces the initial payment (ACV) to reflect the age and condition of the materials, while still acknowledging that a covered loss occurred and paying for it.

• Under an RCV policy, the carrier pays ACV first (replacement cost minus depreciation), then pays the withheld depreciation when you complete repairs.
• Under an ACV policy, the carrier pays the depreciated value — which accounts for the age of the materials.
• Either way, the claim is paid. Depreciation is the policy's built-in method for handling age. Denial is not.

When a carrier denies a claim entirely as “wear and tear” — rather than paying the claim with appropriate depreciation — they are substituting denial for depreciation. They are using the exclusion to do something it was never designed to do: avoid paying a legitimate storm loss on property that happens to be old. See our guide on ACV vs. RCV.

How to Fight a “Wear and Tear” Denial

1. Reframe the question. The issue is not whether wear and tear exists on the property. It always does. The issue is: what caused the damage you are claiming? If a covered peril (wind, hail, falling object) caused the damage, the wear and tear exclusion does not apply.
2. Apply the “but for” test. But for the storm event, would the damage have occurred at that time? If the answer is no, the storm — not wear and tear — is the cause of loss.
3. Cite the policy language.Quote the exclusion back to the carrier. Point out that it excludes loss “caused by” wear and tear — and that the loss was caused by wind/hail/the covered peril, not by deterioration.
4. Get an independent expert. A qualified roofing consultant or independent engineer can inspect the roof and opine on the cause of loss — distinguishing storm damage from age-related deterioration. See our guides on defeating carrier engineer reports and the science of hail damage.
5. Document the storm event. Weather data (NOAA reports, hail verification, wind speed records) objectively confirms that a covered peril occurred. If 60 mph winds hit your area and your shingles are gone, the cause is apparent.
6. Point out that the property was functioning before the storm. The single most powerful fact: the roof was keeping water out before the storm. After the storm, it was not. Something changed — and that something was the storm.
7. Argue depreciation, not denial. If the carrier insists on accounting for age, demand that they do so through depreciation (paying ACV) rather than denial (paying nothing). The policy provides a mechanism for accounting for age. That mechanism is depreciation, not the wear and tear exclusion.
8. Cite California law.The efficient proximate cause doctrine, Insurance Code § 530, and the burden-of-proof requirements all support coverage when a covered peril is the cause of loss.

When Wear and Tear Actually Is the Cause of Loss

To be clear, the wear and tear exclusion does have legitimate applications. It correctly applies when:

• A roof fails gradually over time with no storm event — shingles curling, cracking, and eventually allowing water intrusion as a natural progression of aging
• A pipe slowly corrodes and develops a pinhole leak over months or years with no sudden triggering event
• Siding deteriorates and warps from prolonged sun exposure, not from any specific weather event
• A water heater rusts through and leaks as a result of age and mineral buildup

In all of these cases, there is no covered event. The deterioration itself is the cause of the loss. The exclusion correctly applies. But the moment a covered peril — wind, hail, fire, a falling tree — enters the picture and causes the damage, the analysis changes entirely. The exclusion is about what caused the damage, not what condition the property was in when the damage occurred.