The other day we noticed some water seeping out from under the base cabinet below the sink the other day so we immediately called the plumber. When he arrived he said that the culprit was the water feed line for the refrigerator ice maker. Upon taking the bottom of the dishwasher off, the whole floor is soaked and the sub floor in that area is wrecked. When we went into the basement we saw that the sheet rock is covered in mold(Quick-response came and confirmed it is black mold and said that with all the weeks of hot weather we have had it has been perfect for mold growth) and when we moved a ceiling tile to see all of the damage, the sub floor looks bad. We called the insurance company and they filed a claim and told us that we should get estimates and they would have an adjuster out in a few days to total up the damage. Well the adjuster came today and said that the company might not cover it because it could have happened too long ago. There would be no way to see the damage since it was under the cabinet floor and behind the dishwasher and any water that went into the basement simply went behind the sheet rock and wasn't noticeable until the mold appeared. Well we called the company back today and they said that they won't cover it and now we have a bad sub floor, wrecked sheet rock, mold, and no help. We have never had a claim in the 22 years of living in this house or the 15 years of living in the house before. Is there any other action we can take to get the claim reevaluated or anyone that oversees insurance operations we could talk to?
Update:According to my policy there is up to a $20,000 coverage for mold. The walls do not feel soaked and a couch is up against that wall so it would not be noticeable.
Answers & Comments
Verified answer
It is pretty common for a standard homeowners policy to exclude damage that happens over a period of weeks, months or years. It does not matter if you could see the damage or not.
Additionally, rot is also excluded. So, if by "wrecked" you mean the sub-floor is rotted...then the rot may not be covered either.
The coverage for the mold is for a "covered" loss. This is not a covered loss.
There are also lots of types of black mold. Not all of them are harmful. Many are not. "Stacky" is the bad one. But Stacky is not the only type of black mold.
Ask them to send you a copy of your policy and a letter explaining the basis of the denial. If your policy has the above provisions....sounds like the denial may be sound.
The fact you had the policy for 22 years is greatly appreciated by the company - but it does not mean that you don't have to be held to the same standards as every other policy holder.
The fact you have not made a claim in 15 years is also appreciated by the company - but that has nothing to do with determining if there is coverage on a claim.
What determines if there is coverage is the policy language.
Unfortunately this type of claim will not be covered since it is a maintenance claim. Your insurance covers an occurence that happens suddenly, i.e. if the pipe had burst and caused damage it would have been covered. In this instance though the damage developed from either a small pinprick leak over time or the fitting came loose and leaked slowly over time, etc. which basically puts it at a maintenance issue. It is irrelevant that that you have never had a claim or that you have had insurance with the same company for 22 years -- they cannot just pay you because you are a loyal client, it must be covered under the policy for payment to be made. So the insurance company is not being unreasonable, they are fully complying with the contract that they have with you. I suggest that you take the time to read your policy and you will be able to assure yourself that they are handling this correctly.
In terms of the mold some policies do contain an amount (usually very small & limited) that they will pay for mold claims -- you might want to check your policy and see it if includes coverage for this. However, in terms of the other damage, the subfloor, the ceiling, etc. I am afraid you will have to pay for all of that out of your pocket.
Good Luck
OK, first question, is there any action you can take. Sure. You can file a written complaint to your state insurance commissioner. You can try to hire a public adjuster. Hiring a lawyer, would be a final recourse.
ARe they being unreasonable? Maybe not. Read your policy. If it flat out says, we do not cover any damage from water leaks more than 30 days old (common wording), then it is NOT unreasonable for them to NOT cover something that your policy says is NOT covered.
Keep in mind, most non-food mold is BLACK, and it's just about everywhere. Don't think that EVERY mold is that scarey, "toxic mold" that makes houses uninhabitable - that stuff is pretty rare. Additionally, MOST homeowners policies flat out exclude coverage for mold.
As a homeowner you can be expected to pay attention to maintenance stuff - and seeing wet sheet rock in the basement, is a clue that something bad is going on. You didn't notice it, until AFTER you discovered the water leak? They're going to question that.
Is the Black Mold a gang? This isn't a very clear question. From what I understand The Black Mold came into your house asking for you to file an insurance policy or else they will damage the interior of your house. You refused to give in to the threat of being harmed like a true American. Then the Quick Response Team(to which I assume is your local organized crime task-force) assessed the damage and they were unable to help you. Please Reword your Question so i could answer it more thoroughly.
Hope this helps!
The insurance company only has to interchange the broken gadgets and floor so with a small kitchen the quantity would not seem unreasonable, use the money in direction of a kitchen re vamp and don't use laminate flooring interior the kitchen in case you're able to characteristic to the £2000 have the kitchen re outfitted with all new stable luck
Comb through your policy and read every piece carefully. If you are able to find a loop hole, you can appeal the claim denial. Homeowners need to understand the policy.
If your policy says: no coverage for water damage, then you get none.
And how did you file your claim under? What culprit did you state?
~~You can file a complaint with your state's Insurance Commissioner. Best of luck.~~