 Mold. That ugly, smelly stuff growing on your walls and furniture. You see it and call your insurance company to report a mold claim. After all, you have coverage in your policy for mold/fungi so you should be covered right?
There are many causes for mold growth, especially living in South Florida where the climate is warm for most of the year. You come home from your 10 day vacation to find mold growing in your home and it is everywhere, including your furniture and clothing. You have no idea how this happened and call your insurance company to file a claim. The adjuster comes out to inspect the damage and boom, the insurance company denies your claim stating there is no covered cause of loss. You pay your insurance premiums so how can this be? Your policy says you are covered for mold, so what gives? What you do not realize is that you are only covered for mold when the mold is caused by a peril/loss that is covered under your insurance policy. What caused the mold? Is it humidity? Is it a plumbing leak that caused water damage to your home and then mold started growing? Did you have storm damage to your home where water entered and damaged the interior of your home and belongings which resulted in mold growth? There could be many reasons why this happened and the burden of proof is always on you to prove your damage and what caused the damage. Humidity, in and of itself, is not a covered loss. Water damage is often a covered loss, as well as any resulting mold growth, as long as it has not been going on for a period of time and the cause of the water has been remedied to protect your property from further damage. Your insurance policy covers damage that is sudden and accidental. However, some insurance companies exclude water damage all together resulting in no mold coverage. We get many calls regarding mold damage that ask “should I file a claim?” You first have to know what is causing the mold and if that cause is covered under your policy. Contract us here and we can help you understand what is and is not covered in your policy with our comprehensive insurance policy review.
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isDocumenting the contents of your home and business is very important to do before you have an insurance claim. What are contents? Contents, also described as “personal property” in your insurance policy, or "business personal property" in a commercial policy, is everything that belongs to you that is not attached to the building. For example, if you turned your home or building upside down, everything that would fall out are the contents.
As previously written in our recent blog “Preserving Evidence of Damage Property”, the burden of proof is on you to prove the damage to your property. In this example, we are referring to your personal belongings and business personal property. Let’s say you have a fire or flood that also results in destruction or damage to the contents. Showing the condition of the contents and properly documenting them prior to the damage occurring is key to getting covered for these items. In cases where a fire loss has occurred, the contents may not be recognizable and the burden of proof is on you to prove what you had before the loss, as well as the condition and age of the item. It is never too late to properly document the condition of your property. We specialize in Pre-Loss Property Inspections and can relieve you of this tedious task.  As your insurance rates increase and you may be thinking about shopping for new homeowner’s insurance, I cannot tell you how important it is to shop coverage and not price!
While meeting with a client who had a fire at their home and reviewing their insurance policy, they were sadly underinsured and their policy did not cover the cost of the damages to their home. I was shocked to learn that their personal property coverage was higher than their building coverage! They said “we didn’t think we would ever have an insurance claim. This is the same insurance we have had since we owned the property and it has never changed in all these years”. It is your agent’s responsibility to advise you to insure your home with enough coverage to keep up with the current property values and inflation costs. Sometimes this doesn’t happen, but it is also your responsibility as a homeowner to do the same and make sure you are properly insured. While reviewing policies for our clients, we are always asked if there is a “cheaper” insurance company and should they change their coverage to reduce their rates. This is probably the worst thing you can do because that one day you have an insurance claim, your insurance company will not be there for you with enough money to cover your claim. I am sure you do not want this to happen nor do you want to have to come out of pocket for most of the repairs. It is also important to make sure you do not have policy limits or exclusions on water damage coverage and that you stay away from any managed repair or right to repair insurance companies just to save money and reduce your premiums. For more information or an extensive policy review, please contact us https://www.reliantpa.com/  Recently when my mother received a ridiculous rate increase from her homeowner insurance company, I began researching a new policy for her. Having the knowledge about policies and coverage that I do, I was very specific with her insurance agent on what insurance companies and the types of policies to stay clear from.
When he was providing me a quote from a company I was not familiar with, he stated there were not many options. I was really taken aback by his comment as my mother only had one claim in the 15 years she has owned the home. Upon further research, it turns out the company he provided the quote from is a surplus lines carrier and not an admitted carrier. What does this mean to you? If you are insured by a surplus line carrier, they do not have the protection of the Florida Insurance Guaranty Act if they were to go insolvent. Also, their policy rates and forms are not approved by any Florida regulatory agency. So, if you have have an insurance claim and you have any issues or complaints with them, you are at the mercy of the insurance company with no back up or help from the State. When I pushed further for him to find coverage with an admitted carrier, not only did he come up with a quote from a known admitted carrier, but it was a better quote for less money! At that moment, it became very clear that my mother’s insurance agent was not looking out for what was best for her, but instead his own pocket. There are many insurance agents that protect their client’s interests, but as I stated in my blog last week (The Never Ending Erosion of Coverage – Do You Know What You Are Covered For?) it is important to know what you are and are not insured for in your homeowners or business policy. This is another great example of why it is important to know who insures your property.  When purchasing insurance coverage for your home or business, you expect to be covered when you have an insurance claim. When you least expect it, then comes along that one day you need to file a claim and you are blindsided by your insurance company when they say you are not covered. I cannot tell you how many times we have heard “I didn’t know I wasn’t covered” and “Why didn’t my agent tell me”.
I refer to this as the never-ending erosion of coverage by the insurance industry. Our insurance agents should be explaining coverage to us, or should I say, the lack thereof. Many agents go the extra mile, as they should, and explain coverages to their clients. However, some do not and then beg the questions above. An All Risk policy is supposed to be exactly that and cover us for our insurance losses, but they no longer do. The insurance companies are either placing limits on coverage or excluding coverage all together for example …
It is so important to understand and know what you are covered for and what you are not. We offer policy reviews and suggestions for coverage based on our years of experience. Remember, we are also homeowners and business owners. If you have any questions or concerns about your policy, please contact us.  New clients often ask what they can do to help their claim get paid. The answer we give is a simple one. Make sure your property is clean and neat when the insurance company adjuster comes to inspect the damages with us. By that, we don’t mean remove or cleanup the evidence of the damage, but rather make sure the rooms are uncluttered so the adjusters can move about and inspect without any difficulty. Clean floors and bathrooms so that the property has the look of one that is well kept and maintained.
So why is this important? It comes down to this. If an insurance company adjuster comes to a property that is unclean and poorly maintained, it is more likely they will view the damages they are being shown as being the result of lack of maintenance or neglect by the owners. Insurance covers damage that is sudden and accidental. They do not cover damage that is ongoing over a period of time. If the damages are viewed in a setting that is neat, clean and organized, it is much more likely that an adjuster will see those damages as being new and not consistent with the way the rest of the property looks. It’s just human nature. So, if it’s been a while since your property was treated to a good spring (or winter) cleaning, it may be time to bring out the vacuum and mop. It could help the settlement of your claim down the road.  Most days we receive calls for help with insurance claims. That is what we do and we do it well. Our clients expect us to work miracles and we often do. But, we cannot produce coverage where coverage does not exist.
We recently inspected a home with water damage to the ceilings, walls and floors which were continuous throughout their home. There were also some damaged personal belongings in two adjacent rooms. The homeowners said that during a few days of heavy rains, their roof began leaking and the ceiling in one of the rooms had fallen down. They called their insurance company to file a claim and a company representative told them they were not covered for a roof leak and asked them if they still wanted to file the claim. Unsure of what to do, they decided to hold off and contacted us for assistance. We reviewed their policy and this tricky language was as clear as day to us, “Windstorm or Hail. This peril does not include loss to the property contained in a building caused by rain, snow, sleet, sand or dust unless the direct force of wind or hail damages the building causing an opening in a roof or wall and the rain, snow, sleet sand or dust enters through this opening”. However, in this particular policy, the language was not referring to the actual building damage caused by a roof leak, but was listed under the Personal Property section and referred to the damages to their personal belongings which were not covered due to this excluded language. Luckily for this family, they are covered for the building damage. However, many insurance policies today do not cover water intrusion from a roof leak and use the same language above to exclude building damage from their policies. Thought for the day … It is important to know what is in your insurance policy and what is not. We have extensive knowledge of insurance policies and offer comprehensive insurance policy reviews which is invaluable if you have ever had an insurance claim and found yourself with no coverage.  If you ever have an insurance claim and are expecting your insurance company to cover damage to your home or business, it is important to preserve the evidence. You need proof that the damage you are claiming actually happened, because the insurance company needs to see it in order for them to properly document the damage and pay the claim.
We as property and business owners, have several conditions noted in our insurance policies that we must comply with, for example, “Your Duties After Loss”. This section requires that you “make reasonable and necessary repairs to protect the property”, and also “As often as we reasonably require: Show the damaged property”. Many times, when an emergency arises (like a broken pipe that floods your property) you are understandably in a panic and trying to salvage your property. If you call a mitigation company to dry out the property in order to protect it from further damage, they may have to remove damaged building materials. Protecting your property from further damage is a requirement in your policy. Will your insurance company penalize you for doing this before they inspect the damage? Not necessarily if the damage is properly documented. When this is not done, it becomes a he said, she said, and the insurance battle begins. Some policies also state “Except for emergency measures, there is no coverage for repairs that begin before the earlier of (a) 72 hours after we are notified of the loss, (b) the time of loss inspection by us, or (c) the time of other approval by us”. The burden of proof is always on you, so make sure the evidence of the damage is preserved and not discarded and that you understand what you are required to do under your insurance policy.  After a long day at work, you come home to find water all over your beautiful floors and the water has traveled into many rooms of your home. The panic sets in and you grab every towel you own in an attempt to soak up the water but to no avail and have to call a professional company to remove the water and dry your property. You realize you have extensive damage to your floors, walls, baseboards, kitchen cabinets and furniture.
Of course, you trust that your insurance policy will cover the cost of the damages and the dry out bill. Why wouldn’t they? After all you pay your insurance premiums every year! Then the insurance adjuster arrives at your home to inspect the damages and you quickly find out that you have a $10,000.00 water damage limit in your policy. In recent years, insurance companies have been placing these water damage limits in their policies to limit their payout on a water damage claim caused by a plumbing leak, air conditioning leak or broken pipe. Unfortunately, this limit also includes the cost to dry out your property. In a situation like this, it is truly a catch 22 because you are required to protect your property from further damage as per your insurance policy, yet it could add up to be costly and eat away at the $10k limit, leaving you with limited funds toward repairing your property. This same scenario above happened to a prior client of ours. The cost to replace the pipe itself is never covered, but the cost for a plumber to access the pipe is covered, and also falls under this limit. If your home was built in the 50’s or 60’s and has cast iron pipes, your insurance company may require that you replace all the pipes with PVC before they will continue to insure your property. They may place a $10k water damage limit in your policy or they may exclude water damage coverage all together. It is important to understand and know what is in your insurance policy. That is why one of our comprehensive policy reviews is so valuable. When you know and understand what is actually in the policy you pay for, it gives you the opportunity to shop for a better policy before disaster strikes and you are left to pay for expensive damages that are not covered.
Those of us who live in communities with homeowners associations are familiar with the dreaded letter informing us that our tile roof and/or driveway needs to be pressure cleaned within 30 days. In some cases, this helpful information comes with threats of fines, ouster from the community pool or other horrible social banishment.
At least every week or so in my community, I see a person on a roof with a large circular sidewalk wand moving it over the tiles, washing away the discoloration and restoring the appearance of the roof to its former brilliance. What goes unobserved are the cracked and broken tiles left behind. Sidewalk wands are named that because they are meant to be used on sidewalks and driveways, not on tile roofs! Another thing that can cause damage during roof cleaning is the person walking on the roof. An inexperienced or careless worker can cause a great deal of destruction. Broken and cracked tiles occur by stepping on the curved portion of barrel tiles instead of the flat parts. I have inspected many roofs with damage like this where there has been no storm activity and the only people to have accessed the roof is the pressure cleaning company. So, what do you do? There are roof cleaning companies that do not use destructive methods. Several use a chemical process that is environmentally safe, to wash away the dirt and grime. Do your research. Ask questions. If possible, hire someone that a friend or someone you trust has used and is pleased with. Don’t hire just anyone that knocks on the door and gives you a low bid. It may cost you big time down the road. |
AuthorKaren Schiffmiller Archives
February 2020
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