MOLD INSURANCE CLAIMS
Mold remediation can be very expensive. Be sure to have a professional document that you do in fact have mold as a result of the property damage you incurred. In many cases your insurance company will not check for mold. Mold can cause serious illness and property damage. Mold contamination can also destroy your property and your contents.
Policyholders and their attorneys need to pay careful attention when determining the proper causes of action before filing suit. Jurisdictions differ on the type of claim that can be used to recover for various causes of harm; what may be acceptable in one state may not be in another. Even subtle differences in filing requirements and procedures can make or break a case.
Mold thrives in moisture rich environments such as high indoor humidity, flooding, or a leaky roof or dishwasher. It hides in places you can’t see sometimes. If your insurance company is denying your mold insurance claim, contact Merlin Law Group and as a courtesy our attorneys will review your insurance policy to educate you if your policy does in fact cover mold damage.
Ice dams on roofs form when accumulated snow on a sloping roof melts and flows down the roof, under the insulating blanket of snow, until it reaches below freezing temperature air, typically at the edges of the roof. When the meltwater reaches the freezing air, ice accumulates, forming a dam, and snow that melts later cannot drain properly through the dam. They can also form when gutters and downspouts are clogged allowing the water to accumulate and eventually turn into an ice dam.
Ice dams and melted snow can cause significant premature roofing failure, wet insulation, soffit/fascia deterioration, paint failure on interior surfaces, mold growth, structural decay, and rot and water damage.
While the physical damage to the structure of a home or business may be covered due to ice damming, it’s the hidden mold that forms from unattended moisture the most policies don’t usually cover. Mold can grow fairly quickly and can cause serious damage to your health.
Mold Exclusions- Absolute or Not?
People across the country are becoming increasingly educated regarding the health risks associated with mold exposure. The insurance industry implemented many wording changes in the late 1990’s and early 2000’s after an increase of mold damage submissions in conjunction with covered water damage claims. Insurance companies began rewording their policies to almost eliminate mold coverage. Mold exclusions often contain language like:
This policy does not apply to any loss or damage caused by or resulting from the actual or threatened existence, growth, release, transmission, migration, dispersal or exposure to mold, spores or fungus.
It’s common that water losses produce mold if not properly remediated. In most policies mold that happens over time is not usually covered. However, in some instances, it may be argued that mold may be covered under an insurance policy when it is a result of a covered loss and is the result or proximate cause of the covered loss. Mold exclusions are relatively straightforward, but if the “other damage” is a covered peril, then the policyholder may have coverage.
A good example of when mold may be covered is at the time of a plumbing loss such as a burst water pipe. Because a burst water pipe is a covered loss, any mold resulting is considered an ensuing loss and may be covered.
Water damage is a commonly covered “cause of loss.” Mold growth and water infiltration have a close causal tie, and there has been dispute in the industry over whether property policies respond to mold losses when water infiltration, a covered cause of loss, caused or contributed to the mold. Reasonably interpreted, the ensuing loss clause provides that if one of the specified uncovered events takes place, any ensuing loss which is otherwise covered by the policy will remain covered. The uncovered event itself, however, is never covered. In determining whether or not mold damage is excluded under an ensuing loss provision, courts often look to see if mold is the cause of damage or the result. Whether damage is covered as an ensuing loss is a fact specific question that generally must be analyzed according to the law in the jurisdiction where the claim arose.
Whether or not you have a valid claim can depend on you determining the proximate cause of mold damage. If a covered peril causes the mold to grow, you may be able to collect payments to repair the mold damage.
Some policies are expressly written with an “absolute” mold exclusion. An “absolute” exclusion means that no matter how the mold may come to be, the insurance company will not pay for the damages. Usually, the policy would have specific language indicating that under no circumstances would mold be covered under the policy.
When mold is a result of a covered loss, it is wise to check the policy and get a professional opinion on whether any mold exclusion is “absolute”.