Homeowners Insurance Mess

Another reason I haven't been blogging much a of late. I'll just post the e-mail we sent today rather than try to rehash my pain again.

To all parties concerned regarding X claim,

First, thank you to Mr. M for taking the time to put A Inc.'s [restoration contractor] recommendations and concerns in writing.

We have experienced nothing but confusion and frustration since we made a water damage claim on the evening of May 6th 2007 . On the evening of May 6th, we returned home after being out of our home for the day. While looking for something, we discovered a pool of water under the kitchen sink and water running down the backside of the cold water pipe. We immediately went downstairs to turn off the water main, and upon doing so discovered that the laminate wood floor in the playroom was immersed in water.

We turned off the water and began further investigation to reduce the damage to our home. In a matter of minutes, we removed some of the saturated flooring, which revealed significant amounts of pooled water covering the playroom and extending to a drain in the storage room (as shown in previously shared photos). We hooked up two dehumidifiers and inspected the drywall. We continued our investigation upstairs, noting that the cabinet housing the kitchen sink (including sides, back, bottom shelf, and floorboard) was saturated, warped, and separated. What was visible of the subfloor was saturated.

After our inspection and attempts to halt any further damage, we contacted our LM [insurance company] agent Mr. N and were advised to contact the claims department for further guidance. We contacted the claims department and we were told that our loss was a covered peril and that someone would contact us. The following morning, we contacted a plumber who repaired both the hot and cold water pipes. This allowed us to restore water service to our home. We also requested the addition of shut-off valves under the kitchen sink as a precaution. On May 7th, we received an e-mail from Mr. W, the claims handler assigned to our claim, and Mr. W contacted us by telephone the next day. We discussed the events of the claim (as stated above) and we were told that our loss was a covered water damage loss. We also mentioned an uneducated concern regarding the possibility of mold due to the water saturation of various structures. We looked to Mr. W for further guidance. We were told that continuing to run the dehumidifiers was appropriate and to not use any circulating fans to err on the side of caution. It was also explained that we could choose to use a LM preferred contractor to begin assessing and repairing the damages. It was our understanding that the assessment and repair would begin within the next few days once A Inc. contacted us.

Mr. G of A Inc. came to our house on May 8th and did a thorough assessment of all damaged areas. We were under the impression that work would begin and that the process was seamless, meaning all details would be worked out between LM and A Inc. We would be responsible for our $1000 deductible, and the water damaged areas of the kitchen and basement would be repaired and/or replaced with comparable quality.

Shortly after, it was determined that a mold test should be conducted. The tests were conducted on May 15th. It appeared that air tests were conducted in the kitchen, in the basement, and on the covered wood deck (it was raining heavily at the time of the test). We were later told that both water damaged areas contained elevated levels of molds that are common in the environment. Please note we have not seen any reports on the said tests nor are we aware of any state or federal guidelines as to what constitutes an ‘unsafe’ elevated level of mold.

After the results of the mold testing, representatives from LM and A Inc. met at our home on May 23rd. A further assessment of the damages was completed by Mr. W. Documentation, pictures, and the damaged pipe were provided by us. We also clarified that the affected areas of our home were used daily. It was at this time Mr. W explained that our policy had a mold amendment with a limit of $5000. He also mentioned our right to leave our home if we felt the need, mentioning that the use of our $1000 deductible could be applied in this case. There was much discussion between all parties regarding remediation costs being categorized under water damage or mold damage. Our feelings on this categorization remain the same, and are restated below.

On June 9th, on our request, we received LM's cost proposal from Mr. W. The proposal was not finalized, and Mr. W noted that the removal and resetting of the cabinets along with the “possibility” of further testing was an open item. According to this written communication and a later phone conversation, it appeared that irregardless of the visible water damage of the kitchen cabinet that LM wished to pull out and reset the cabinet to determine how remediation should be classified. This seems pointless to us since, as just stated, the cabinet is currently visibly water damaged without visible mold. Shortly after, Mr. G of A Inc. returned to our home for additional assessment and to direct A Inc. staff to begin preparing for basement clean up. We were appreciative of the clean up as our basement was a safety risk for our children. The water damaged flooring was removed and taken off premises and barriers were put in place.

It has now been nearly two months since the original claim, and resolution has not been reached by all parties. Our functional living space has been reduced and the upheaval due to the water damage and the amount of time it is taking to resolve our claim has put our family under great strain. Based on an e-mail from A Inc. on June 27th, it appears that mold clean up can begin; however, there are uncertainties as to what damage might be directly or indirectly caused and who is responsible for additional costs. We have only received one early proposal from LM, and are unsure of the company’s exact breakdown of the remediation costs. We have received one cost proposal from A Inc. detailing the scope of work necessary only for the mold clean up.

We, the homeowners, believe that our property was water damaged first and foremost. This visibly includes the cabinet in the kitchen and the drywall and flooring in the basement. It is possible that drywall behind the kitchen cabinet, adjacent cabinets, and the subfloor were also water damaged. We believe the cabinets and all water damaged property should be repaired or replaced to comparable quality as stated in our policy. Our policy specifically states that the mold endorsement is an “additional coverage” of a covered peril. Thus far, it has been treated as exclusionary, which we do not believe is the intention of the coverage. Property that is initially water damaged should be classified as such, and remediation costs should reflect this classification.

Finally, we find it irresponsible and potentially disastrous for us to enter any type of contract until complete resolution is reached by all parties (see paragraph four of Mr. M’s previous e-mail). We will not agree to a “wait and see approach” to decide what is and isn’t covered. If LM feels the need for further investigation to determine how it should classify our claim, then that investigation along with any incurred damages and repair of such damages from the desired investigation should be the responsibility of LM. We as responsible homeowners should not be held liable after the fact for costs incurred while LM decides if and how it will treat our claim, especially since we were originally told by several LM representatives that our claim was water damage and a covered loss, and we began the process under that premise.

We cannot in good faith proceed until it is stated in writing and agreed to by all parties what investigation and remediation will be performed and how it will be paid for—this includes any unforeseen expenses incurred and additional living expenses. Meanwhile our family continues to live with this disruption in our lives. We suggest that all parties meet [...] in order to come to a resolution in a more timely manner than what has occurred thus far.

Sincerely,

Us