Greetings all, Firstly, it is a blessing in disguise to have found online resources such as PropertyChat. I didn't quite know who to speak to given the situation I'm in but remembered this forum and the help that others were so kind to give. Where things are at: I am running into a bit of strife with RACV and their Home/Building/Landlords insurance cover. It seems no matter what I do and how much evidence I provide the assessor/insurer will not budge to meet me at some sort of acceptable medium, and have thus issued me a no cover letter to which I can dispute. The issue, as best as I can describe: From the outset the issues can be definitely perceived as convoluted. Long story short, a. The builders (assessor) are not changing their determination even though my reasons for my claim are sound, b. Insurance company is not working with me to reach an understanding and have chucked me in the barrel of the never ending vortex that is to come. It is an issue of growing mold due to excessive water that had been stagnant under the sub-floor (timber) of the property. Investigations were carried out by licensed trades but this was hit and miss, the real problem was never actually rectified until late in the piece. This unfortunately has left a lot of time for the mold to grow and is now making conditions unlivable for the tenant. The question: Writing this it really does sound like an unfolding legal issue and it is hard to not get my haunches up. But what I am concerned with most is getting living conditions back for the tenant forthwith. This does mean that I do need to play the insurance game and I do believe strongly that my claim is valid. I ask then, if there is any expedient solution that can help my claim be accessed more reasonably with the insurer? Best
So what is your actual claim, and how was it caused? You only mention stagnant water under the house, which is unlikely to be claimable under insurance.
How and when did the water get under the sub floor? Are you claiming it was due to a storm? If you are, was the claim lodged immediately after the storm?
How old is the house? Is it still under builders warranty? Water pooling in the subfloor is a serious issue and the builder has to fix it if within warranty period. Has the water issue been fixed yet?
Are you after clarity around if it is up to insurance to rectify? If so, more information about the why, what, where, when is required to get a sense of this. Or are you looking for somebody to share the costs with you as part of property ownership?
Should this be a maintenance issue or subfloor ventilation? Insurance won't cover it due to lack of maintenance or construction fault.
Okay here goes. It's a good story for property ownership; highlights that your investing in an ongoing project and not just about numbers. The case is tricky because the issue itself happened over a year ago. I proceeded to fix the issue myself and never thought to claim on insurance as I didn't think the cause would warrant. Only I was looking at the wrong place when trying to rectify the problem through my own means: hiring trades etc. This never solved the actual issue and it wasn't until sometime later upon the rediscovery that it was able to be resolved and the water under the house finally dissipated. This had all led up to this years winter and the resulting effects on the house' condition is a mold that has run quite rampant. OHS contractors have been in and applied a temporary solution this was good of the insurance company to organise however I'm afraid that the health hazards and the severity of the issue is confronting the insurance company with a very serious question. What ticks me off the most is that I have all the photo evidence, invoices, reports to back this claim up, yet the insurance company won't accept at all my version of the story. I've spoken to the ombudsman and have a chance to dispute, which I will. But not sure if it's gonna be fruitless and whether I should just go for a different solution. What I do pay these guys for? Best
Insurance wont cover defects in a building causing damage in many cases. Its a repair issue not tied to a event (eg struck by lighting, hail impacts etc.). If a defined event caused the damage then it may be insured. A leak due to construction however defective wont be. Otherwise its up to you to maintain the building whether or not someone can be liable fior that matter. Its like expecting a insurer to cover termite damage. They wont. Read your policy its excluded. Mould and water leaking is usually a excluded matter in a policy unless a impact or burst issue or a accidental breakage occurred to a pipe or vessel (hws, bath etc). Policies vary in the wording and many are more restrictive or have clear limitations. It arises from water leaking and accumulation and only when its insured can consequential damage be considered - They will usually need a event causing water to enter from damage like a tree impact, hail, inundation (maybe) etc. Have you read the policy and understood why the claim is being refused ? This sounds pretty normal. Water lying under a property wont be insured. Its not a inundation or a impact, to flooding, not a burst vessel etc. Its poor drainage. The insurance company arent obliged to cover a repair to the decet or its consequential matter that is not defined within the policy terms. Mould is usually not accepted unless flooding from rising water occurred and some policies exclude flood. You may be wasting their time and your own.
The actual issue that I found months later after realizing failure the first time, was to do with a burst pipe from the bath. You can imagine how much water had accumulated. So it's funny, the only reason to which the insurance company has not been able to refute, is that I believe the burst pipe which was significantly damaged as if by excessive force, was caused by the tenants pet. Pets are covered under my policy, loss or damage from mold is not. After inspection from mold specialists they believe that the mold was definitely caused by the stagnant water resulting from the burst pipe. This goes against the report made by the insurers assessor, even though the mold specialists were contracted through them.
I've run an insurance consumers advocacy organisation, after winning a very large insurance dispute with my insurer. It's what prompted me to become a lawyer. I don't like your chances, based on what you've said. The insurer's argument is likely that if you'd notified them of the burst pipe promptly, or fixed it promptly, there wouldn't have been mold. Combine that with a specific mold exclusion and I'd say you're out of luck. If you'd notified them of the burst pipe promptly, you may have had a claim for, say, carpet damage, and the insurer perhaps should have dehumidified, but I'm not seeing the path to liability for mold. It may still be there but I'm not following your reasoning.
There's some pieces that don't seem to be joining together. The issue happened over a year ago and you proceeded to fix the issue. Great, what were you fixing at this point in time if this wasn't the issue as you found later with the burst pipe under the bath? The mould ran rampant through this winter? Or was it there all along? I have no expertise in this area but could it have been there all along, wouldn't warmer conditions be more conducive to mould growth? And yes it may be confronting the insurance company with a very serious question though of more interest for you is what are you doing/going to do to assist yourself in this situation if the insurance doesn't come through?
There are a variety of companies that specialize in cleaning and fogging for mould. The treatments for a more seriously affected house would be somewhere around the $800-$1500 mark? Have you investigated this option?
I’m stilll confused about what happened. Is this a good summary: 1. There was mould in the house and you did something (what?) to fix it. You thought your fix was successful. 2. A year later, you discovered there was still mould. You then discovered a burst pipe under the bath (in the subfloor?) that you think was caused by a pet. 3. Now you wish to claim on insurance to remedy the mould. 4. The insurance company has refused your claim because it was a year ago, it is a maintenance issue not an insurable event - and possibly because they can’t see how it could be pet damage, as claimed. Does that cover it? My main question is what did you do to remedy the issue initially? Also, curious about whether the pet is a cat or dog? And how did it get access to the subfloor?
