Knowing the ins and outs of mold damage insurance claims is more important than ever.
Toxic mold homeowners’ insurance claims have increased significantly since 2018. The average settlement has increased significantly, too. Usually, the insurance company must not only replace the damaged area but also redo the room or even the entire home.
To fight against this rising tide, many insurance adjusters are fussier than ever. Frequently, they claim that simply drying out the area cures the problem. Many companies conveniently overlook the fact that an insurance policy is a two-way street. Frequently, policyholders make sacrifices to pay premiums. When these homeowners file claims, they’re entitled to the same treatment.
A New Orleans insurance claims lawyer plays several vital roles in this process.
First, lawyers help homeowners find the right policies, coverages, and providers to fit their needs. Second, lawyers review policies with homeowners, so they clearly understand their rights and responsibilities and are ready to file claims if needed. Third, if the claims process goes sideways, a New Orleans insurance lawyer intervenes on behalf of a homeowner.
Understanding Mold Damage
“Mold” includes several types of fungi, all of which grow in moist environments, cling to surfaces, and release toxic spores. Common causes of mold infestations include:
- Water leaks (from pipes, roofs, or windows),
- Floods,
- A combination of high humidity and improper ventilation (a condition that describes almost every older home in the New Orleans area), and
- Poor HVAC maintenance that causes excess condensation.
Some structural issues in homes, like sagging foundations or wind-damaged roofs, develop slowly over time. Mold, on the other hand, develops within forty-eight hours of water exposure. The aforementioned house issues are usually localized. But untreated mold spreads quickly, causing:
- Wood rot and structural damage,
- Staining and odors, and
- Respiratory problems and allergic reactions.
Not even the fastest insurance company can get a repair crew onsite in under forty-eight hours and treat the localized problem. Instead, by the time remediation begins, mold has usually spread throughout the house, requiring extensive (and expensive) remediation. That’s where a good insurance policy comes into play.
Does Homeowners Insurance Cover Mold Damage?
The short answer, which you probably never expected, is maybe. Most standard homeowners’ insurance policies apply to covered peril mold damage. A “covered peril” refers to specific risks listed in your policy, such as:
- Sudden pipe bursts,
- Accidental water overflow from appliances, and
- Storm-related roof damage that causes leaks.
What do all these things have in common?
We’re glad you asked. In one way or another, they’re almost completely beyond the homeowner’s control.
Defective products or substandard installation usually cause pipe bursts, at least in this neck of the woods. Examples of accidental overflow include children overfilling bathtubs and adults improperly hooking up the washing machine. A storm is an act of God.
Sometimes, homeowner maintenance is a contributing cause. A contributing cause usually does not trigger a policy exclusion. Examples of water leaks substantially caused by homeowner negligence include:
- Slow and gradual leaks or seepage,
- Most excess humidity and condensation issues, and
- Flooding (unless you have separate flood insurance).
When most insurance adjusters see “mold,” they immediately think “negligence.” So, before the adjuster comes onsite, ask a mold remediation company for a “free” inspection. You will most likely pay something and almost certainly listen to an aggressive sales pitch, but the report is valuable evidence in the claims process.
Types of Mold Coverage
Especially in Louisiana, every policy is different, but in most cases, two main clauses apply to coverage for mold damage:
- Standard Coverage with Limitations: Most policies that include mold coverage cap it with a sub-limit, such as $5,000 or $10,000 for remediation. This amount may not be high enough if mold has spread extensively or if professional remediation is required.
- Mold Endorsement (Rider): Some insurers offer an optional mold endorsement, which expands coverage for mold-related damage and increases policy limits. Usually, coverage limits are high and premiums are low. Therefore, if you live in a humid or flood-prone area, a mold rider is at least worth a look.
Carefully review your policy or speak with your insurance agent to understand your specific coverage and whether purchasing additional protection makes sense. Understand, however, that the agent wants to sell you a policy. A New Orleans insurance lawyer is a neutral party.
Filing a Mold Damage Insurance Claim
Determining potential coverage is just the first step. Follow these tips to increase the likelihood of claims approval:
- Act Quickly: We can’t over-emphasize this point. Insurance companies expect homeowners to take immediate steps to prevent further damage. Delay almost always results in denial. Notify the company and get confirmation of receipt.
- Document Damage: Note that policyholders should file claims before they document damage. Time is that critical. Smartphone video usually clearly records moisture source, visible mold growth, and damage to floors, walls, appliances, or personal items. Expert camera work often speeds the response process. Insurance companies always prefer quick, cheap fixes to expensive remediation.
- Demonstrate Mitigation: This step is simple but critical. Mitigating damages basically means voluntarily reducing them, which in this case means turning off the water, plugging the leak, clearing the cabinet or other affected area, and so on.
- Contact a Professional: We mentioned this step above. Now, let’s break it down a little more. Most mold professionals produce written reports that identify the moisture source, assess the extent of the mold infestation, and propose a remediation plan.
- Record Expenses: Covered or not, save all receipts for necessary temporary lodging, remediation and repairs, cleaning supplies, and contractor work. Even if these expenses aren’t covered, they help establish the extent of the damage.
Plenty of things are on the to-do list, but only one major item is on the “don’t do this” list. Avoid major damage with DIY remediation. Anyone can clean minor surface mold on tile as part of the aforementioned mitigation process.
But large outbreaks require professional removal to prevent health risks and meet insurance standards. Improper cleanup usually makes things worse and jeopardizes the claim.
Appealing Claims Denials
Mold claims are frequently denied due to maintenance issues or policy exclusions. Usually, mold remediation is far too expensive to pay out of pocket. A New Orleans insurance lawyer assists homeowners through the complicated claims appeal process.
Frequently, rather than fight an appeal, insurance companies offer partial payouts. Once again, an attorney helps determine if the offer is fair, given all the facts and circumstances.
Preventing Future Mold Issues
Frequently, an ounce of prevention is worth a pound of cure. Since insurance may not always help, prevention is your best defense. To reduce the risk of mold:
- Repair leaks immediately,
- Use dehumidifiers in damp areas,
- Ensure good ventilation in bathrooms and kitchens,
- Inspect roofs, plumbing, and HVAC systems annually, and
- Use mold-resistant materials in high-risk areas (e.g., basements)
These steps not only protect your property but also improve your chances of a successful claim if a mold infestation does occur.
Contact Our New Orleans Mold Damage Attorney
Insurance companies take advantage of policyholders if they can. For a confidential consultation with an experienced mold damage claims lawyer in New Orleans, contact Insurance Claim HQ.
