Insurance Claims Associated With Water Damage & Mold

Will an Insurance Company Pay For Environmental Testing?

Though terms of insurance policies vary depending on numerous factors, often damages to property associated with rainwater and plumbing leaks are coverable.

Though an insurance company may not suggest environmental testing, they will often approve covering costs associated with testing if the property owner requests it and if their preliminary evaluation of the claim indicates that the claim is coverable.

Scope of Work

The extent of coverable repairs can be influenced by the scope of work defined by an adjuster or repair company, which is often limited to what they can visually observe. Often the scope of work needed to address airborne mold and/or bacteria associated with water damage may be much greater than what can be observed with the naked eye.

Lab analysis for microbiological contamination can indicate that additional work activities need to be performed to reduce levels of contaminants associated with microbiological activity on surfaces and in the air. Lab analysis can also indicate the need for additional work activity to be performed to reduce microscopic allergens associated with building material debris such as drywall dust, talcum, and glass-like insulation particulates, which become airborne when demolition occurs.

Avoid Health & Financial Risks

The financial and health consequences associated with not performing environmental testing prior to defining the scope of work for a water damage event can be significant. Exposure to allergens and toxins associated with water damage and building material debris can result in health symptoms. Residual microbiological contaminants sealed within wall and ceiling cavities, in carpet, on surfaces, or in the air can result in future microbiological growth, more health symptoms, and future expenses associated with decontamination. 

For these reasons it’s important to perform air and surface testing for contaminants and toxins associated with mold, building materials, and sometimes bacteria, whenever there is a rainwater or plumbing leak.

Preferred Vendors List

Insurance companies often provide a list of service providers who perform repairs associated with a claim. You may find that service providers on the list provided by your insurance company may not challenge the scope of work recommended by the insurance adjuster, though the scope of work recommended by the insurance adjuster may not necessarily be conducive to addressing concerns associated with contamination.

In some instances the full scope of work needed to address a water damage event is not completely coverable by an insurance policy. The property owner still needs to know the full scope of work so that the work is performed properly, whoever pays for it.

An insurance adjuster may limit his prescribed scope of work to what he believes is coverable by the associated policy. A service provider on an insurance company’s preferred vendor list may faithfully execute the scope of work as prescribed by the adjuster. This, of course does not mean that the work prescribed and performed are conducive to addressing the health and safety concerns associated with a water event. Without lab analysis it is not possible to know the extent that microbiological and building material contamination has occurred.

In some instances, insurance adjusters and service providers differ in their opinions about the scope of work, especially when the service provider is not on the preferred vendor list. Keep in mind that establishing the actual scope of work needed is a different conversation than establishing the amount of coverage that your policy allows.

If you first establish the actual scope of work without regard for the cost or who is paying for it, and if you ensure that the scope of work is justified by documented objective visual and laboratory evidence, the process of determining what is coverable by your insurance policy may unfold more accurately.

For these reasons, if you have water damage associated with a rainwater or plumbing leak, always perform testing of air and surfaces to determine the extent that contamination has occurred. Consider getting a quote to remediate and repair all damages and contamination associated with water damage in writing prior to settling your insurance claim.

Call Indoor Air Quality Services at 770-363-2670 to discuss your situation and concerns or to schedule an appointment for testing.