Hi there. I am looking for some general advice relative to a customer before I engage claims rep. I'll try to be as brief as possible but there's a little bit to this. This property is located in TN.
Customer has had some past water claims between 5-10 yrs old. Claims originated from water leaks in guest bathroom and master bathroom (separate legit claims, different times). Each time, carrier dried out the water damage, removed some drywall, and replaced to get the bathrooms working again. Typical water claims, right?
Well, customer's wife has been having some pretty major health issues within the last couple of years. After seeing several doctors and not getting any answers, they ran a test that measures mold toxicity in the blood. It turns out that she has high levels of mold in her bloodstream and that is the likely culprit of her health issues.
These customers are also friends of mine, and I have been to their house many times. They keep a nice house and there is certainly no visible indication of mold. They hired an independent mold inspector who did an exhaustive inspection on the house. Turns out that there are concentrations of toxic mold centered around samples taken from the areas that were previously remediated and repaired from previous claims. Sample data is very thorough and explicit in the findings that the problem areas likely are the subfloor and underlying floor joists under the prior problem areas. To completely fix this issue, the inspector believes that these bathrooms are going to have to be demo'd, problem areas are going to have to be disposed of (not treated) and replaced, and the bathrooms redone.
Customer has replacement cost HO3 policy and still has the same carrier they've had throughout these prior claims. They have basically $10k per occurrence in mold property coverage and $50k mold coverage coming out of coverage E (liabilty), which i don't believe helps much in this case.
Here are my questions, and I know all states vary, and all policies differ, but I'm just reaching out to see what info or advice I can get on how to help before I engage an adjuster and ding their claims history.
1. In your experience, do you believe the $10k mold coverage is their only recourse here? I personally believe that since there's correlation between mold inspection results and the location of the prior claims, there's got to be some way for the company to go back and make things right.
2. How far back have you ever seen a carrier go to reopen old claims? Or in your experience, would it trigger a new claim? What is the basis of a new claim without a loss?
3. Simply put, if it were you and you were trying to help your customer, what do you do?
I'm glad to answer any questions you may have but I'd rather keep the carrier name private.
Many thanks in advance!
Customer has had some past water claims between 5-10 yrs old. Claims originated from water leaks in guest bathroom and master bathroom (separate legit claims, different times). Each time, carrier dried out the water damage, removed some drywall, and replaced to get the bathrooms working again. Typical water claims, right?
Well, customer's wife has been having some pretty major health issues within the last couple of years. After seeing several doctors and not getting any answers, they ran a test that measures mold toxicity in the blood. It turns out that she has high levels of mold in her bloodstream and that is the likely culprit of her health issues.
These customers are also friends of mine, and I have been to their house many times. They keep a nice house and there is certainly no visible indication of mold. They hired an independent mold inspector who did an exhaustive inspection on the house. Turns out that there are concentrations of toxic mold centered around samples taken from the areas that were previously remediated and repaired from previous claims. Sample data is very thorough and explicit in the findings that the problem areas likely are the subfloor and underlying floor joists under the prior problem areas. To completely fix this issue, the inspector believes that these bathrooms are going to have to be demo'd, problem areas are going to have to be disposed of (not treated) and replaced, and the bathrooms redone.
Customer has replacement cost HO3 policy and still has the same carrier they've had throughout these prior claims. They have basically $10k per occurrence in mold property coverage and $50k mold coverage coming out of coverage E (liabilty), which i don't believe helps much in this case.
Here are my questions, and I know all states vary, and all policies differ, but I'm just reaching out to see what info or advice I can get on how to help before I engage an adjuster and ding their claims history.
1. In your experience, do you believe the $10k mold coverage is their only recourse here? I personally believe that since there's correlation between mold inspection results and the location of the prior claims, there's got to be some way for the company to go back and make things right.
2. How far back have you ever seen a carrier go to reopen old claims? Or in your experience, would it trigger a new claim? What is the basis of a new claim without a loss?
3. Simply put, if it were you and you were trying to help your customer, what do you do?
I'm glad to answer any questions you may have but I'd rather keep the carrier name private.
Many thanks in advance!