INSURANCE CLAIM TIPS FOR MOLD DAMAGE

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INSURANCE CLAIM TIPS FOR MOLD DAMAGE

http://www.unitedpolicyholders.org/claimtips/tip_mold.html

Traditionally, mold damage has been covered where it results from a

covered peril, such as a broken pipe, a storm, or fire suppression

efforts,

but not where it occurs gradually over time due to wear and tear.

However,

public awareness and scientific knowledge of the health hazards of

mold

have increased dramatically. Techniques for cleaning up mold have

become more sophisticated and expensive. As a result, insurers are

panicking, refusing to cover mold claims under existing policies and

rewriting their policy forms to exclude all coverage for mold,

regardless of

origin. This in turn is creating a national crisis. UP believes that

a

combination of governmental regulation, proper underwriting and

competitive forces in the private insurance marketplace will remedy

the

situation.

Meanwhile, here's what to do if you think your property may have a

mold

condition:

1. TAKE MOLD CONTAMINATION SERIOUSLY.

Mold can cause serious illness and property damage. Insurance claim

representatives, adjusters and industry consultants are fond of

dismissively

telling policyholders that mold has been around as long as people

have

been living in houses. Whenever you hear that, cite Leviticus 14:33-

48 to

them–chapter and verse–and tell them that for just as long, " mold

remediation professionals " have been tearing out mold contaminated

walls,

and demolishing entire mold contaminated houses:

The Lord said to Moses and : " When you come into the land of

Canaan, which I give you for a possession, and I put a leprous

disease

[ " mold " or " fungus " ] in a house in the land of your possession, then

he

who owns the house shall come and tell the priest [ " certified

industrial

hygienist " ], 'There seems to me to be some sort of disease in my

house.'

Then the priest shall command that they empty the house before the

priest

goes to examine the disease, lest all that is in the house be

declared

unclean; and afterward the priest shall go in to see the house. And

he shall

examine the disease [ " visual inspection " ]; and if the disease is in

the walls

of the house with greenish or reddish spots, and if it appears to be

deeper

than the surface, then the priest shall go out of the house to the

door of the

house, and shut up the house seven days [ " containment/testing " ]. And

the

priest shall come again on the seventh day, and look; and if the

disease has

spread in the walls of the house, then the priest shall command that

they

take out the stones in which is the disease and throw them into an

unclean

place outside the city [ " licensed land fill " ]; and he shall cause

the inside of

the house to be scraped round about, and the plaster that they

scrape off

they shall pour into an unclean place outside the city; then they

shall take

other stones and put them in the place of those stones, and he shall

take

other plaster and plaster the house [ " remediation/operations &

maintenance

plan " ]. If the disease breaks out again in the house, after he has

taken out

the stones and scraped the house and plastered it, then the priest

shall go

and look; and if the disease has spread in the house, it is a

malignant

leprosy [ " too far gone " ] in the house; it is unclean. And he shall

break

down the house, its stones and timber and all the plaster of the

house; and

he shall carry them forth out of the city to an unclean place

[ " demolition " ].

Moreover he who enters the house while it is shut up shall be

unclean until

the evening; and he who lies down in the house shall wash his

clothes; and

he who eats in the house shall wash his clothes [ " decontamination " ].

But if

the priest comes and makes an examination, and the disease has not

spread

in the house after the house was plastered, then the priest shall

pronounce

the house clean, for the disease is healed [ " clearance testing " ]. "

Leviticus 14:33-48 (Revised Standard Version)

With the introduction of mass-produced building products, tract home

construction techniques, and the national energy conservation drive

in the

wake of the 1973 oil embargo, residential and commercial buildings

have

become more susceptible to developing mold contamination in any

moist

breeding ground. Mold contamination can destroy building products,

finishes, furnishings, and belongings, and cause mild to serious

health

consequences to those exposed.

The more things change, the more they stay the same: Leviticus'

priests

have passed the mighty rod and staff to highly trained Certified

Industrial

Hygienists (CIH), Registered Microbiologists (RM), Certified

Biosafety

Professionals (CSP) and Registered Environmental Health Specialists

(REHS). So, don't be intimidated if your insurance company makes

light

of your concerns.

2. LEARN ABOUT MOLD CONTAMINATION, HEALTH EFFECTS

AND REMEDIATION FROM A RELIABLE SOURCE.

Mold horror stories–and mold jokes–are everywhere. Run the

term " mold "

through your favorite online search engine, and you'll come up with

hundreds of hits (and misses). Always be aware of the bias in any

source

of mold advice you turn to: remediation contractor's commercial web

sites

want to sell you their products and services; insurance industry web

sites

want to downplay the seriousness of the health effects, and

exaggerate the

financial consequences to their bottom line; plaintiff lawyer's web

sites

want to sign you up; insurance defense lawyer's want to impress

insurance

industry clients.

Unfortunately, even the " disinterested " interests of mold experts

are usually

aligned with the commercial interests that generate their income.

How else

could an " objective " scientist have a " conflict of interest " ? In

other words,

some experts usually only work for insurers, and some experts

usually

only work for property owners. Even academic institutions, public

health

organizations and government agencies often have their own political

or

professional agendas coloring the work they do and recommendations

they

make.

With that in mind, here are some helpful online links you can click

on for

information about mold contamination, health effects and

remediation. We

do not maintain the information at these sites, and cannot be

responsible

for their accuracy or completeness:

United States Environmental Protection Agency (EPA):

Mold Resources

Mold Remediation in Schools and Commercial Buildings

Centers For Disease Control And Prevention (CDC), National Center

For

Environmental Health:

Questions And Answers On Stachybotrys Chartarum And Other Molds

Federal Emergency Management Agency (FEMA):

http://www.fema.gov (search for " mold " )

New York City Department of Health, Bureau of Environmental &

Occupational Disease Epidemiology:

Guidelines on Assessment and Remediation of Fungi in Indoor

Environments.

Facts About Mold

California Department of Health Services:

Mold - Background

Mold Q & A

Indoor Air Quality Info Sheet: Mold in My Home: What Do I Do?

Indoor Air Quality Info Sheet: Stachybotrys chartarum (atra)

Health Effects of Toxin-Producing Indoor Molds in California

Fungi and Indoor Air Quality

Bioaerosols and Green-Waste Composting in California (MS Word)

Misinterpretation of Stachybotrys Serology

Washington State Department of Health, Office of Environmental

Health

Assessments:

Is Indoor Mold Contamination a Threat to Health?

University of Minnesota, Department of Environmental Health and

Safety:

http://www.dehs.umn.edu/iaq/fungus/ (Fungus Main Page)

Fungal Glossary

American Academy Of Pediatrics:

Policy Statement Toxic Effects of Indoor Molds

National Association Of Mutual Insurance Companies (an insurance

industry resource site):

www.moldupdate.com

The American Industrial Hygiene Association (AIHA):

www.aiha.org

3. REVIEW YOUR POLICY CAREFULLY. UNDERSTAND YOUR

COVERAGES.

If you don't have a complete copy of your policy, get one from your

insurance agent. Review the " declarations page, " which tells you the

coverages you have, the policy limits for each coverage, and the

effective

dates of the policy. Review the fine print of the policy form itself

to

identify what's insured, what's excluded, and what you have to do to

prove your claim. Review any " endorsements " added on to the policy

form to see if they change, eliminate or add coverages to your

policy.

Homeowner and business property policies typically have separate

coverages for dwelling, contents (personal property), business

personal

property (inventory and fixtures), additional living expenses (if

you have to

move out during repairs), loss of business income (if you are a

business

and can't earn income during repairs), building code upgrade

coverage (if

you have to spend more money to meet current building codes),

" scheduled " personal property items (artwork, jewelry, valuables),

electronic data, and " extra expense " (to relocate or to reconstruct

lost

records or data). If your policy doesn't seem to reflect the

coverage you

thought you had, contact your agent. You may need to contact your

state's department of insurance, a public adjuster (licensed

professionals

that specialize in helping policyholders prepare and submit

insurance

claims) or a policyholder attorney.

Although most states require insurance companies to write their

policies in

plain, ordinary English, the typical insurance policy reads like

Sanskrit -

unintelligible to the average person. Don't be intimidated. There

are no

dumb questions when it comes to understanding an insurance policy.

Mold Contamination Insurance Coverage 101: The Basics

Mold is fungus. There are all kinds. It's everywhere–indoors and

out. At

trace background levels, mold is not usually a problem for most

people.

There are exceptions. Mold needs a moist breeding ground to grow and

reproduce. Mold can grow almost anywhere there is water intrusion,

high

humidity or dampness. Most often mold is confined to areas near the

source of water. As mold grows, it may break down or otherwise

compromises the integrity of its host material. The first 48 hours

after

water damage can be critical in preventing or containing mold

growth.

Mold reproduces by generating spores–microscopic reproductive bodies

similar to seeds. Spores and microscopic fragments of mold growth

are a

natural component of both outdoor and indoor air. However, when mold

germinates and grows, it can produce large amounts of spores.

Elevated

levels of mold spores in indoor living or working environments can

cause

adverse health effects, particularly respiratory problems. When

moldy

material becomes damaged or disturbed, spores can be released into

the

air. Even if you kill the mold with bleach, but don't remove the

mold, when

it dries, you may actually make the problem worse by disturbing the

dry

mold and releasing spores in the air. Exposure can occur if people

inhale

the spores, directly handle moldy materials, or accidentally ingest

them.

Some species of mold are considered benign.

Some species of mold are considered hazardous. And there is

everything

in between. Mold sometimes produces chemicals called mycotoxins.

Mycotoxins can cause moderate to severe illness in people who are

sensitive to them or if they are exposed to large amounts in the

air.

Most mold insurance claims typically arise in one of two

circumstances:

(1) mold comes to the property owner's attention along with the

discovery

of ongoing moisture buildup, water leakage or water intrusion that

has gone

on for some time below the property owner's radar; or (2) after a

sudden,

accidental flood or leak from a plumbing system or appliance, there

is a

delay in or failure to adequately dry out water damaged building

products,

fixtures, furnishings, finishes or belongings.

If you are making a claim to your own insurer for damage to your

property, you are making a " first party " property claim. If you are

asking

your insurer to investigate or defend a claim against you–for

example, your

tenants are suing you for mold contamination–you are making a

" third-party " liability claim to your insurer. Here are some helpful

pointers

for each type of claim.

Property Damage Coverage

Homeowner, commercial property owner and renter property policies

differ in kind and in scope from insurer to insurer. Whether mold

contamination is covered under your policy will depend on the

specific

policy language and the cause or causes of the mold contamination.

Read

your policy carefully. Some property policies are " specified peril "

policies,

which may cover mold contamination if you can prove that it is

caused by

one the listed " perils " or causes. Some property policies are " all

risk "

policies, which may cover mold contamination, unless the insurer can

prove that the cause(s) or the mold contamination itself is excluded

in the

policy.

Most property policies have a long laundry list of exclusions for

damage

caused by mold, dry or wet rot, corrosion, pollution, wear and tear,

deterioration, faulty workmanship and materials, construction

defect, and

the like. To make matters more complicated, some policies have

limited

" exceptions " to the exclusions–kind of like a double negative–that

may

provide some very limited coverage for mold contamination. In

several

states, like California and Texas–in response to insurers

threatening to

boycott coverage for water damage, as well as mold contamination

coverage–insurance regulators are developing rules to permit

insurers to

provide minimum mold contamination coverage, e.g., $5,000 property

limits, unless the policyholder buys more expensive coverage

separately.

Check your policy after it has been renewed to see if mold coverage

limitations have been inserted.

When, however, mold contamination develops as a secondary or

" ensuing " problem from water damage that is covered, your insurance

company may cover the additional cost to remediate the mold

contamination. More often than not, the real fight with your

insurance

company is over identifying the most important cause or causes of

the

mold contamination–are they covered or excluded? The jury is still

out in

most states as to whether mold is a " pollutant " within the meaning

of most

pollution exclusions.

As a general rule, most insurers attempt to exclude coverage for

mold

contamination associated with long-term leakage, moisture or water

intrusion from a construction defect, wear and tear, deferred

maintenance

or poor repairs. Most insurers will acknowledge coverage for mold

contamination associated with accidental discharge of a closed

plumbing

system–as long as you take reasonable steps to protect and repair

the

property after you discover the damage. Accordingly, never speculate

or

guess about the cause(s) of the mold contamination or suggest to or

agree

with your insurance company that the mold must have been around for

a

long time or that there must be some hidden leak somewhere. Wait

until all

the investigation is completed before you acknowledge or agree as to

the

cause(s) of the loss with your insurance company.

Once you determine that you have a covered loss, be sure to go down

the

list of all the coverages in your declarations page, including

additional

living expense (if you have to move out during repairs), and make

sure that

you explore all the benefits you are entitled to.

Third-Party Liability Coverage

In most liability policies, your insurer agrees to defend you if

you're sued,

and to reimburse ( " indemnify " ) you if get hit with a judgment.

Somewhere

in between, there is a duty to settle claims against you. The duty

to defend

you is much broader than the duty to indemnify you: typically the

insurer

must defend you if the person suing you alleges facts that merely

potentially seek damages within the coverage of your policy. You

only

have to show that the claim might be covered, the insurer has to

show

conclusively that the claim cannot under any circumstances be

covered.

Accordingly, immediately tender the defense of any lawsuit against

you to

your insurer by sending a copy of the complaint and summons and

asking

for a defense. Don't wait. Tender early and often. You may not be

able to

recover attorneys fees you have to pay before you tender your

defense to

your insurer. If your insurance company refuses to defend you,

consult a

policyholder attorney to analyze your policy and the claims against

you.

4. CALL YOUR INSURANCE AGENT AND REPORT A SUSPECTED

CLAIM IMMEDIATELY. PUT EVERYTHING IN WRITING.

Call your insurance agent immediately to report a suspected claim.

Follow

the phone call with a fax, an email and a letter. In a catastrophic

flood or

pipe burst claim, getting a remediation team in within the first 48

hours to

begin drying out property can be crucial to preventing or containing

mold

growth. If you get the run-around from your agent, insurance

company,

independent adjuster, or restoration company, follow up with a fax,

an

email and a letter confirming their delay in responding. Be firm,

but always

be courteous. Insurance representatives and adjuster's do have their

own

crosses to bear. If you can elicit the adjuster's sympathy, empathy

or

kindness–or at least avoid ticking them off–your claim is likely to

be

handled more expeditiously.

Take detailed notes of every conversation, including the name,

company,

phone number, address, and job title of every insurance adjuster,

representative, consultant and contractor you deal with. Confirm all

agreements in writing. Insist that appointments and deadlines be

honored.

Keep a log or binder of all notes and letters. Ask for and keep

business

cards from everyone involved in your claim.

5. PROTECT ALL PROPERTY FROM ANY FURTHER DAMAGE,

BUT DO NOT MAKE PERMANENT REPAIRS, AND DO NOT

DISPOSE OF ANY DAMAGED PROPERTY UNTIL AFTER IT HAS

BEEN INSPECTED.

Turn off any water flow to broken appliances or pipes. Take any

necessary emergency measures to protect the building and personal

property from any further damage. Do not throw anything away until

you

have the permission of the insurance company, and you have

documented

its condition. In mold claims you may need to hang on to mold

contaminated items until they can be sampled by a lab for mold

content. If

in doubt, wrap the items in plastic or seal them in a plastic bag

and store

them.

If there is roof damage to your building, you may need to hire a

contractor

to cover it with a plastic tarp or tent the building to protect

against bad

weather. If the insurer delays in authorizing these measures, or in

getting

back to you, confirm the insurer's delay in a fax, email and a

letter, and

take whatever reasonable measures you can afford to protect the

property.

If your loss is covered, the insurance company should also cover the

cost

of any reasonable emergency measures you had to take to protect your

property. It is not unusual for an aggressive insurer to deny

coverage for

damage resulting after the initial claim on the grounds that you

failed to

protect the property from further damage.

6. PHOTOGRAPH, VIDEOTAPE AND INVENTORY ALL DAMAGED

PROPERTY. DOCUMENT YOUR LOSS AS THOROUGHLY AS

YOU CAN, AND DON'T EXAGGERATE, GUESS OR SPECULATE

ABOUT THE LOSS OR THE VALUE OF ANY PARTICULAR PIECE

OF PROPERTY.

Photograph, videotape and inventory all damaged property. Make sure

you

record the date of the photos and videotape. It is important to

document

the source and extent of water intrusion, and visible mold

contamination.

Seal and save contaminated items. In a dispute with your insurer

over

whether any particular building component, finish, furnishing or

belonging

is contaminated, the item may need to be tested by a remediation

consultant–the insurer's and perhaps your own. Don't throw these

items

away until any such issues are resolved in writing.

In most states a material misrepresentation, concealment or omission–

even

an unintentional one–made in connection with the claim–for example,

claiming that an item was destroyed that really wasn't, or

substantially

overstating the value of a damaged item–may give your insurer a

valid

excuse to reject the claim and even rescind the policy. It is not an

uncommon tactic for adjusters and claim representatives who are

predisposed to reject or lowball a claim, to ferret out even minor

discrepancies between your first recorded statement and subsequent

recorded statements, and argue that these discrepancies constitute

material

misrepresentations sufficient to reject your claim. Don't give them

the

opportunity. Don't exaggerate, speculate or guess about the loss or

value

of any particular piece of property. Make it clear to your insurer

when your

recollection may not be accurate, and when you are estimating value,

and

on what you are basing your estimate. It's fine to insert " To Be

Determined " for the value of items you're not sure about. If you

don't have

receipts to show what an item cost, get catalogs, statements from

retail

clerks, bank statements, credit card statements or statements from

family

members or friends. If all else fails, obtain a formal appraisal.

Save this as

a last resort, because your insurer will usually refuse to reimburse

you for

the costs of hiring your on appraiser and consultants.

7. UNDERSTAND YOUR RIGHTS. LEARN YOUR STATE'S LAWS

THAT REGULATE HOW INSURANCE CLAIMS ARE SUPPOSED

TO BE HANDLED.

Every state has statutes and regulations that set minimum standards

for

handling insurance claims. You usually can find these laws through

your

state department of insurance or insurance regulator website. Our

website

links to http://info.insure.com/states/, which in turn links you to

all 50 state

insurance regulatory agencies, where you can typically find a link

to

insurance laws in your state. You can also call your state's

department of

insurance or insurance regulator for information.

8. YOU MUST COOPERATE WITHIN REASON WITH YOUR

INSURANCE COMPANY'S INVESTIGATION AND HANDLING OF

YOUR CLAIM, BUT DO NOT GIVE A RECORDED STATEMENT, A

SWORN STATEMENT OR A SWORN " PROOF OF LOSS " FORM

UNTIL YOU ARE SURE YOU UNDERSTAND YOUR RIGHTS,

YOUR INSURANCE COVERAGE AND THE FULL EXTENT OF

YOUR CLAIM.

You have a contractual obligation under your insurance policy to

cooperate with your insurer in its investigation and handling of

your claim.

You do not have an obligation to allow yourself to be abused. In

most

states you and your insurance company have a reciprocal obligation

to act

in good faith and deal fairly with each other to investigate and

process your

claim. This means that each of you should avoid taking any

unreasonable

position or doing or saying anything that would unreasonably

frustrate

each other's rights under the policy. The insurer should never make

an

unreasonable request to you. You should never refuse a reasonable

request

from your insurer for information related to your claim.

Your insurer may require you to give one or more recorded

statements.

Use your own tape recorder to tape your statement and the insurer's

questions. More often than not, insurers and their attorneys delay

or refuse

to give you a copy of your recorded statement. Do not give a

recorded

statement until your are sure you understand your rights, your

insurance

coverages, and the full extent of your claim.

You may also be required to appear for an " Examination Under

Oath " ( " EUO " ). Your insurer may hire an attorney to take your EUO.

You

may have an attorney present to represent you, but your insurer will

not

pay for your attorney. Do not appear for an EUO until your are sure

you

understand your rights, your insurance coverage and the full extent

of your

claim.

Your insurer may ask you to make available various documents related

to

your claim, including banking statements, investment reports,

receipts and

other personal financial documents. You are not required to produce

your

tax returns, but you are required to produce any other documentation

reasonably related to your insurer's investigation of your claim.

Your

insurer can require you to produce these kinds of documents as long

as

they are reasonably related to its investigation. Do not provide

these

documents to your insurer until your are sure you understand your

rights,

your insurance coverage and the full extent of your claim.

Most policies require that you submit a " sworn proof of loss " form

to

your insurer within a certain amount of time after being provided

the form.

In most states you are contractually obligated to submit the sworn

proof of

loss within the time limit, or at least to substantially comply with

the

requirement, unless you get an agreement from your insurer for more

time

or an agreement to dispense with the sworn proof of loss. Do not

submit

the sworn proof of loss to your insurer until your are sure you

understand

your rights, your insurance coverages, and the full extent of your

claim. It

is not unusual for an aggressive insurer to use mistakes in the

sworn proof

of loss to reduce or reject coverage for a claim.

Aggressive insurers may keep asking you for more and more

information,

anticipating that at some point, you will draw a line in the sand.

If,

however, you refuse to comply with reasonable requests for a

recorded

statement, an EUO, a sworn proof of loss, or documents reasonably

related to your insurer's investigation, you may be giving your

insurer a

valid excuse to deny your claim, based solely your purported breach

of the

duty to cooperate. If you believe that any requests are

unreasonable, ask

you insurer to explain the reason for the requests in writing. Err

on the side

of caution. If in doubt, consult with a policyholder attorney, a

public

adjuster or your state department of insurance, before you say " no

way " to

a request that may–in retrospect–turn out to have been a reasonable

one.

9. NEVER SIGN A RELEASE, WAIVER, INDEMNITY OR " HOLD

HARMLESS " AGREEMENT WITHOUT PROPER LEGAL ADVICE.

You should never have to sign a release to settle an undisputed

claim. If

your insurer, adjuster, consultant or contractor asks you to sign a

release,

waiver, indemnity or hold harmless agreement, ask them to explain

why in

writing. These kinds of agreements can be used to deprive you of

rights

and benefits forever. These kinds of agreements can obligate you to

pay

thousands of dollars for issues that come up down the road that you

never

anticipated. Consult a policyholder attorney as to your rights

before

signing any such agreement.

10. GET A SECOND OPINION. DON'T ACCEPT A LOWBALL

OFFER.

Be wary of " lowball " estimates from insurance friendly contractors.

Get a

second and even a third written estimate to repair and replace

damaged

property from reputable, independent professionals that you would

hire to

do the actual work. You are entitled to have your damaged property

replaced with " like kind and quality. " Insist on it. When you can't

match

the remaining undamaged tile, wallpaper, carpeting, or other

portions of

undamaged property, you are entitled to have the entire " line of

sight "

replaced to match. Insist on it.

Make sure that you understand how your insurance policy pays out on

covered claims. Some losses are paid on " actual cash value, " which

in

many states can mean either the " fair market value " or the cost to

replace

the property, less depreciation for age, wear and tear. Some losses

are

paid out on a replacement cost value. Your policy may permit your

insurer

to pay you actual cash value, and withhold the additional cost to

replace

property until you actually go out and replace it. In recent years,

some

insurers have attempted to also withhold an amount for

contractor " profit

and overhead. " Don't let them. Policyholder attorneys and some

insurance

regulators have successfully prevented insurers from withholding

these

amounts.

If you have a disagreement with your insurer over the amount of your

claim, you may be required by your insurer to submit the dispute to

" appraisal. " Appraisal is a form of binding arbitration to settle

disagreements over the amount of your claim. It typically does not

decide

disagreements about what is covered, what is not covered, what

caused

the loss or poor claims handling problems, unless you and your

insurer

agree to submit those additional disputes to the appraisal. While

appraisal

was initially designed to be an inexpensive, informal resolution of

insurance

disputes, insurers have turned it into one of the most expensive,

over-lawyered, dragged out sideshows in insurance claim resolution.

If you

cannot resolve a dispute with your insurer over the amount of your

claim,

or your insurer demands appraisal, you should consult with a

policyholder

attorney.

11. THOROUGHLY INVESTIGATE THE QUALIFICATIONS,

LICENSE, AND REFERENCES OF YOUR INSURANCE

COMPANY'S " APPROVED " CONTRACTOR BEFORE AGREEING

TO HIRE THEM TO DO THE REPAIRS.

You do not have to use consultants or contractors recommended or

" approved " by your insurer to perform repairs. " Approved "

contractors

are typically contractors who have agreed to discount their labor

and

costs, and follow insurer guidelines, in exchange for a volume of

business

from the insurance company. If your insurer promises to " guarantee "

the

approved contractor's work, the " guarantee " is generally limited to

replacing any defective materials or correcting faulty workmanship.

Your

insurer is not insuring against any contractor delays, negligence or

liability.

Accordingly, do not use the " approved " contractor unless it is a

contractor that you would independently hire to do the work after a

thorough screening.

Be sure to check that each contractor's license is valid, and for

any

complaints against the license. Be sure that the contractor is

bonded and

insured. You can usually find some of this information online at

your

state's contractor licensing agency website.

12. GET PROFESSIONAL HELP IF YOU NEED IT.

If you reach an impasse with your insurer, be sure to document the

dispute

fully in writing. Explain why your position is reasonable, and your

insurance company's position is not reasonable. If your dispute does

not

necessarily require legal advice, you may be able to resolve the

dispute by

calling your state's department of insurance or insurance regulator,

or by

hiring a public adjuster. If your dispute requires legal advice,

contact a

lawyer who is experienced and specialized in representing

policyholders.

If you need a qualified consultant for testing or advice about mold

remediation, be sure to contact a qualified certified industrial

hygienist

(CIH) with experience in microbial contamination and testing. You

can find

a qualified firm in your area by searching through the American

Industrial

Hygiene Association's website at

http://www.aiha.org/ConsultantsConsumers/html/consultantshome.htm.

There are a lot of consultants out there who have jumped on

the " mold

bandwagon " without adequate training or experience.

13. MAKE SURE YOU KNOW ALL THE DEADLINES THAT MAY

CUT OFF YOUR RIGHT TO FILE A LAWSUIT.

All states have statutes of limitation that will cut off your right

to bring a

lawsuit against your insurance company if you don't file a lawsuit

in time.

The statutes of limitation differ from state to state. Most property

insurance policies have a shorter contractual limitation period that

will cut

off your right to bring a lawsuit against your insurance company if

you

don't file a lawsuit in time. These periods are typically one year

or two

years after a loss occurs or after you first discover a loss.

Sometimes the

" clock " stops running during the time your claim is pending, and

starts

again once your insurer denies your claim. In most states your

insurance

company is required to tell you in writing that your claim is

denied, and

that the limitations clock is running. Make sure you understand all

possible

deadlines. Consult with a policyholder attorney sooner, rather than

later.

You will make it harder for a policyholder attorney to give you the

representation you deserve, if you show up on her doorstep the day

before

the clock stops ticking.

14. REPORT ALL UNFAIR CLAIM HANDLING TO YOUR

DEPARTMENT OF INSURANCE OR INSURANCE REGULATOR.

Most state insurance regulators track policyholder complaints about

their

insurers and compile the results. The results may be available

through your

state insurance regulator's web site. In some states you can file a

formal

complaint online. Insurance regulators also regularly

compile " market

conduct " reports on unfair claim practices. If you don't file a

complaint,

you can't make a difference.

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UP thanks Schindler for drafting and Amy Bach and Stan Parrish

for

editing this tip sheet.

United Policyholders is a non-profit organization founded in 1991

and

dedicated to educating the public on insurance issues and consumer

rights.

UP is a resource and a voice for insurance consumers throughout the

United States. We have provided insurance claims assistance and

information to disaster victims in Northern California in the

Oakland/Berkeley hills, Point Reyes/Inverness, Napa and Sacramento

Counties, in Southern California in Northridge, Malibu and Laguna

Hills, in

Texas, Florida, New Mexico, and in Oregon. We file pro-policyholder

briefs in precedent-setting insurance cases in every major state. We

advocate the consumer perspective in public policy forums on

insurance

issues. Write to UP at 110 Pacific Ave., PMB 262, San Francisco, CA.

94111, or call us at (510) 763-9740.

The information presented in this Site is for general informational

purposes, and should not be taken as legal advice. If you have a

specific

legal issue or problem, United Policyholders recommends that you

consult

with an attorney. United Policyholders does not sell insurance or

certify,

endorse or warrant insurance products or vendors. United

Policyholders is

not a referral service.