Answers to Mold Questions Mold illness and other important facts

The "MOLD" Info Source

The Truth You have been looking for

Mold and Insurance

 This is Going to be Painful for Most of You

 

This Might be the Most Important Page
 You Have Ever Read Concerning Mold

 

This is important information concering the insurance company that you are hoping will cover your Mold claim.
 

       WHY  WON’T  INSURANCE  PAY?


This is a FACT: 


You may have Mold Coverage, And your Insurance Company or Adjuster will tell you it's not a Covered Loss.

If you push the Fact, they may finally tell you... Oh.. it is covered, sorry, "Our Bad". The fact is you may never question what they tell you and take their word as Gospel, and they just saved a fortune. Now multiply that by 100,000 times people actually believed them. And if they get caught doing it (trying to Cheat you), Hey... it was just an oversight and they're on the job now. What a crock, it happens everyday. Isn't that illegal or something? Mistakes are not against the law, however the mistakes are usually in their favor and not yours.

  NEVER SETTLE with their FIRST OFFER to REPAIR

           It's a Card Game, and You're In...

When a used car dealer offers you his first price without a doubt, you know he's going to come down some more on the price. The insurance company is the same way. It's their first offer, it will be cheap, count on it. And if you take it you've just left money 
on the table. Yes, the estimate or the settlement price is always negotiable.



Over the last four years all of the insurance companies issued Endorsements to their current Policyholders that gave them notice that they had totally Excluded Mold Coverage or that you would need to buy a “Mold Rider” for basic or additional Mold coverage.

 

They did this from a liability standpoint as the insurance industry paid out Billions of dollars for Mold claims and needed to stop the financial bleeding. Even though they implemented spot gap measures the industry still pays out over $1 Billion Dollars per year in Mold related claims.

 

The first source of liability was from their own insurance Field Adjusters. The Adjusters would tell Policyholders, “It’s not Mold”, or “Don’t worry about it” and not pay the claim to fix the Mold problem. The next thing is that they got slammed with hundreds of million dollar lawsuits for negligence, and guess what?  They paid!

 

Now it’s a hard row to hoe to get your Mold claim paid.

 

                        BE CAREFUL

 

Before you complain or mention the word Mold to your insurance company, “READ YOUR INSURANCE POLICY” and know your coverage’s.

 

A policy is thick like a book not the three pages they sent to you, That’s called a “Declarations Page” or a “Dec Page” that’s not a policy. It’s a brief outline of coverage’s and won’t tell you what you need to know. If you don’t have a complete policy call your Agent ask that they email you one. Insist on it!

 

     Water Damage Or Mold Damage?

 

You had better figure this one out prior to talking to your insurance company.

 

If you call up your insurance company and have no Mold Coverage and start screaming about “MOLD”, Guess what?  There’s a high probability they will pay next to nothing.

 

However, if your call up and scream ‘WATER DAMAGE” and don’t mention Mold, you may get
about 90% of your problem paid for.

 

Your safest bet, even if you have a Mold Rider, is to scream "Water Damage" first, and see what they pay under water damage and then start talking Mold.

REMEMBER:  You also have to be extremely careful when screaming "Water Damage" as all water damage is not a covered Loss under many insurance policies. Long-Term water leaks and rot are not payable under most policies. "Ground Water", leaks into your structure may also not be covered. Before proceeding you may want to ask your Agent to explain your policy coverage's in detail.

  Don't Forget Mold Claims are three Part:

1. Fixng what caused the Mold and
    usually tearing out what has been
    damaged by the Mold

2. Putting back what got ripped out of 
    your home or building and restoring it 
    to a livable condition

3. Cleaning or replacing your furniture
    contents and clothing. If there Mold in
    your environment don't you think it's in
    your contents too.

         DON'T FORGET YOUR HEALTH?


       How To Increase Your Chances of  
          Getting Your Mold Claim Paid?

Document Everything

First take pictures of everything

Call in your own Mold professional for Mold testing and estimates so you know what a legitimate Scope of Work should look like

If you're going to try and claim health damages get Blood testing done

If you call anyone in to help you before you've documented your own facts chances are you may never get the proof you need to get you damages addressed

Once you've documented, Now call in the Insurance Company


You may want to hire an Insurance professional (Public Adjuster) and that's not always  bad deal. Usually they want 10% of the amount that they collect. This is for your structural damages and your contents only.

Make sure the 10% is only on "NEW Money" only and they don't get paid unless you collect.  You may think 10% is a lot of money, what you don't know is usually they get an additional 20% from the insurance company in settlement more than what you could have gotten settling on your own through the Profit and Overhead portions of their estimates.

A Lawyer should be your last Resort with an Insurance Company


Consult with your States Insurance Commissioner First!

Think about it.  The insurance adjuster that is assigned to your claim creates a file on you they are now in charge of settling your claim, "They are Responsible". Every week they meet with their Boss and go over their claims files, and the Claims over 30-60-90 days old. they get told to get the files closed.

If you file with a lawyer and sue, your insurance adjuster won't care and neither will there Boss, because the problem (you) have just been moved off their desk and moved into the legal department. The Adjuster is actually glad, now they have less work.

                             BUT

When you Complain to the State's Insurance Commissioners Office, it's more work for the insurance adjuster and their Boss.

Now they must both write a letter of explanation to their Boss, who in turn must write to their Bosses and the Corporate Legal department, which is attention no one wants. Who then in turn writes to the Insurance Commissioners Office. 

There is a great chance they may have to appear personally before the Insurance Commissioner for a day or two and explain why they did not pay your covered loss.

    No One Wants to go Through That 
        And Many Times they will Just
                  Pay your Claim

Using the Insurance Companies Preferred
   Contractors...   The "Pro's and Cons"

1. You don't ever have use the Insurance
   Companies Preferred Contractor to do any work
   and no one can force you to do so. From what
   we've been told it's not legal to force you to use
   anyone. Once you get the insurance check the
   money is yours to hire whomever you like. An
   Insurance adjuster might tell you, if you use your
   own contractor you are on your own and they
   won't back up the work. Guess what, even if you
   use their guy some of them will tell you it's
   between you and the Contractor if problems arise.

FACT: The contractors on the insurance companies list is approved because they are good people... WRONG. They are on the list because they have agreed to work at the insurance companies price, which is always for less, than a regular contractor. Or they have agreed to work to only the insurance companies' Scopes of Work and estimates. Insurance companies always short you on the Scope of Work.

"Scope of Work", is the amount of work they will be doing in the estimate. The other thing they always short you on is "Unit Pricing". They tell you "YES", we're going to replace your whole wall. And they will, but at the rate of $1.83 per Square foot when the fair market price for that repair is $3.35 per Square foot. Now multiply that by a 15 x 20 Living room and your suddenly short $948.15... now mutiply that by 10 rooms...  and that's just for drywall... what about carpet, paint, lights etc... Now you're getting it.

Insurance companies do pay claims, but since you don't know the price of materials and labor or what a correct Scope of Work really should be you're about to get shorted.

Also, when they tell you to get three estimates... Tell them that no where in your policy does it state you need to get three estimates. That you have hired a contractor and please negotiate the price and Scope of Work with your contractor.