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
Hi Jim,
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.
Good luck,
Andy
Also published on Medium.
I have recently had a client that had a water leak from a faulty seal on a Whirlpool icemaker. The leak occurred under cabinets in the kitchen and went unrealized by the homeowner for roughly 3 months. He finally noticed some discoloration on the wood flooring in his dining room which is adjacent to the kitchen. He tore up some of the wood and found green mold. ANPAC had an exclusion for mold in their policy, AND they denied CAT 3 coverage.
We were contracted to remediate and what we found under the cabinets was unbelievable.
We have been paid about 50% of what we billed to date – excluding ALL drying equipment, air scrubbers, and hydroxyl generator. The kicker is that his wife has fibromyalgia. She was having serious issues prior to our efforts, but since our remediation she is able to occupy the home.
Kevin Hussey
http://www.unitedfireandwater.com
http://www.cajunmaintenance.com
I JUST RECENTLY NOTICED THE FLOORS IN MY KITCHEN AND I HAVE CHERRY OAK WHICH WAS VERY EXPENSIVE. I CALLED STATE FARM TO NOTIFY THEM. EMPIRE CAME OUT AND GAVE A FIGURE OF $5,100.00. SHORTLY AFTER THAT AN ADJUSTER CAME OUT, HE NEVER LOOKED BEHIND THE REFRIDGERATOR BECAUSE THATS WHERE THE WATER CAME FROM. HE SAID THE HE LITTERALY HAD TO COUNT EVERY PIECE OF WOOD THE HAD BEEN DAMAGED. THEN HE SAID NOW I HAVE TO DEPRECIATE THE FLOOR BECAUSE IT HAD BEEN FOUR (4) YEARS SINCE IT HAD BEEN PUT DOWN. THIS ONLY GETS BETTER I ALSO HAVE MOLD DAMAGE FROM THE LEAK. THE ADJUSTER DIDNT NOTICE IT. THEY HAVE SENT ME A CHECK OF $1,600,00 AND THAT WILL NOT COVER THE FLOOR AND MOLD. IF THERE IS ANYONE OUT THERE THAT CAN TELL ME WHERE TO GO FROM HERE GIVE AN EMAIL BACK, THANKS VIKI
Hi Vickie,
I’m sorry to hear that your insurance company isn’t making you feel like a good neighbor.
I recommend you have a contractor bid the repairs, then submit that bid to State Farm for reimbursement.
Depreciation is typically only a temporary hold-back, which is paid once repairs have been made.
After Hurricane Michael hit thr Panhandle on Oct 10, 2018, my mothers home sustained severe damage. After having the damage assessed, State Farm assessed all the roof damages of a 3000sqft 2 story home at $9400 with a deductible of $4000. 3 months after the storm and unable to find a construction or roofing company to repair the roof for $5400, the 2nd floor now has even more extensive rain damage and mold throughout the 2nd floor. We are just finding out this week that State Farm dropped mold coverage from her policy. They just sent her a letter this week stating such but she has been paying the same premium. We are now at a standstill after being denied by FEMA because she has homeowners insurance. Does anyone have any other recommendations.
Sounds like SF isn’t afraid of you or your mom.
1)File a complaint with Florida Department of Insurance.
2)Find an attorney who will take your case on.
3)Find a contractor to perform repairs, provide their estimate to SF, then find a way to get the work done regardless of SF payment.
State Farm ain’t no good neighbor!!
Had a pine branch puncture my roof during a snow storm. Of course, because I am 55 and I woman, I don’t spend a lot of days climbing a ladder to check the condition of my roof, and therefore had no idea until the spring rains came that I had a roofing issue.
Once I saw evidence of a small water mark on the ceiling Sheetrock- I did get on the roof where there were other tree branches and a branch lodged into my roof -about a foot on each side. I tracked down a 4x 6 taro with roofing nails. Fast forward a few months – called my State Farm office who gave me the name of o r of their approved roofing contractors. He quoted just under my deductible to replace a 2’ X 2’ board, paper, shingles.
I used that estimate ( which I felt was high- 25% of he entire cost of the roof replaced 8 yes before!)
And got an estimate 1/4 if that price and had the roof repaired. There may be another leak and tststr farm denied my claim for mold (water that got into walls prior to repair) and residual water that would mar the ceiling.
Lots of other details – but this experience alone will cause me to leave state farm after 26 years –
It will be about 8k to fix all interior Sheetrock, sand – paint – and remediate mood from the incredible hot summer and after effects – but glad to have the rose color glasses off w State Farm. Going with progressive – same premium same coverage.
Who cares whether I pay company A or B … for this gouging. Also all these insurance companies have no honesty about contents – they charge a percentage of home value – whether you have thrrr pieces of furniture or 300
– what a sponsored scam —-
Screw you State Farm
You should submit all your costs to State Farm. They are all part of the original claim, which they can’t deny because they’ve already made payment.
If they balk, demand appraisal. Or find a good insurance attorney.
We had a claim on 2014 for a broken water pipe and it wasn’t fixed right so we found mold in the same place and the dr said this is why my husband has only 40 percent of his lungs,he want let him go back in trailer .we have had it all checked out by mold people worse black you can have! State farm giving us the run around, its been three weeks nothing done. How can we get them to fix it we have a 10,000 dollar coverage on it.