Original Build vs Upgrades — The Rule That Controls Every HOA Claim

What This Actually Means (And Where Everyone Gets It Wrong)

This is the part everyone gets wrong.

HOA insurance is not there to rebuild your unit the way it looks today.

It’s there to rebuild what was originally there when the building was first constructed.

An HOA master policy is the insurance policy that covers the entire condo or townhouse community. But that coverage is based on how the property was originally built—not how your specific unit looks today after years of changes, upgrades, or renovations.

If that building was constructed 20, 30, or even 50 years ago, the master policy is tied to that original construction standard. Most units were built similarly, using the same materials and finishes. That original condition is what the HOA policy is designed to restore.

The exact cutoff point—where the HOA stops and your policy begins—is defined in the HOA bylaws. This is often described as “bare walls,” “studs out,” or original builder-grade finishes.

The wording can vary.

But the concept does not.

👉 The HOA covers the baseline.
👉 Everything beyond that is your responsibility.

What “Original” Actually Means

“Original” means:

• What was installed when the unit was first built

• What came with the unit when it was first sold

• What has never been changed or upgraded

If nothing in your unit has ever been changed, then in many cases, the HOA policy will cover most of what needs to be rebuilt after a loss.

But that situation is rare.

Because the moment something changes, the responsibility shifts.

What Counts as an Upgrade (Even If You Didn’t Do It)

An upgrade is anything that is different from the original build.

That includes:

• Cabinets

• Flooring

• Countertops

• Fixtures

• Finishes

• Any changes to layout or materials

And here’s where people make a major mistake:

👉 It does not matter who made the upgrade.

If a previous owner upgraded the unit before you bought it, it is still considered an upgrade.

And it is still your responsibility under your HO6 policy.

The Kitchen Example (This Is How It Actually Works)

Let’s keep this simple.

• Original kitchen when the unit was built: $10,000

• Kitchen as it exists today (after upgrades): $20,000

Here’s how the claim is handled:

• HOA master policy pays: $10,000 (original build)

• Your HO6 policy pays: $10,000 (upgrade difference)

You are not getting paid twice.

You are being paid correctly from two separate policies that each cover a different portion of the same rebuild.

The Same Rule Applies to Everything

This isn’t just kitchens.

This applies to every part of your unit.

Example:

• Original flooring: $5,000 (vinyl)

• Upgraded flooring: $10,000 (tile or hardwood)

Result:

• HOA pays: $5,000

• HO6 pays: $5,000

Each room can be different. Each material can be different.

But the rule never changes:

👉 Original = HOA
👉 Upgrade = HO6

Why This Is NOT Double Dipping

This is one of the biggest misconceptions in HOA claims.

Homeowners often think:

“I’m getting paid twice.”

You’re not.

You’re being paid from two different policies that are each responsible for different portions of the same loss.

One policy restores the original condition.
The other restores the improvements.

Together, they bring your unit back to where it was before the loss.

Where Things Start to Break Down

The confusion doesn’t come from coverage.

It comes from how the estimates are written, separated, and compared.

To properly settle an HOA claim, there are typically multiple estimates involved:

• The HOA master policy estimate (what they are paying)

• Your HO6 estimate (the full rebuild of your unit as it exists today)

• A final adjusted estimate that applies credits for what the HOA already paid

Here’s what that looks like in real life:

• Full rebuild cost: $20,000

• HOA pays: $10,000

• Credit applied to your estimate: $10,000

• HO6 pays remaining: $10,000

That’s how it’s supposed to work.

But this is where things start to break down.

Because now someone has to:

• Separate what is original vs upgraded

• Write the insurance estimate correctly

• Apply the right credits

• And make sure both policies align

If that estimate is not written cleanly:

👉 delays happen
👉 payments get questioned
👉 and everything slows down

Not because it’s complicated—

👉 but because it requires accurate, real-world estimating

And most of the time, that’s where the process fails.

Why the Contractor Matters More Than People Think

You are allowed to choose your own contractor for your HO6 repairs.

You are not required to use the HOA’s contractor.

But in many cases, using the same contractor for both scopes can make the process faster and cleaner.

Why?

Because one estimator can:

• Separate the HOA scope from the HO6 scope correctly

• Apply credits properly

• Align both estimates without conflict

When different contractors are involved, the estimates often need to be reviewed, compared, and justified against each other—which can slow everything down.

What This All Comes Down To

It’s not complicated.

It’s just rarely explained clearly.

Every HOA claim comes down to one simple question:

👉 Who pays for what?

• The HOA pays for what was originally there

• Your HO6 policy pays for what changed

That’s it.

Everything else you’re going to learn about HOA insurance builds on this exact rule.

One Last Thing (What Everything Comes Down To)

Everything comes down to the estimate.

If your claim is delayed, underpaid, or being pushed back, that’s usually the reason.

If you’re not finding a clear answer to your situation here, go through the other case studies. Most real-world claim problems — and how they were handled — are already shown there.

And if your estimate is in good shape, the other issues tend to be straightforward to push through.

To understand why this happens and how to fix it, review the following:

Why Insurance Claims Get Delayed (It Comes Down to the Estimate): The Real Reason Claims Get Delayed
The Entire Insurance Industry Runs on One Thing That’s Rarely Explained: It’s the Estimate — And This Is Why Contractors Get It Wrong: Contractors Don’t Fail at Building — They Fail at Writing
The Entire Insurance Industry Runs on One Thing That’s Rarely Explained: It’s the Estimate — And This Is Why Adjusters Rewrite Instead of Approving: Adjusters Don’t Approve What They Can’t Follow
The Entire Insurance Industry Runs on One Thing That’s Rarely Explained: It’s the Estimate — And This Is What It Should Look Like: A Proper Estimate Is Not Just a Number

How to Read an Insurance Estimate (Room by Room): Why Most Homeowners Feel Confused by Estimates

How to Vet a Contractor, Public Adjuster, and Mitigation Company: Why This Matters More Than Anything Else

If you still have questions about your claim, visit our Homeowners Insurance Claim FAQs page for quick answers and links to detailed guides.

Learn More At ClaimHelpMe.com

This page explains the basics of how this part of the insurance claim process works.

However, inside ClaimHelpMe.com, homeowners can access real repair estimates, detailed examples, and step-by-step explanations showing how claims are documented, evaluated, and presented to insurance carriers.

The free content explains the fundamentals.
The ClaimHelpMe platform shows how the process actually works.

Explore more homeowner insurance claim guides in our Claim Guides section.

About The Author

Mark Grossman is a Licensed Public Adjuster and NASCLA Certified Contractor with 28 years in the restoration insurance industry and 35 years in construction.

Learn more → Mark Grossman