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Stachybotrys toxic mold growing on and in drywall.

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Insurance Companies and Insurance Adjusters as Scam Perpetrators


Here are several mold frauds perpetrated by insurance companies and insurance adjusters:

  1. Hiring incompetent, low-paid, company-stooge testing personnel to do the least possible mold testing in the least likely mold-locations in an insured's property so that any actual mold is NOT likely to be discovered.

  2. Utilizing ineffective Air-O-Cell mold testing media so that little or no mold will be discovered. Air-O-Cell cassettes test too small of an air sample to give a truly accurate insight into a property's real mold infestation problems. Direct sampling of visible molds and mold culture plates are vastly superior to Air-O-Cell technology in determining the extent of mold problems in a property and in identification of the molds present.

  3. If the mold testing stooges uncover any mold problems, the serious mold test results are not to be shared with the insureds and are to be kept a complete secret forever from the insureds [this common insurance company fraud is one of the causes of actions in the $20 million Ed McMahon lawsuit against his homeowner's insurance company and its two insurance stooge testing and remediation companies. The McMahon defendants kept secret mold test results showing a serious mold infestation in the McMahon residence of the deadly mold Stachybotrys.

  4. Telling insureds that there is no mold insurance coverage even though there is evidence that insurance-covered water damage is the direct cause of the resulting mold infestation.


QUESTIONS & ANSWERS
ON MOLD INSURANCE CLAIMS

[June 30, 2003]

Q. I had a copper pipe leak in the slab of my home. The leak was repaired on January 3, 2003. I am still not even close to remediation as my insurance keeps sending out these so called experts, civil engineer, leak detection companies forensic investigator, etc. who incidentally are a subsidiary of the insurance adjusters company. The last person who came to my home even took pictures under my kitchen and bathroom sinks. The mold is in my hallway and two bedrooms and also the living room has Stachybotrys only discovered when I insisted they check the living and dining areas. In the meantime, my beautiful furniture is sitting in this infested home. My insurance is trying to establish that the additional mold and sweating of the slab in the laundry room (six inches from the original leak) may have been caused by another leak or another source. My irrigation system was tested and no leaks were found. This is driving me crazy and concerned about what my insurance company is up to.

A. You will be unsuccessful in collecting for mold damage from your insurance company unless you pay for your own mold inspection and mold testing [www.sanjan.com] and hire either an independent insurance adjuster [works only on your behalf against the insurance company on a commission basis] or an environmental attorney [www.moldlawyer.com]

[February 5, 2003]

Q. I have a friend who had water damage caused by a slow leak from the water fitting in the shower/bathtub area behind a wall. The leak eventually got so bad that water was standing in the bathroom and joining room - which is the kitchen. She called her insurance company who dispatched a contractor to stop the leak and clean up the mess. Mold was identified as present in the walls and the insurance company stated that there was a $10K limit on liability and the estimated cost for repair to eliminated the mold was $16K. Due to the wall location infected with mold, this will require removing the kitchen wall cabinets (top and bottom) and countertop to replace the wall board and treat the studs. And, repair will be necessary to remove the mold to be able to get it 'certified' as mold free to ever be able to sell the house. the insurance company will pay (less deductible) for some of the water damage (floors and carpet), but the mold affected areas and getting the mold free certification is capped at $10K. My friend lives in California.

A. Your friend should be very concerned about making sure that ALL of the home mold has been discovered and that it will be all remediated even though he has to pay a big part of the cost. Most insurance company's mold inspection and mold testing is very inadequate to find the total extent of mold in a home. If there is a serious mold contamination problem in one area of your friend's home, the hvac system is probably itself contaminated with mold spores and perhaps mold growth. The hvac system takes mold spores throughout the home. The entire home needs mold inspection and mold testing by a Certified Mold Inspector. Your friend is lucky that the insurance company will pay at least $10,000 of the mold remediation cost. Most insurance companies try every legal trick they know to pay absolutely nothing for mold damage inspection, testing, and remediation. Depending on how widespread the mold infestation is, your friend may need to get financial help from the mortgage lender on the property, or get a second mortgage on the property, or get funds in some other way. Persons who don't have insurance coverage can do some or all of the mold repairs by doing it themselves utilizing mold equipment and supplies from Mold Mart.

[May 20, 2002]

Q. I live in Hudson, NH. Recently we found out that a few houses in our neighborhood had to undergo mold remediation (all built by the same builder--we know there are several others in similar circumstances as we are right now as well, all built by the same builder). Once we heard them describe the mold in their attics, we immediately realized we had the same problem, but had dismissed it as it appeared like 'dirt' on our attic roof. A friend of ours is a local mold expert went up in our attic to check it out. Without performing any testing, he felt that it indeed was a problem and should be taken care of. It looked just like the mold in the home of one of our neighbor's for whom he did take samples for testing. We called our insurance company to put in a claim and an adjuster came out to look at it and take pictures. That's as far as we have gone thus far. The adjuster asked us to provide them with a 'statement of origin' from our mold expert. We are currently waiting for this statement and should receive it this week. The mold expert says that he feels the mold is due to moisture seeping in from the roof. There is only 'black tar paper' around the perimeter of our roof, not all over it underneath the shingles. Due to a few bad winters 3-4 years ago, he feels that there were ice dams that caused the problem and without this barrier, it seeped into the wood. We have no known sources of moisture in our attic from any other source as we have checked bathroom fans, etc. To support this, the mold is more prevalent on the outer parts of the roof, versus where the fan ducts are located. Also, the mold is only on the back side of the house. The front side of the house that gets sun all day long is free from mold. The back side is in the shade most of the day. I don't have a good feeling about the insurance company's honoring our claim, but I guess we'll have to wait to see how things go once we provide them with a statement of origin. Should we wait to be denied by the insurance company to go to a lawyer, or should we find one now? I'm very disturbed by the cost estimates I'm hearing to tear off our roof and redo it (those we've heard from neighbors that have done this recently). Without insurance monies, there is no way that we can do this ourselves.

A. Not having black tar paper underneath all of the shingles might possibly be a construction defect that a lawyer could pursue against the builder if the statute of limitations for suing has not already expired. To avoid ice dams backing up water underneath shingles, roofs in cold climates should have something better than black roofing paper---a thick rubber-like waterproof membrane underneath the shingles to make absolutely sure that water doesn't penetrate the roof decking into the attic area to cause mold growth. As far as collecting from an insurance company, the damage must be something specifically covered in your insurance policy, and be sudden and accidental and related to a specific occurrence date. You must also file a claim with a policy-provided time period [usually very short from the date of occurrence].

[April 21, 2002]

Q. We need help very quickly. We filed a law suit pro se against Foremost Insurance and we are treading water, barely. We had a great deal of difficulty getting them to do the appropriate clean up. The adjustor came out, made an initial assessment authorize certain work and disappeared for several days. He left mold growing over approximately 900 sq. ft. area of a 2000 sq. ft. home. It is a mobile home and he did not check under the house on that initial visit. One of the contractors checked the following day and found a river being held up by the vinyl sheeting. We could not get a contractor to remove it without authorization from the insurance company and the company insurance adjuster did not return calls from us or from two of the contractors. The water stayed under the house for over a week and the mold was spreading in the house. The company insurance adjuster would not authorize removal of soft goods from the house to protect them. He had the furniture and materials moved to an adjoining room where there was not even a door to protect the property from mold spores. One of our contractors is an expert on mold cleanup and they advised we would need to move all of the furnishing out of the home for treatment as they were exposed to mold growth. The company insurance adjuster refused to do this. We received a letter from  the insurance adjuster giving what he declared was the final payment. He said we had voided the contract because we refused to allow the contractors in to work. We have written statements from the contractors, stating they were never told to either stop or start work and putting a lie to the time line he says they communicated to them. The insurance company has already paid twice the amount that the insurance adjuster stated as total damages in that letter. Our problem is we are not lawyers and we do not know how to navigate this system. Please would somebody out there help us. Sandra BarMcQ 505-383-9526, Las Cruces. We do have pictures, we have a test of several mold plates showing an overgrowth of mold throughout the house. One of the molds is an especially toxic one. We also have a letter from a doctor stating responding to these tests that the house could not to be inhabited by anybody.  Again, would somebody out there please help.

A. Your letter has been posted on our website www.certifiedmoldinspectors.com to get the attention of a New Mexico mold attorney to help you. You need to locate a New Mexico attorney who will handle your legal case on a contingency basis---meaning you pay no fees in advance to the attorney. Rather, the attorney gets a percentage of your ultimate insurance settlement or jury award. If the attorney doesn't get money for you, he or she doesn't get paid! One place to locate an attorney is to visit the website www.moldlawyer.com.

[April 8, 2002]

Q. How can I get my homeowners insurance company to reimburse me for all the things we have done inside our home per doctors orders to rid our home of bad air quality, and thereby improving my life, such as pulling up all carpets and putting down wood flooring, changing out duct work in attic, putting in new whole house air purification system with UV light, new furnace, etc.?

A. In order to collect on an insurance policy, there must be an insured peril that your insurance policy specifically covers and that is NOT excluded in the fine print of the policy. Besides being an insured peril, the problem usually has to be "sudden and accidental" and something that happened on a specific date or during a narrow time range that you can prove to the satisfaction of the insurance claims adjuster. Improving your home under a doctor's orders to rid your home of allergens is probably not covered in your insurance policy. To find out for sure, seek out the assistance of a public insurance adjuster or an insurance attorney to study your policy and your situation. A public insurance adjuster represents only you in trying to collect from an insurance company [on a commission basis].

[April 2, 2002]

Q. We had a leaky shower pan and are getting a new shower put in. The demolition of the old shower was yesterday, and there is now mold exposed. Our insurance company has been quick to have a clean-up crew call us, and although I would like to believe they are being nice and doing the right thing, they have been a little too quick and too nice. I'm afraid I won't get the clean-up job done right or may not have everything cleaned as it should be--i.e., can carpet be cleaned, or should it be removed? What about upholstered furniture? Mattresses? Personal belongings in the house? We have been told we may have to get a motel room for a few nights while they run the "air cleaners"--I can't help but wonder if they aren't telling me everything. But I want to believe they are being fair and honest. We do have coverage, but I don't want to agree to all this, and perhaps end up settling for a less than good cleanup, but I don't want to cause unneeded concern or trouble either. I want to get my house cleaned up and life back to normal, but I have health concerns also. Two of my sons have been sicker this last year than ever before--sore throats, coughs, ear infections--taking Zyrtec and Claritin and never had before. One has allergies and asthma, and it's hard to say if he is worse because he has so many pulmonary problems. Maybe I'm making too much of it. I need advice.

A. If you rely solely on your insurance company to do the initial testing, develop the remediation plan, carry it out, and test the area afterwards, you will probably NOT get rid of all of the unhealthy mold growth that may be hidden in your home walls, ceilings, floors, attic, crawl space, basement, and hvac equipment and ducts. You should find out the true facts involved before and after mold remediation by hiring a Certified Mold Inspector to test your home both before and after mold remediation. It is very common that when most remediation is done that the mold problems are just as great or greater than prior to the remediation efforts. To find a Certified Mold Inspector in your area, please visit www.moldprofession.com.

[April 1, 2002]

Q. I currently have a mold claim filed against Allstate September 17, 2001 and am pulling teeth to get any information out of them. They don't want to talk to me don't want to pay added living reimbursements -- keep trying to get me to settle and have hired a mold company to retest my house and they did a shoddy job. How can I make them get a protocol form the first mold company or from a new one? I don't feel safe using their company since the numbers were so far off from the first.

A. You need to hire your own qualified mold inspection and testing company to work ON YOUR DIRECT BEHALF. You can locate qualified Certified Mold Inspectors by visiting the website www.certifiedmoldinspectors.com. Don't just wait for the insurance company to hire an insurance-oriented testing service---hire a testing service that will find ALL OF THE MOLD IN YOUR HOME and search for insurance-covered causes for the mold growth. Once you get the insurance company to accept liability for the mold damage, you can usually get your paid testing fees reimbursed from the company.

[February 21, 2002]

Q. Our house is infested by black mold which makes everybody sick. We are going to move out our house by this week and told not to take anything with us. We are so naive about this situation and do not know what to expect from collecting on a mold insurance claim. My question is the insurance said that they can clean the wood furniture's, but what about the mattress the cloth sofa and couch? we are planning to dispose this things and we want to file a mold insurance claim from our insurance because we think that it will be hard to clean this particular item. Do you think we are right? can we demand that our mold insurance company pay for health purposes that we need to disposed anything that is a treat to our health. I am scared because I do not know how bad is our health now, we still have to see a doctor to find out about our health especially my two children who are sick all the time.

A. In your mold insurance claim, you should insist upon new replacements for any soft materials like mattresses and upholstered furniture. Although such items can sometimes be effectively cleaned of mold contamination, results are not necessary mold-free and the cost can be considerable. By representing yourself against the insurance company, you are asking to be taken advantage of by the insurance company. You will probably get a bigger settlement more quickly if you are represented by either a public insurance adjuster [represents only you against the insurance company on a commission basis], especially a mold insurance adjuster, or a plaintiff's attorney who specializes in suing insurance companies for bad faith in not paying mold insurance claims.
 


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