When toxic mold is discovered in a home or rental property, many tenants and homeowners turn to their insurance policies for help covering remediation and medical costs. Unfortunately, getting mold damage covered by insurance isn’t always straightforward. Insurance companies often deny mold-related claims, arguing that the mold was caused by something outside the policy’s coverage or that it falls under maintenance exclusions.
If you’re facing toxic mold and your insurance company is refusing to cover the costs, understanding the common tactics used by insurers can help you fight back. In this article, we’ll explain how mold is covered by insurance, what a covered peril is, and how insurers attempt to deny claims for mold damage.
One of the most common reasons insurance companies deny mold claims is by arguing that the mold was not caused by a covered peril. A covered peril refers to a specific type of event or condition that is explicitly covered under your insurance policy. Common covered perils include:
If mold develops as a result of one of these events, it may be covered by your policy. For example, if a pipe bursts and causes water damage that leads to mold growth, the mold remediation costs might be covered because the burst pipe is a covered peril. However, if the mold develops slowly over time due to a leaky roof or poor maintenance, the insurance company may deny your claim, arguing that it is not a covered peril.
Insurance companies use several common tactics to deny coverage for mold damage, even when mold is caused by a covered peril. Here are some of the most frequent arguments insurers use to reject mold claims:
Most insurance policies contain exclusions for mold that develops due to maintenance problems, such as leaks that go unfixed or poor ventilation in bathrooms or kitchens. Insurers may argue that you, as the homeowner or tenant, failed to properly maintain the property and that the mold growth is your responsibility, not theirs.
To counter this, it’s crucial to have documentation showing that the mold was caused by a specific event (e.g., a burst pipe) and not due to poor maintenance. A mold inspection report and photos of the damage can help strengthen your case.
Another common reason for denying a claim is the assertion that the mold was pre-existing. Insurers may argue that the mold was present in the home before the event you’re claiming caused it, which allows them to deny coverage.
If you’ve recently purchased the home or rented the property, it’s important to prove that the mold developed after a covered peril, not before. Having a pre-move-in inspection report can help show that the mold developed after you took possession of the property.
Insurance policies typically require policyholders to report damage within a specific timeframe. If you delay reporting mold, even by a few weeks, the insurance company may deny your claim on the grounds that you did not notify them promptly. This is why it’s crucial to report mold damage as soon as you discover it.
Fighting an insurance company’s denial can be challenging, but working with the best toxic mold lawyer can make a significant difference in your case. A skilled attorney can review your insurance policy, gather evidence to prove that mold was caused by a covered peril, and negotiate with the insurance company on your behalf.
In some cases, your lawyer may recommend hiring a mold remediation expert to testify that the mold was the result of a sudden event, like a pipe burst, and not a maintenance issue. If negotiations fail, your attorney can take the case to court to ensure you receive the coverage you’re entitled to.
Dealing with toxic mold is stressful enough without having to fight your insurance company for coverage. Understanding how mold claims are handled—and the common tactics insurers use to deny them—can help you take the right steps to secure coverage. If your claim has been denied or delayed, contact Ironclad Injury Law to speak with the best toxic mold lawyers for your case. We’ll fight for your rights and ensure that you receive the compensation you deserve.
