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Reliant Blog

Why Did My Insurance Company Deny My Mold Claim?

3/29/2022

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Dealing with a public insurance adjuster is different than dealing with an independent adjuster in South Florida. An independent adjuster, is a third party who works for the insurance company. A public adjuster will make sure to review your insurance coverage and assist you with reporting your claim properly.  Oftentimes, we receive calls about property damage and the property owner uses the wrong terminology while explaining their damage. This can be detrimental to your claim if you do not report your loss or explain the damage correctly, and your claim could be denied. 

The same cannot be said with an independent adjuster. The difference is that an independent adjuster works for and represents the insurance company, not you. We are sometimes referred to as independent adjusters, however our true title is public insurance adjuster. 

Therefore, if you have any issues with property damage and mold, you should seek help and assistance from an independent public adjuster to handle your claim. If your claim gets denied, you could be throwing thousands of dollars out the window. What do you need to know about mold claims, and why do some claims get denied? 


Why Was Your Mold Claim Denied? 

When Does an Insurance Company Cover Mold Damage? 

Mold remediation is covered if it results from a covered peril in your insurance policy. For example, if your pipe breaks and causes water damage to your property that results in the presence of mold growth, then yes, you can file an insurance claim. Additionally, your insurance policy should also cover the ensuing damage and repairs to your property, as long as it is not excluded in the policy. 

If your insurance policy includes accidental water damage, it should also cover mold damage providing it is not excluded in your policy. As long as you can prove that the mold growth was a result of the water damage, you will avoid getting a claim denial. 

Some examples of covered perils are a leaking hot water heater that resulted in mold growth in your walls and a malfunctioning washing machine that caused moisture to penetrate your floors and possibly produce mold.  

However, it is essential to mention that not all policies are the same. So, before you invest your time and effort filing an insurance claim, make sure you have thoroughly read and understand your policy. Insurance policies are confusing at best because they provide coverage, then remove or exclude the coverage in a different portion of the policy, then can replace the coverage with different language and coverage. An
independent adjuster will review your policy and explain the coverage so you should get help to make sure you are covered for your loss. 

What Are the Reasons Why Insurance Claims Get Denied? 

Not all insurance policies include mold coverage. So, the first thing you should do is review your policy and see if it is included. Then, you should seek assistance and guidance from an independent adjuster. 

Usually, insurance companies deny claims if there is sufficient evidence proving that the mold infestation resulted from poor maintenance, long term damage or neglect. An example is if you have a plumbing problem and you wait too long to get it fixed and the leak continues for a period of time. 

Do You Need to Talk to an Expert Independent Adjuster in South Florida? 

Dealing with water and mold damage is stressful, but what is more stressful is receiving a claim denial.  Hiring an independent adjuster will relieve you of much stress and they will assist you every step of the way. 
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At Reliant Insurance Adjusters, we have your best interest at heart. We strive to give you nothing but the best service by offering our knowledge and experience so that you can get the highest possible claim settlement. Give us a call to learn more about what we do.
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