Insurance Companies and Insurance Adjusters
as Scam Perpetrators
Here are several mold frauds perpetrated by insurance companies and insurance adjusters:
-
Hiring incompetent, low-paid, company-stooge testing
personnel to do the least possible mold testing in the least likely
mold-locations in an insured's property so that any actual mold is NOT likely to be
discovered.
-
Utilizing ineffective Air-O-Cell mold testing media so
that little or no mold will be discovered. Air-O-Cell cassettes test too
small of an air sample to give a truly accurate insight into a property's real mold
infestation problems. Direct sampling of visible molds and mold culture plates are
vastly superior to Air-O-Cell technology in determining the extent of mold problems in
a property and in identification of the molds present.
-
If the mold testing stooges uncover any mold problems,
the serious mold test results are not to be shared with the insureds and are to be kept
a complete secret forever from the insureds [this common insurance company
fraud is one of the causes of actions in the $20 million Ed McMahon lawsuit against his
homeowner's insurance company and its two insurance stooge testing and remediation
companies. The McMahon defendants kept secret mold test results showing a serious mold
infestation in the McMahon residence of the deadly mold Stachybotrys.
-
Telling insureds that there is no mold insurance coverage
even though there is evidence that insurance-covered water damage is the direct cause
of the resulting mold infestation.
QUESTIONS & ANSWERS
ON MOLD INSURANCE CLAIMS
[June 30, 2003]
Q.
I had a copper
pipe leak in the slab of my home. The leak was repaired on January 3, 2003. I am still
not even close to remediation as my insurance keeps sending out these so called experts,
civil engineer, leak detection companies forensic investigator, etc. who incidentally are
a subsidiary of the insurance adjusters company. The last person who came to my home even
took pictures under my kitchen and bathroom sinks. The mold is in my hallway and two
bedrooms and also the living room has Stachybotrys only discovered when I insisted they
check the living and dining areas. In the meantime, my beautiful furniture is sitting in
this infested home. My insurance is trying to establish that the additional mold and
sweating of the slab in the laundry room (six inches from the original leak) may have
been caused by another leak or another source. My irrigation system was tested and no
leaks were found. This is driving me crazy and concerned about what my insurance company
is up to.
A.
You will be
unsuccessful in collecting for mold damage from your insurance company unless you pay for
your own mold inspection and mold testing [www.sanjan.com]
and hire either an independent insurance adjuster [works only on your behalf against the
insurance company on a commission basis] or an environmental attorney [www.moldlawyer.com]
[February 5, 2003]
Q.
I have a friend
who had water damage caused by a slow leak from the water fitting in the shower/bathtub
area behind a wall. The leak eventually got so bad that water was standing in the
bathroom and joining room - which is the kitchen. She called her insurance company who
dispatched a contractor to stop the leak and clean up the mess. Mold was identified as
present in the walls and the insurance company stated that there was a $10K limit on
liability and the estimated cost for repair to eliminated the mold was $16K. Due to the
wall location infected with mold, this will require removing the kitchen wall cabinets
(top and bottom) and countertop to replace the wall board and treat the studs. And,
repair will be necessary to remove the mold to be able to get it 'certified' as mold free
to ever be able to sell the house. the insurance company will pay (less deductible) for
some of the water damage (floors and carpet), but the mold affected areas and getting the
mold free certification is capped at $10K. My friend lives in California.
A.
Your friend should
be very concerned about making sure that ALL of the home mold has been discovered and
that it will be all remediated even though he has to pay a big part of the cost. Most
insurance company's mold inspection and mold testing is very inadequate to find the total
extent of mold in a home. If there is a serious mold contamination problem in one area of
your friend's home, the hvac system is probably itself contaminated with mold spores and
perhaps mold growth. The hvac system takes mold spores throughout the home. The entire
home needs mold inspection and mold testing by a
Certified Mold Inspector.
Your friend is lucky that the insurance company will pay at least $10,000 of the mold
remediation cost. Most insurance companies try every legal trick they know to pay
absolutely nothing for mold damage inspection, testing, and remediation. Depending on how
widespread the mold infestation is, your friend may need to get financial help from the
mortgage lender on the property, or get a second mortgage on the property, or get funds
in some other way. Persons who don't have insurance coverage can do some or all of the
mold repairs by doing it themselves utilizing mold equipment and supplies from
Mold Mart.
[May 20, 2002]
Q.
I live in Hudson,
NH. Recently we found out that a few houses in our neighborhood had to undergo mold
remediation (all built by the same builder--we know there are several others in similar
circumstances as we are right now as well, all built by the same builder). Once we heard
them describe the mold in their attics, we immediately realized we had the same problem,
but had dismissed it as it appeared like 'dirt' on our attic roof. A friend of ours is a
local mold expert went up in our attic to check it out. Without performing any testing,
he felt that it indeed was a problem and should be taken care of. It looked just like the
mold in the home of one of our neighbor's for whom he did take samples for testing. We
called our insurance company to put in a claim and an adjuster came out to look at it and
take pictures. That's as far as we have gone thus far. The adjuster asked us to provide
them with a 'statement of origin' from our mold expert. We are currently waiting for this
statement and should receive it this week. The mold expert says that he feels the mold is
due to moisture seeping in from the roof. There is only 'black tar paper' around the
perimeter of our roof, not all over it underneath the shingles. Due to a few bad winters
3-4 years ago, he feels that there were ice dams that caused the problem and without this
barrier, it seeped into the wood. We have no known sources of moisture in our attic from
any other source as we have checked bathroom fans, etc. To support this, the mold is more
prevalent on the outer parts of the roof, versus where the fan ducts are located. Also,
the mold is only on the back side of the house. The front side of the house that gets sun
all day long is free from mold. The back side is in the shade most of the day. I don't
have a good feeling about the insurance company's honoring our claim, but I guess we'll
have to wait to see how things go once we provide them with a statement of origin. Should
we wait to be denied by the insurance company to go to a lawyer, or should we find one
now? I'm very disturbed by the cost estimates I'm hearing to tear off our roof and redo
it (those we've heard from neighbors that have done this recently). Without insurance
monies, there is no way that we can do this ourselves.
A.
Not having black
tar paper underneath all of the shingles might possibly be a construction defect that a
lawyer could pursue against the builder if the statute of limitations for suing has not
already expired. To avoid ice dams backing up water underneath shingles, roofs in cold
climates should have something better than black roofing paper---a thick rubber-like
waterproof membrane underneath the shingles to make absolutely sure that water doesn't
penetrate the roof decking into the attic area to cause mold growth. As far as collecting
from an insurance company, the damage must be something specifically covered in your
insurance policy, and be sudden and accidental and related to a specific occurrence date.
You must also file a claim with a policy-provided time period [usually very short from
the date of occurrence].
[April 21, 2002]
Q.
We need help very
quickly. We filed a law suit pro se against Foremost Insurance and we are treading water,
barely. We had a great deal of difficulty getting them to do the appropriate clean
up. The adjustor came out, made an initial assessment authorize certain work and
disappeared for several days. He left mold growing over approximately 900 sq. ft. area of
a 2000 sq. ft. home. It is a mobile home and he did not check under the house on that
initial visit. One of the contractors checked the following day and found a river being
held up by the vinyl sheeting. We could not get a contractor to remove it without
authorization from the insurance company and the company insurance adjuster did not
return calls from us or from two of the contractors. The water stayed under the house for
over a week and the mold was spreading in the house. The company insurance adjuster would
not authorize removal of soft goods from the house to protect them. He had the furniture
and materials moved to an adjoining room where there was not even a door to protect the
property from mold spores. One of our contractors is an expert on mold cleanup and they
advised we would need to move all of the furnishing out of the home for treatment as they
were exposed to mold growth. The company insurance adjuster refused to do this. We
received a letter from the insurance adjuster giving what he declared was the final
payment. He said we had voided the contract because we refused to allow the contractors
in to work. We have written statements from the contractors, stating they were never told
to either stop or start work and putting a lie to the time line he says they communicated
to them. The insurance company has already paid twice the amount that the insurance
adjuster stated as total damages in that letter. Our problem is we are not lawyers and we
do not know how to navigate this system. Please would somebody out there help us. Sandra
BarMcQ 505-383-9526, Las Cruces. We do have pictures, we have a test of several mold
plates showing an overgrowth of mold throughout the house. One of the molds is an
especially toxic one. We also have a letter from a doctor stating responding to these
tests that the house could not to be inhabited by anybody. Again, would somebody out
there please help.
A.
Your letter has
been posted on our website
www.certifiedmoldinspectors.com to get the attention of a New Mexico mold attorney to
help you. You need to locate a New Mexico attorney who will handle your legal case on a
contingency basis---meaning you pay no fees in advance to the attorney. Rather, the
attorney gets a percentage of your ultimate insurance settlement or jury award. If the
attorney doesn't get money for you, he or she doesn't get paid! One place to locate an
attorney is to visit the website
www.moldlawyer.com.
[April 8, 2002]
Q.
How can I get my
homeowners insurance company to reimburse me for all the things we have done inside our
home per doctors orders to rid our home of bad air quality, and thereby improving my
life, such as pulling up all carpets and putting down wood flooring, changing out duct
work in attic, putting in new whole house air purification system with UV light, new
furnace, etc.?
A.
In order to
collect on an insurance policy, there must be an insured peril that your insurance policy
specifically covers and that is NOT excluded in the fine print of the policy.
Besides being an insured peril, the problem usually has to be "sudden and accidental" and
something that happened on a specific date or during a narrow time range that you can
prove to the satisfaction of the insurance claims adjuster. Improving your home under a
doctor's orders to rid your home of allergens is probably not covered in your insurance
policy. To find out for sure, seek out the assistance of a public insurance adjuster or
an insurance attorney to study your policy and your situation. A public insurance
adjuster represents only you in trying to collect from an insurance company [on a
commission basis].
[April 2, 2002]
Q.
We had a leaky
shower pan and are getting a new shower put in. The demolition of the old shower was
yesterday, and there is now mold exposed. Our insurance company has been quick to have a
clean-up crew call us, and although I would like to believe they are being nice and doing
the right thing, they have been a little too quick and too nice. I'm afraid I won't get
the clean-up job done right or may not have everything cleaned as it should be--i.e.,
can carpet be cleaned, or should it be removed? What about upholstered
furniture? Mattresses? Personal belongings in the house? We have been told we may have to
get a motel room for a few nights while they run the "air cleaners"--I can't help but
wonder if they aren't telling me everything. But I want to believe they are being fair
and honest. We do have coverage, but I don't want to agree to all this, and perhaps end
up settling for a less than good cleanup, but I don't want to cause unneeded concern or
trouble either. I want to get my house cleaned up and life back to normal, but I have
health concerns also. Two of my sons have been sicker this last year than ever
before--sore throats, coughs, ear infections--taking Zyrtec and Claritin and never had
before. One has allergies and asthma, and it's hard to say if he is worse because he
has so many pulmonary problems. Maybe I'm making too much of it. I need advice.
A.
If you rely solely
on your insurance company to do the initial testing, develop the remediation plan, carry
it out, and test the area afterwards, you will probably NOT get rid of all of the
unhealthy mold growth that may be hidden in your home walls, ceilings, floors, attic,
crawl space, basement, and hvac equipment and ducts. You should find out the true facts
involved before and after mold remediation by hiring a
Certified Mold Inspector to
test your home both before and after mold remediation. It is very common that when most
remediation is done that the mold problems are just as great or greater than prior to the
remediation efforts. To find a
Certified Mold Inspector in your area, please visit
www.moldprofession.com.
[April 1, 2002]
Q.
I currently have a
mold claim filed against Allstate September 17, 2001 and am pulling teeth to get any
information out of them. They don't want to talk to me don't want to pay added living
reimbursements -- keep trying to get me to settle and have hired a mold company to retest
my house and they did a shoddy job. How can I make them get a protocol form the first
mold company or from a new one? I don't feel safe using their company since the numbers
were so far off from the first.
A.
You need to hire
your own qualified mold inspection and testing company to work ON YOUR DIRECT BEHALF. You
can locate qualified Certified Mold Inspectors by visiting the website
www.certifiedmoldinspectors.com. Don't just wait for the insurance company to hire an
insurance-oriented testing service---hire a testing service that will find ALL OF THE
MOLD IN YOUR HOME and search for insurance-covered causes for the mold growth. Once you
get the insurance company to accept liability for the mold damage, you can usually get
your paid testing fees reimbursed from the company.
[February 21, 2002]
Q.
Our house is
infested by black mold which makes everybody sick. We are going to move out our house by
this week and told not to take anything with us. We are so naive about this situation and
do not know what to expect from collecting on a mold insurance claim. My question is the
insurance said that they can clean the wood furniture's, but what about the mattress the
cloth sofa and couch? we are planning to dispose this things and we want to file a mold
insurance claim from our insurance because we think that it will be hard to clean this
particular item. Do you think we are right? can we demand that our mold insurance company
pay for health purposes that we need to disposed anything that is a treat to our health.
I am scared because I do not know how bad is our health now, we still have to see a
doctor to find out about our health especially my two children who are sick all the time.
A.
In your mold
insurance claim, you should insist upon new replacements for any soft materials like
mattresses and upholstered furniture. Although such items can sometimes be effectively
cleaned of mold contamination, results are not necessary mold-free and the cost can be
considerable. By representing yourself against the insurance company, you are asking to
be taken advantage of by the insurance company. You will probably get a bigger settlement
more quickly if you are represented by either a public insurance adjuster [represents
only you against the insurance company on a commission basis], especially a mold
insurance adjuster, or a plaintiff's attorney who specializes in suing insurance
companies for bad faith in not paying mold insurance claims. |
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