Claim Doctor Q&A: State Far Denies Mold Claim
Often I get questions about denied claims. Too often it is too late for me to provide any meaningful assistance. The moral of this Q&A is: Don’t delay in getting professional help. The longer you wait, the worse your chances of a fair settlement.
Q: Jim R.
I’m a mold remediation contractor who is trying to help a homeowner.
They had some storm damage to the house and did not realize the damage until months later. The incident date was May 22nd 2014 and they applied for coverage 11 months later after realizing the situation.
Neighbors had roofs replaced with other repairs but these clients are struggling with State Farm to get the repairs completed.
In addition, they have a condition 2 mold situation that is concealed by carpeting and sheetrock. An air test was completed with structures still in place an did not come up elevated. The problem is that the species count of penicillium/aspergillus is 3 times higher in the affected area vs. an unaffected area.
If mold removal was to take place, without following S520 protocol, the spore count would skyrocket and mold spores would spread throughout.
This is a sensitive situation as one of the homeowners was involved in a very serious auto accident and is mostly bedridden in the affected area. Medications have reduced immunity and an increase in mold sensitivity is a major concern.
So far, State Farm has rejected any mold claim and I’m not completely sure about costs covered, if any, for the roof.
A: Andy McCabe
Thanks for reaching out.
Coverage issues are always tough, and State Farm is notorious for denying coverage for mold.
I would recommend putting together a package of anticipated costs, including the roof repairs, and have the homeowner submit it as part of a Proof Of Loss.
This is getting fairly old and it is likely less than $100k, so getting a PA to take the case isn’t very likely. That doesn’t mean you shouldn’t reach out to a local Public Adjuster to ask some questions.
I can help with developing repair scopes, but beyond that I’m afraid I don’t have any magic bullets.
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