Aug 11, 2022

Part 2; When the Insurance Company is Being Difficult

This is a follow up from blog post When the Insurance Company is Being Difficult since this just happened on a recent inspection and insurance claim.  You need an expert to advocate for you when you are dealing with a difficult insurance adjuster or the like.  For some reason they don’t want to honor your claim or perhaps not all of it depending on the situation. Below is the recent account and result.

An initial inspection was performed on a house and a definite moisture issue (a leak) was found in the kitchen and it appeared to have been occurring for some weeks.  However, when filing a claim, you don’t tell the adjuster that is what you or the inspector (like myself) that since there is no way to determine when the moisture issue had actually started.  I always tell my customers that when I do the inspection and find the moisture issue then that is when you, the owner, discovered the apparent leak.  Otherwise, the insurance company can deny your claim since it now appears that you knew about the leak and did not do anything about it right away.  That is considered homeowner neglect and is a valid reason for the insurance company to deny your claim.

In this particular case I advised the owner to file a claim with their insurance and because it also affected the floor tile which covered most all of the downstairs and that would normally be covered by the insurance in performing any remediation and tile replacement.  The owner filed the claim and the insurance sent them a check for some of the damages.  But like most owners they did not know how to get everything together to have the claim handled properly and the fact that the insurance company involved did not do a very good job on their part. 

The owner reached back out to me and I assisted providing the appropriate repair estimate and recommendations due to the water damage that occurred.  The adjuster eventually said that the moisture under the kitchen floor tile (next to where the leak was found) was not supported by the leak that was found. Therefore they were not going to pay for the floor tile replacement. Did you see that? The adjuster was trying to deny the exact evidence that supported there being moisture under the tile from the leak that was found right next to it!

I advised the owner to let me send an email, after his review and approval of it, to the adjuster and her supervisor calling the adjuster out on this ridiculous reasoning against logic. I basically said in the email that the adjuster was not qualified to make that determination and that the credentials I possess do.  If the rest of the claim is not approved (to pay for the floor tile) then I recommend the owner file a complaint with the California State Insurance Commissioner where this evidence will be presented and also have the owner’s attorney address the matter.

About ten days later the adjuster acquiesced and paid for the floor tile replacement!


Steve Mullins (mold detector)
CMC, Certified Microbial Consultant
Moisture and Mold Detection, Inc.


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