Mold Damage Insurance Claims

Filing an Insurance Claim for Mold Damages

There are multiple reasons to make an insurance claim for mold damage. Mold can come to the attention of you, the property owner, along with the discovery of ongoing moisture buildup, water intrusion or water leakage that has gone on for some time below the property owner’s radar.

Or, after a sudden leak from a plumbing system or appliance or accidental flood, there is a delay in or failure to adequately dry out water-damaged building products, furnishings, fixtures, finishes or belongings. Our certified mold inspectors at All Green Air LLC have been trained to detect any water damage and/or intrusion affiliated with the property.

You are making a "first party" property claim if you are making a claim to your own insurer for damage to your property. And you are making a "third-party" liability claim to your insurer if you are asking your insurer to investigate or defend a claim against you–for example, your tenants are suing you for mold contamination. All Green Air provides all of our clients with a detailed report that will assist with any type of insurance claim.

For more information and to schedule your FREE consultation, contact us today!

Insurance Claim Tips for Mold Damage

Take Mold Contamination Seriously

Mold can cause serious illness and property damage. Due to the introduction of mass-produced building products, tract home construction techniques, residential and commercial buildings have become more susceptible to developing mold contamination in any moist breeding ground. Mold contamination can destroy building products, furnishings, finishes and belongings, and cause moderate to serious health consequences to those exposed. If you suspect you may have a mold problem, contact a certified mold inspection company as soon as possible to ascertain the severity of the mold growth while avoiding further damage.

Contact Your Insurance Agent and Report a Suspected Claim Immediately - Put Everything in Writing

Contact your insurance agent immediately upon receipt of your inspection report from All Green Air to report the suspected claim and submit the full mold inspection report. And make sure everything is in writing. In a flood or pipe burst claim, getting a remediation team within the first 48 hours to begin drying out property can be crucial to preventing or containing mold growth.

Take detailed notes of every conversation, including the name, company, phone number, address and job title of every insurance agent, representative, consultant or contractor you deal with. Be sure all agreements are in writing. Insist that appointments and deadlines be honored. Keep a log of all notes and letters. Ask for and keep contact details with you like business cards or anything else from everyone involved in your claim.

Understand Your Coverages and Review Your Policy Precisely and Carefully

Get a complete copy of your policy from your insurance agent. Review the "declarations page," which tells you the coverages you have, the policy limits for each coverage, and the effective dates of the policy. Review the fine print of the policy from what’s insured, what’s excluded, and what you have to do to prove your claim. Review any "endorsements" added on to the policy form to see if they change, eliminate or add coverages to your policy.

Do Not Dispose of Any Damaged Property Until After It Has Been Inspected - Protect All Property From Any Further Damage But Do Not Make Permanent Repairs

During an inspection, the technicians at All Green Air document all damages with the use of visual digital imaging.

Turn off any water flow to broken appliances or pipes. Take any necessary emergency measures to protect the building and personal property from any further damage. In mold claims you typically need to have the mold sampled by a mold inspection company and analyzed by a microbial laboratory. Do not throw anything away until you have documented its condition.

If there is roof damage to your building, you may need to appoint a contractor to cover it with a plastic tarp or tent the building to protect against bad weather. If the insurer delays in authorizing these measures, or in getting back to you, confirm the insurer’s delay in writing. Take reasonable measures you can afford to protect the property. The insurance company should also cover the cost of any reasonable emergency measures you had to take to protect your property if your loss is covered. It is usual for an aggressive insurer to deny coverage for damage resulting after the initial claim on the grounds that you failed to protect the property from further damage.

Videotape, Photograph and Inventory All Damaged Property; Document Your Loss as Carefully as You Can and Don't Exaggerate, Speculate or Guess About the Loss or Value of Any Particular Piece of Property

Videotape, photograph and inventory of all damaged property. Be sure you record the date of the photos and videotape. It is important to document the source and extent of visible mold contamination and water intrusion. In a dispute with your insurer over whether any particular building component, finish, furnishing or belonging is contaminated, the item may need to be tested by a remediation consultant–the insurers and perhaps your own. Don’t throw these items away until any such issues are resolved in writing. As part of our detailed inspection, Our Inspector will photograph and document each and every damaged area throughout the property to insure you the appropriate coverage available for your claim.

It is a common tactic for adjusters and claims representatives who are predisposed to reject a claim, to break out even minor discrepancies between your first recorded statement and subsequent recorded statements, and argue that these discrepancies constitute material misrepresentations sufficient to reject your claim. Don’t give them the opportunity. Don’t exaggerate, speculate or guess about the loss or value of any particular piece of property. Make it clear to your insurer when your recollection may not be accurate, and when you are estimating value, and on what you are basing your estimate. All Green Air LLC will provide a detailed analysis of the treatment process necessary for repairs.

Learn Your State's Laws That Regulate How Insurance Claims Are Supposed to Be Handled and Understand Your Rights

Every state has regulations that set minimum standards for handling insurance claims. You usually can find these laws through the insurance regulator website or your state department of insurance. You can also call your state’s department of insurance for information.

You Must Cooperate Within Reason With Your Insurance Company's Investigation and Handling of Your Claim But Do Not Give a Recorded Statement, a Sworn Statement or a Sworn "Proof of Loss" Form Until You Are Sure You Understand Your Rights, Your Insurance Coverage and the Full Extent of Your Claim

You have a contractual agreement under your insurance policy to cooperate with your insurer in its investigation and handling of your claim. You do not have an obligation to allow yourself to be abused. In most states you and your insurance company have a reciprocal obligation to act in good faith and deal fairly with each other to investigate and process your claim. The insurer should never make an unreasonable request to you. You should never refuse a reasonable request from your insurer for information related to your claim.

Your insurer may require you to give one or more recorded statements. Use your own tape recorder to tape your statement and the insurer’s questions. Do not give a recorded statement until you are sure you understand your rights, your insurance coverages and the full extent of your claim.

Your insurer may ask you to make available various documents related to your claim, including banking statements, investment reports, receipts and other personal financial documents. You are required to produce any other documentation reasonably related to your insurer’s investigation of your claim. Your insurer can require you to produce these kinds of documents as long as they are reasonably related to its investigation.

Most policies require you to submit a "sworn proof of loss" form to your insurer within a certain amount of time after being provided the form. Do not submit the sworn proof of loss to your insurer until you are sure you understand your rights, your insurance coverages, and the full extent of your claim. It is usual for an aggressive insurer to use mistakes in the sworn proof of loss to reduce or reject coverage for a claim.

Aggressive insurers may keep asking you for more and more information, anticipating that at some point, you will draw a line in the sand. If, however, you refuse to comply with reasonable requests for a recorded statement, a EUO, a sworn proof of loss, or documents reasonably related to your insurer’s investigation, you may be giving your insurer a valid excuse to deny your claim, based solely on your purported breach of the duty to cooperate. If you believe that any requests are unreasonable, ask your insurer to explain the reason for the requests in writing. Err on the side of caution. If any doubt, consult with a policyholder attorney, your state department of insurance or a public adjuster before you say "no way" to a request that may–in retrospect–turn out to have been a reasonable one.

Without Proper Legal Advice, Never Sign an Insurance, Release, Waiver or "Hold Harmless" Agreement

You should never have to sign a release to settle an undisputed claim without proper legal advice. If your insurer, adjuster, consultant or contractor asks you to sign an indemnity(insurance), release, waiver or hold harmless agreement, ask them to explain why in writing? These kinds of agreements can be used to deprive you of rights and benefits forever and can obligate you to pay thousands of dollars for issues that come up down the road that you never anticipated. Be free to consult a policy-holder attorney as to your rights before signing any such agreement.

Don't Accept a Lowball Offer, Get a Second Opinion

From insurance-friendly contractors be wary of "lowball" estimates. Get a second and even a third written estimate to repair and replace damaged property from independent reputable professionals that you would hire to do the actual work. You are entitled to have your damaged property replaced with "like kind and quality." When you can’t match the remaining undamaged tile, wallpaper, carpeting, or other portions of undamaged property, you are entitled to have the entire "line of sight" replaced to match.

Make sure that you understand how your insurance policy pays out on covered claims. Some losses are paid out on a replacement cost value. Your policy may permit your insurer to pay you actual cash value, and withhold the additional cost to replace property until you actually go out and replace it. Some losses are paid on "actual cash value," which in many states can mean either the "fair market value" or the cost to replace the property, less depreciation for age, wear and tear. In recent years, some insurers have attempted to also withhold an amount for contractor "profit and overhead." Don’t let them. Policyholder attorneys and some insurance regulators have successfully prevented insurers from withholding these amounts.

You may be required by your insurer to submit the dispute to "appraisal," if you have a disagreement with your insurer over the amount of your claim. Appraisal is a form of binding arbitration to settle disagreements over the amount of your claim. It typically does not decide disagreements about what is covered, what is not covered, what caused the loss or poor claims handling problems, unless you and your insurer agree to submit those additional disputes to the appraisal. While appraisal was initially designed to be an inexpensive, informal resolution of insurance disputes, insurers have turned it into one of the most expensive and dragged out sideshows in insurance claim resolution. If you cannot resolve a dispute with your insurer over the amount of your claim, or your insurer demands appraisal, you should consult with a policyholder attorney.

Before Agreeing to Hire a Contractor to Do the Repairs, Thoroughly Investigate the Qualifications, License and References of Your Insurance Company's "Approved" Contractor

You do not have to use consultants or contractors recommended or "approved" by your insurer to perform repairs. "Approved" contractors are typically contractors who have agreed to discount their labor and costs, and follow insurer guidelines, in exchange for a volume of business from the insurance company. If your insurer promises to "guarantee" the approved contractor’s work, the "guarantee" is generally limited to replacing any defective materials or correcting faulty workmanship. Your insurer is not insuring against any contractor delays, negligence or liability. Accordingly, do not use the "approved" contractor unless it is a contractor that you would independently hire to do the work after a thorough screening. Be sure to check that each contractor’s license is not invalid, and for any complaints against the license. Be sure that the contractor is insured and bonded.

If You Need It, Get Professional Help

Be sure to document the dispute fully in writing, if you reach an impasse with your insurer. Explain why your position is reasonable, and your insurance company’s position is not reasonable. If your dispute does not necessarily require legal advice, you may be able to resolve the dispute by calling your state’s department of insurance or insurance regulator, or by hiring a public adjuster. If your dispute requires legal advice, contact a lawyer who is experienced and specialized in representing policyholders.

Make Sure That You Know All the Deadlines That May Cut Off Your Right to File a Lawsuit

If you don’t file a lawsuit in time, all states have statutes of limitation that will cut off your right to bring a lawsuit against your insurance company. The statutes of limitation differ from state to state. If you don’t file a lawsuit in time, most property insurance policies have a shorter contractual limitation period that will cut off your right to bring a lawsuit against your insurance company. These periods are typically one year or two years after a loss occurs or after you first discover a loss. In most states, your insurance company is required to tell you in writing that your claim is denied, and that the limitations clock is running. Make sure you understand all possible deadlines. Consult with a policyholder attorney as soon as, rather than later. You will make it harder for a policyholder attorney to give you the representation you deserve if you show up on her doorstep the day before the clock stops ticking.

Report All Unfair Claims Handling to Your Insurance Department or Insurance Regulator

Many state insurance regulators track policyholder complaints about their insurers and compile the results. The results may be available through your state insurance regulators web site. You can file a formal complaint online in some states. Insurance regulators also regularly compile "market conduct" reports on unfair claim practices. If you don’t file a complaint, you can’t make a difference.