Insurance Co. mandates repairs.

I did a severe moisture penetration inspection two years ago and the insurance company is still trying to figure out what they will pay for. The roof was pulled off during a roof job when a major rain storm soaked the house all day with rain (blew off the tarps). Moisture was everywhere inside the house and in the attic.

The insurance company called me today to ask me some questions. During the discussion they said that because they do not cover mold issues, there will be no mold inspection or remediation. The subject will not be mentioned, even though I raised the issue in my report.

They are slow to pay and no mold issues will be looked at because the insurance company mandates the repair process.

What is wrong with this picture.?

Insurance Company can pay for what ever repairs or inspections that they are contracted to cover.

Does not mean the Home Owner can not do something else.

Is the home owner going to loose the payments of the insurance company if they try to stop the repair process by bringing in a mold remediation contractor? You can’t do remediation after the walls and ceiling are covered up. Are they suppose to tear it all apart, after the insurance company finishes their repairs (while looking the other way and ignoring the mold)?

The system seems broken to me.

I have no idea John, it may be time for Legal advice on this one.

Client from 4 years ago puts in an insurance claim for a leaking pipe and damage to a ceiling in the kitchen. He is concerned that water leaked into other areas.

Adjuster looks at walls and ceiling, and goes into basement, where he sees one of the walls appears bowed. He looks at the floor in the kitchen (marble tile), and declares it has buckled.

Two days later, the client gets a cancellation notice from the carrier, stating that the house is structurally unstable. Mind you, the adjuster took no measurements, and made no invasive diagnosis.

Client pays me to come back and snoop around. I open the bowed wall and see that sheetrock on one side has pulled away from the moist, moldy 2"x6" vertical studs. The side with the “bow” is the heated side. The opposing finished side is the unheated garage. The insulation in the wall cavity faces the wrong direction. Opposing side of wall is straight as an arrow. Chair rail has pulled away because the end of it was not attached to any nailing surface, just the sheetrock.

Lifted the dropped ceiling tiles in the basement (the home is modular), and viewed the area where the kitchen floor was allegedly buckled. I saw no indication of anything. Put a torpedo level against the underside of the underlayment; level from all sides. Everything is square and securely fastened, with no signs of movement whatsoever.

Used a laser level on the kitchen floor. Used torpedo level at many tiles in multiple directions. Used a 3’ level as well. Checked door openings for plumb and square. Examined sheetrock for signs of separation, cracking, peeling, tearing, etc. Nothing. Check glide characteristics of all sliding doors; fine. Checked kitchen cabinets and countertops; level.

I write a report questioning the adjusters findings, and noting that neither he nor I are professional engineers, but noting that my investigatioin took four hours and used invasive techniques, benchmarks, measurements, etc.

Client sent letter to carrier. They re-instated coverage. But… someone in upper management still cancelled it and insisted they (the insurance carrier) send a PE to follow up.

PE shows up, walks into the kitchen, puts a level on the floor, claims the floor has buckled. Looks at nothing else. Spends a total of 10 minutes in the house, and tells the homeowner their foundation has shifted and needs to be reinforced. Mind you that four years later, I still do not know what type of foundation exists at this house, as literally every foundation surface is finished or hidden. PE is paid by the carrier and regularly works for them.

One last thing… all exterior walls in the basement show no signs of distress, tearing, splitting, etc.

In this instance, the client loses. The insurance company claims they are not responsible to repair structural issues.

Insurance company adjuster’s job is too pay very little out on claims. If an inspector, contractor, or engineer will not give the answers the insurance company wants to hear, the insurance company finds somebody else who is only wanting to make the insurance company happy. I use to work for several insurance companies and I have been let go by most of these insurance companies because I did not give them the answers they wanted to hear.
Most insurance companies will not pay for mold remediation and if they do it is only about $5,000, and if the mold is caused by an outside water source they will not pay at all. Sad but true.

James, all you have to do is change your post words from “insurance company/adjuster” to “real estate agent”, and you can see what problems we are having out here.