Insurance Company Gets Away With Fraud Again

The same adjuster has treated three of my customers with similar circumstances the same within the last year, and it hasn’t been to the customer’s advantage. One customer had a very high deductible and not very much damage so he didn’t challenge the insurance company. Another customers’ policy was very recent and some of the damage happened before the policy was in force. The other customer I thought was going to hold the insurance company accountable.

Each of these customers had homeowners insurance policies with the same insurance company, and their policies actually had coverage for mold. Each of these customers had water damage in their home from what should have been a covered water damage event. Mold was also discovered on some of the wet materials in each home. Each had insurance for water damage and mold, but this adjuster denied all three claims using the following rational: The adjuster said “because there is mold present the current leak started much earlier, went undetected and allowed mold to grow.” Policies have language that says if there is long term seepage that is undiscovered, the damage is not covered.

Let me tell you more about the case in question. The homeowners came home one day and found their entire basement flooded. The water was from a leaky pipe in a wall. There was also some evidence (mold) that suggested that the leak may have started as a very small leak some time before. If this leak had been going on for awhile, it would have been very small because the homeowners never noticed any dampness or puddles on the floor in the area. We also found mold in the bottom of some other walls that were not near the leak. This mold could not have been from the current leak, the dampness could not have reached those walls undetected. So this suggests that some of the mold or maybe all of it was not related to the recent leak. And even if the leak started smaller earlier, there was clearly “an event” that took place, a sudden event that flooded their entire basement. This “event” should have been a “covered event” for insurance purposes. It was clearly an event and not long term seepage. This is where the adjuster really tried to stretch things. He said “because it is from the ‘same source’ as the alleged seepage the damage is not covered”. So to summarize: Even though there is little or no evidence that there was any long term seepage, the water damage from the pipe leak which should have been a covered event is not going to be covered because there is mold present, which they also should have coverage for.

I have been looking forward to going to small claims court in support of this customer as they sued their insurance company. We have coached this customer on what they needed to do. Only they can sue their insurance company, we cannot do it for them. We can coach them, advise them, show up and testify, and be an expert witness, but we cannot sue their insurance company for them. We have been waiting for a few months for this customer to get the paperwork filed with the court. They have procrastinated and just haven’t gotten it done. Just recently they took out a lone and paid our bill in full. I hope they still follow through and hold their insurance company accountable, but I fear that they may not which would allow this adjuster and his insurance company to get away with fraud once again.

We have seen nearly identical circumstances many times and the damage has always been covered by insurance. The damage adjusting process is not consistent, and is sometimes not fair or ethical. The best way to protect yourself is to hire a restoration company that is loyal to you and able and willing to be an advocate on your behalf.

 

Kids Will Always Surprise You!

I went out to a new flood in Alpine, Utah not to long ago. About 85% of the basement was flooded. turns out one of their kids happened to leave the hose on for a long time near a window well and it was not long before the window well was flooded enough to allow the water to begin gushing into the basement. It was one of those unexpected things people just can not really plan on. I would be giving my kids an iou when they turn 18 for all the turmoil. Unfortunately this was not these peoples first flood and due to previous floods there was more damage to unseen places of the home no one could have really accounted for. Like mold. So maybe this flood came at a good time because during our mitigation process we were able to make them aware of a problem they would not have been able to see otherwise. And there youngest daughter was already suffering from breathing problems because of her lungs. So sometimes you have to see the cup half full.

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The Flood CO. Can Arrive In a Timely Matter to Deal With All Types of Floods

When water damage occurs timing is crucial. A delay of even 48 hours can result in significant water damage compared to an immediate, timely response. This is why our personnel are on call 24 hour a day, 7 days a week. Your initial response is very important as it helps to prevent further damage. Once the flood begins to dissipate the task of water removal and water damage restoration starts immediately.

There are three categories of water damage…

Clean Water - Originate from a source that does not pose substantial harm to humans. Examples: tub or sink overflow, broken water supply lines, melting ice and snow.

Gray Water - Unsanitary water contains some degree of contamination that would cause sickness if consumed by humans. Examples: Aquariums, water beds, a dishwasher overflow, toilet backup with no feces present.

Black Water – Highly contaminated water that could cause death or serious illness if consumed by humans. Examples: sewage backup, ground surface water or rising water from streams or rivers that carry silt and organic matter.

Water Damage Inspections – We have over 17 years of experience with Water Damage Restoration and Clean up. Because of our experience and training we know what to look for and what we are looking at to help you get it cleaned up as quickly as possible. We are licensed, insured and certified in water damage, water damage restoration, water removal, flood damage, and sewer cleanup. We use a variety of instruments, tools and meters to diagnose and detect water damage including, moisture meter, moisture probe, non penetrating meter, penetrating meter, hammer probe,humidity sensors,  and infrared cameras.

Water Damage Restoration And Repair

Water damages are everywhere in your household. They may be caused by different factors but their effects are usually the same. They can be as big as property losses or as small as a water spot. But then again, these damages can be frustrating and tedious when they evolve into a bigger problem.

Floods are usually one of the causes of water damages. And the kinds of floods would entail the intensity of the damage that can be done. For instance, there are many types of floods that usually flood Utah: urban, flash and river flooding. And most of the floods in Utah are caused by snow melt and mountain runoff which can be considered disastrous.

When residing in a place like Utah, it is important to be aware of what you can do to be prepared. The first thing that you should prioritize is the strength of your own homes. Having a strong home would entail having a safer place to stay in times of these scary disasters. But if your house cannot really handle the strength of the catastrophe, it would be wise to evacuate and find a safer place.

There is worse condition in the home after result of the heavy flood. Flood water is the source of bacteria & mold growth in house & it is important you to start water damage repair procedure immediately to prevent damage to your home.

It is very important that you throw out the thing that are damaged by water; and ensure that make a list of all the damaged things for insurance. Getting rid of house hold & personal items can be a painful experience. It should be done to protect your health. If there is water damage to your walls & floors, you must repair the damage. It is best to call an expert to perform the cleanup & restore your home to a living condition once again.

There are a few tips to apply during a flood:

Never plug in electrics or try to turn your electricity off in standing water. Call a qualified technician.

When it comes to water and flood damage, cleanup should begin within 24-48 hours to prevent the growth of mold and other harmful bacteria.

Never try to do work without the proper knowledge as it can do more damage to the house.

Discussing The Dangers Of Carrying Out DIY Fire And Flood Restoration Following A Fire In Your Building

Where a property has been subject to a serious blaze; the owners are often left with the daunting fact that the need to repair both the fire damage as well as flood damage. Due to the huge amounts of water that must be used to put a blaze out it is likely that the property will be left with a few inches of water on the floors. There can be a strong temptation for many to carry out their own fire and flood restoration following a fire, without fully understanding the risks.

A shock to the system

A potentially lethal danger that must be considered by those carrying out their own fire and flood restoration is that of electrocution. The damage that is caused by fire can frequently leave electrics exposed. These wires provide the opportunity for an electric shock – especially when combined with the excess water in the building.

Toxic risks

The possibility that there could be unseen toxins in the air is the next factor you must consider if attempting your own fire and flood restoration. Toxic mold will often form in concealed areas of flooded buildings and poses a serious health risk. In addition there is a good chance that toxic fumes from burnt materials could still be present in the property.

Structural weaknesses

The final risk that must always be kept in mind is the damage that can be sustained by the physical structure of a building that has suffered from fire and flood damage. Just flooding or fire on its own has the power to make floors and walls unsafe. A combination of the two only serves to multiply the risk of floors falling in and walls collapsing.

The safest option

We suggest that anyone thinking of carrying out their own fire and flood restoration should first ponder employing a specialist service first. Most property owners will be able to claim on their insurance for the cost of fire and flood restoration. We suggest that you are better advised to bring in a specialized restoration team, who have all the right equipment, rather than put yourself at risk.