Insurance coverage?

[Guest guest]

I WAS DIANOSED FOR HEP C IN 1998...WENT TO GET TX..NEVER ASKED..NEVER TOLD I GOT THE "SO CALLED" MEDICATION..AS YOU CAN TELL...I DIN;T FINISH TX..

[Guest guest]

I GAVE BLOOD AT BLOOD BANK IN 1995...AND GOT TX IN 2003

[Guest guest]

Is this for only the state you are in, or is this nationwide? That would

definitely account for the statistics that posted from time to time as to

how many people in the USA have Hepatitis C...

Princess

http://groups.msn.com/HCVReflections/

[ As I recall the dr that discovers the positive result for hcv is required

to report it to the health department. ]

[Guest guest]

Do insurance companies ever pay for mold remediation work?

Thanks.

[Guest guest]

Pwr2Heal,

Yes, insurance companies still pay for mold remediation work but

there are word games they play. So the simple (but useless)

answer is " yes, " " no, " and " it depends. "

Most insurance companies have excluded mold entirely, some

have a cap on the amount and a few high-end policies have little

or no restriction.

The ones which exclude or severely limit mold coverage play

word games. If they hear the word " mold " they include all the

remediation, including the water damage part, under the category

of " mold. " They should be excluding only that part of the work

specifically dealing with mold, not the underlying water conditions

which caused the mold.

Also, if they delay the adjustor arriving for more than a couple of

days then any mold resulting from the delay should be covered

because it's often their fault for not allowing work to begin quickly

enough.

Most insurance companies with limitations on mold will categorize

costs for containment and PPE for workers as mold costs. In

2006 the ANSI-IICRC S500 Standard and Reference Guide for

Professional Water Damage Restoration identified containment

and PPE as necessary to control the dust and other debris from

water damage restoration whether mold was present or not. If

mold were present then there would be no extra cost for the mold

because it is controlled by the water damage procedures.

Insurance companies are acutely aware of this because some

are now starting to exclude water damage, not just mold.

Another way insurance companies are paying for mold is if the

remediation company - especially if sent or recommended by the

ins company - screws up and does not prevent additional mold

growth or they cross-contaminate. Then the insurance company

should cover that and recover from the remediation company.

Finally, some adjustors will claim the mold growth was pre-

existing and is therefore not covered. The response here is for a

qualified consultant to evaluate the situation. If there is any new

mold growth then it should be removed. But does the ins

company want to pay for massively extensive testing to try to

separate the old mold growth from the new mold growth? Usually

not. So they try to pay for nothing. But a strong case can be made

to remove it all (or at least most of it) because even old mold

growth may grow again and amplify from the new water.

As you can see, there is no simple answer and an understanding

of insurance practices is helpful. The better water damage

restorers and mold remediators know this and how to work with

insurance companies. This is in addition to a competent ability to

diagnose and fix the damage and the underlying conditions.

Consultants can play an equally important role by keeping

remediators and restorers " honest " by writing an appropriate

" Goldilocks " scope of work which is neither too much or too little,

but just right. They are also an independent source of

information, judgment, and most importantly verification.

(Verification criteria should include the ability of the occupants to

re-enter without reaction or complaint).

If there are any insurance people out there who think I've

mistated anything I'd love to hear from you so we can all get the

latest and the most accurate information.

Carl Grimes

Healthy Habitats LLC

-----

Do insurance companies ever pay for mold remediation work?

Thanks.

[Guest guest]

Carl made some good points, but left out some other criteria. Mold related to

ordinary maintenance is not covered. For example, if a drain trap under your

sink rusts through and leaks a little, resulting in mold, it's not covered. If

your roof leaks due to old shingles which should have been replaced 5 years ago

and mold forms in your attic, that's not covered. If a sewer pipe in your

basement or crawl space deteriorates and leaks, resulting mold (and other

biohazards) is not covered. The building owner is responsible for all preventive

maintenance, and resulting damage from neglect is not covered. Many policies

also exclude coverage from sewer back-up. Construction defects also are not

covered. If your builder did not waterproof the basement, or didn't install an

adequate vapor barrier in the crawl space, resulting mold is not covered. It's

an issue between the owner and the builder. A major such case was synthetic

stucco (Dryvit Systems and others). Mold was so bad in some homes' exterior

walls that even the studs needed replacing. A construction defect not covered by

homeowner's insurance.

What is covered? Catastrophic events should result in valid insurance claims.

A tornado damaging your roof qualifies, and resulting mold in the attic also

might qualify, if you took steps to minimize damage after the storm. A burst

water supply pipe is sudden and catastrophic. Related mold damage should be

covered. But, if you went on vacation, didn't turn off the water (who does?) and

come home three weeks later and find a moldy house with six inches of water in

the basement, the company might claim your negligence in failing to turn the

water off while away an extended time. Read your policies and learn how

insurance might protect you, but fail to protect you from the negligence of

yourself or other building owner.

Re: Insurance coverage?

Posted by: " Carl E. Grimes " grimes@... grimeshh

Date: Sat Aug 28, 2010 1:16 pm ((PDT))

Pwr2Heal,

Yes, insurance companies still pay for mold remediation work but there are word

games they play. So the simple (but useless) answer is " yes, " " no, " and " it

depends. "

Most insurance companies have excluded mold entirely, some have a cap on the

amount and a few high-end policies have little or no restriction.

The ones which exclude or severely limit mold coverage play word games. If they

hear the word " mold " they include all the remediation, including the water

damage part, under the category of " mold. " They should be excluding only that

part of the work

specifically dealing with mold, not the underlying water conditions which caused

the mold.

Also, if they delay the adjustor arriving for more than a couple of days then

any mold resulting from the delay should be covered

because it's often their fault for not allowing work to begin quickly enough.

Most insurance companies with limitations on mold will categorize costs for

containment and PPE for workers as mold costs. In

2006 the ANSI-IICRC S500 Standard and Reference Guide for Professional Water

Damage Restoration identified containment

and PPE as necessary to control the dust and other debris from water damage

restoration whether mold was present or not. If

mold were present then there would be no extra cost for the mold because it is

controlled by the water damage procedures.

Insurance companies are acutely aware of this because some are now starting to

exclude water damage, not just mold.

Another way insurance companies are paying for mold is if the remediation

company - especially if sent or recommended by the

ins company - screws up and does not prevent additional mold growth or they

cross-contaminate. Then the insurance company

should cover that and recover from the remediation company.

Finally, some adjustors will claim the mold growth was pre-existing and is

therefore not covered. The response here is for a

qualified consultant to evaluate the situation. If there is any new mold growth

then it should be removed. But does the ins

company want to pay for massively extensive testing to try to separate the old

mold growth from the new mold growth? Usually

not. So they try to pay for nothing. But a strong case can be made to remove it

all (or at least most of it) because even old

mold growth may grow again and amplify from the new water.

As you can see, there is no simple answer and an understanding of insurance

practices is helpful. The better water damage

restorers and mold remediators know this and how to work with insurance

companies. This is in addition to a competent ability to

diagnose and fix the damage and the underlying conditions. Consultants can play

an equally important role by keeping

remediators and restorers " honest " by writing an appropriate " Goldilocks " scope

of work which is neither too much or too little,

but just right. They are also an independent source of information, judgment,

and most importantly verification.

(Verification criteria should include the ability of the occupants to re-enter

without reaction or complaint).

If there are any insurance people out there who think I've mistated anything I'd

love to hear from you so we can all get the

latest and the most accurate information.

Carl Grimes

Healthy Habitats LLC

[Guest guest]

Gil,

Thanks for the excellent additional information. Very important to read the fine

print. Because in one place they say they cover something and later they take it

away. Some policies cover a few negligent acts but others don't.

This isn't a problem just for homeowners but also the trades, consultants and

contractors for their various forms of liability insurance.

Be particularly diligent for changes when your policy renews or you get a change

of coverage notice. When you have a claim verify what the coverage was at the

time of the claim.

As is more than obvious by now insurance is complicated. Read the policy closely

and don't assume.

Carl Grimes

Healthy Habitats LLC

(fm my Blackberry)

[] Re: Insurance coverage?

Carl made some good points, but left out some other criteria. Mold related to

ordinary maintenance is not covered. For example, if a drain trap under your

sink rusts through and leaks a little, resulting in mold, it's not covered. If

your roof leaks due to old shingles which should have been replaced 5 years ago

and mold forms in your attic, that's not covered. If a sewer pipe in your

basement or crawl space deteriorates and leaks, resulting mold (and other

biohazards) is not covered. The building owner is responsible for all preventive

maintenance, and resulting damage from neglect is not covered. Many policies

also exclude coverage from sewer back-up. Construction defects also are not

covered. If your builder did not waterproof the basement, or didn't install an

adequate vapor barrier in the crawl space, resulting mold is not covered. It's

an issue between the owner and the builder. A major such case was synthetic

stucco (Dryvit Systems and others). Mold was so bad in some

homes' exterior walls that even the studs needed replacing. A construction

defect not covered by homeowner's insurance.

What is covered? Catastrophic events should result in valid insurance claims.

A tornado damaging your roof qualifies, and resulting mold in the attic also

might qualify, if you took steps to minimize damage after the storm. A burst

water supply pipe is sudden and catastrophic. Related mold damage should be

covered. But, if you went on vacation, didn't turn off the water (who does?) and

come home three weeks later and find a moldy house with six inches of water in

the basement, the company might claim your negligence in failing to turn the

water off while away an extended time. Read your policies and learn how

insurance might protect you, but fail to protect you from the negligence of

yourself or other building owner.

Re: Insurance coverage?

Posted by: " Carl E. Grimes " grimes@... grimeshh

Date: Sat Aug 28, 2010 1:16 pm ((PDT))

Pwr2Heal,

Yes, insurance companies still pay for mold remediation work but there are word

games they play. So the simple (but useless) answer is " yes, " " no, " and " it

depends. "

Most insurance companies have excluded mold entirely, some have a cap on the

amount and a few high-end policies have little or no restriction.

The ones which exclude or severely limit mold coverage play word games. If they

hear the word " mold " they include all the remediation, including the water

damage part, under the category of " mold. " They should be excluding only that

part of the work

specifically dealing with mold, not the underlying water conditions which caused

the mold.

Also, if they delay the adjustor arriving for more than a couple of days then

any mold resulting from the delay should be covered

because it's often their fault for not allowing work to begin quickly enough.

Most insurance companies with limitations on mold will categorize costs for

containment and PPE for workers as mold costs. In

2006 the ANSI-IICRC S500 Standard and Reference Guide for Professional Water

Damage Restoration identified containment

and PPE as necessary to control the dust and other debris from water damage

restoration whether mold was present or not. If

mold were present then there would be no extra cost for the mold because it is

controlled by the water damage procedures.

Insurance companies are acutely aware of this because some are now starting to

exclude water damage, not just mold.

Another way insurance companies are paying for mold is if the remediation

company - especially if sent or recommended by the

ins company - screws up and does not prevent additional mold growth or they

cross-contaminate. Then the insurance company

should cover that and recover from the remediation company.

Finally, some adjustors will claim the mold growth was pre-existing and is

therefore not covered. The response here is for a

qualified consultant to evaluate the situation. If there is any new mold growth

then it should be removed. But does the ins

company want to pay for massively extensive testing to try to separate the old

mold growth from the new mold growth? Usually

not. So they try to pay for nothing. But a strong case can be made to remove it

all (or at least most of it) because even old

mold growth may grow again and amplify from the new water.

As you can see, there is no simple answer and an understanding of insurance

practices is helpful. The better water damage

restorers and mold remediators know this and how to work with insurance

companies. This is in addition to a competent ability to

diagnose and fix the damage and the underlying conditions. Consultants can play

an equally important role by keeping

remediators and restorers " honest " by writing an appropriate " Goldilocks " scope

of work which is neither too much or too little,

but just right. They are also an independent source of information, judgment,

and most importantly verification.

(Verification criteria should include the ability of the occupants to re-enter

without reaction or complaint).

If there are any insurance people out there who think I've mistated anything I'd

love to hear from you so we can all get the

latest and the most accurate information.

Carl Grimes

Healthy Habitats LLC

[Guest guest]

Hi, broadening the insurance discussion a bit, I have come to believe

thru my struggles with blue shield, that insurance as we think of it is

not really insurance. It almost always ends up not covering and

excluding what we need it to include, whether it be house related or

medical related or something else, I have had this experience now with

medical, home, and even school tuition insurance. They take your $'s in

premiums and then when you need the help it's all delay, deny, don't

pay....For profit insurance means maximize revenues, in this case the

premiums, and deny payouts, maximize profits......

sue v.

Gil,

>

>Thanks for the excellent additional information. Very important to read

>the fine print. Because in one place they say they cover something and

>later they take it away. Some policies cover a few negligent acts but

>others don't.

>

>This isn't a problem just for homeowners but also the trades,

>consultants and contractors for their various forms of liability insurance.

>

>Be particularly diligent for changes when your policy renews or you get

>a change of coverage notice. When you have a claim verify what the

>coverage was at the time of the claim.

>

>As is more than obvious by now insurance is complicated. Read the policy

>closely and don't assume.

>

>Carl Grimes

>Healthy Habitats LLC

>(fm my Blackberry)

>