On June 11, 2009 my husband and I noticed the wood on the bottom of our bathroom door jam was bowing out and the door wasn’t closing. It was obvious that there was some sort of water issue within the wall. My husband pulled it back and we saw black mold. We were very concerned that this mold might be toxic especially since we have an infant. We immediately stop using the shower by that area, in case that was what was adding to the problem. We then contacted 911 Restoration to test the mold to find out what type of mold we had and to get an estimate to get the mold removed. 911 Restoration came out to take samples, they sent the collected to Pro-Lab. We found out that the mold is toxic. On June 18, 2009 we contacted Fidelity to submit our claim, at that time we discovered that our insurance had lapsed and as of April 4, 2009.
On March 27, 2009 we refinanced our home loan and with that refinance we had impounds taken out of our monthly payments that would pay our insurance and taxes. We mistakenly thought that Wells Fargo would take care of our insurance payments from that moment on. They actually weren’t scheduled to start until July 26, 2009. As soon as we found out we didn’t currently have home owners insurance we contacted Wells Fargo and asked them to pay Fidelity so we would be covered. We have been loyal Fidelity customers for over three years (from when we first purchased our home), with the exception of the two month lapse (4/4/09 to 6/15/09).
We contacted a second mold remediation company, Alliance Professional Results to get a second estimate to see if it would vary from 911 Restorations estimate (the difference was $2,446.77). On June 23, 2009 Fidelity sent us a letter, informing us that our claim had been denied due to our insurance policy lapsing. We were very upset that our policy had lapsed and were unsure as to what our next step should be in trying to resolve this problem. We spoke to several individuals and were advised that we should contact one of the companies that gave us an estimate to see if they could give us an idea how long the mold had been present, if it was prior to our insurance lapsing (4/4/09) Fidelity should cover it. We contacted XX from Alliance Professional Results and he told us considering the amount of mold it had been there and growing for at least 7 or 8 months (July or September 2008). We were obviously happy to hear this and contacted Fidelity again.
Fidelity reopened our claim and sent 2 men out to our house to look at the problem.
Then on September 9, 2009 Fidelity sent out another letter stating that our claim had again bee denied. They stated that, “The Hygienist report that you have provided demonstrates that the samples were collected on June 13, 2009; therefore, the loss did not occur during the term of the policy effective June 15, 2009.” We understand that it isn’t covered under the policy effective June 15, 2009 but it should be covered under the prior policy #…which is why Fidelity reopened our claim to begin with.
It is clear that XX with Fidelity continues to send us out form letters and obviously isn’t listening to me when I have spoken with him. We continue to get the run around. We have been dealing with this for 3 months now. In the past three months we haven’t been able to use the master bathroom or bedroom (there isn’t a door between the 2 so there is no way to block just the bathroom off) not only for fear of making the problem worse but also due to health problems.
I have an autoimmune disorder which is aggravated by the mold so I have to try to stay as far away as possible which has probably minimized it as much as possible but is still a daily problem (I have missed several work days, have had to go to the ER at least 3 times and now have to carry an Epipen in case my airways get blocked). We have covered the area with plastic, purchased 2 air purifiers and keep the door closed (with a towel shoved at the bottom of the door to prevent as much of the mold spores as possible form escaping into the rest of the house). My infant daughter has also suffered with a case of Bronchitis. However, we aren’t asking Fidelity to cover any medical expenses or suffering that this has caused we simply want our house fixed and for them to abide by what our policy offers…which is $2500 for mold remediation and then the cost to rebuild.
Please understand that not having use of our master bathroom and master bedroom is a huge portion of our house (square footage is about 1400). For the past 3 months my husband and I have slept on an Aero bed in our living room. The Aero bed takes up most of the area in our living room which is very disruptive but even more upsetting because in this time our daughter has learned to crawl but due to the current state of our house there I no room for her to crawl. We just want our housed fixed and would appreciate any assistance you could provide in seeing that this happens.
Recent Email Strine w/ Fidelity:
Mr.,
Thank you for your response but if anything I think your email supports what I am saying. These are “Perils Insured Against” they are not under a “Perils Not Insured Against”. I believe the real issue at hand was that on the date we discovered the problem and made our claim, we discovered our insurance had lapsed. But after finding out the “date of occurrence” was in the summer of 2008 (when we were covered under our pervious policy) this should be covered. I could understand agreeing paying a portion since it did lapse for 2 months. After calculation it out, I believe we would reasonably be responsible for 16%, leaving Fidelity responsible for 84%.
Kellie
From: Fidelity
With all respect, this loss was a progressive loss in which the mold and water loss commenced sometime in July or September 2008 but wasn’t discovered until June 11, 2009. In our previous communication to you in the reservation of rights letter, we advised you of the coverage issues involved in this claim and that long term loss involving water exposure and mold growth commencing sometime indefinite in July-September 2008 would not be covered loss as cited below.
Endorsement A6138
Under SECTION I - PERILS INSURED AGAINST, A. Coverage A - Dwelling And Coverage B - Other Structures, and Coverage C - Personal Property, the following language is added under 2.e.:
(10) Any accidental discharge, overflow, continuous or repeated seepage, leakage or dripping of water or steam over a period of days, weeks, months or years from within a plumbing, heating, air conditioning, irrigation, automatic fire protective sprinkler system or from within a household appliance. Plumbing system includes from within or around any shower stall, shower bath, tub installation, or other plumbing fixture, including their walls, ceilings or floors.
Under SECTION I - PERILS INSURED AGAINST, A. Coverage A - Dwelling And Coverage B - Other Structures, item 2.c. (5) (a) and (b) and Exception To c.(6) are deleted in their entirety and replaced by the following:
Acts or omissions of persons can cause, contribute to or aggravate rust, mold, fungus or rot. Also, rust, mold, fungus or rot can occur naturally to cause a loss or combine with acts or omissions of persons to cause a loss. If rust, mold, fungus or rot occurs as the result of a loss, that is not otherwise excluded, we cover up to $2,500 in total of following items:
1. Damage caused by the rust, mold, fungus or rot;
2. Remediation, which means the reasonable and necessary treatment, removal or disposal, of covered rust, mold fungus or rot, any ensuing repairs resulting from covered remediation or necessary relocation to eliminate the rust, mold, fungus or rot; or
3. Testing of the rust, mold, fungus or rot.
This limit applies to Coverages A, B, C, D and ADDITIONAL COVERAGES limits of liability.
The policy wasn’t in effect on June 11, 2009 when the loss was discovered. Water and mold damaged the property progressive through continuous exposure and growth over a period of weeks or months until discovered in June 2009.
The There may be other reasons why coverage does not apply. We do not waive our rights to deny coverage for any other valid reason, which may arise.
Our decision is based on the facts presented to us. If you have any additional information, which would be relevant to your claim, please forward this information to us for our consideration.
We wish to advise you, you have the right, if you so desire, to have this matter reviewed by the California Department of Insurance, Claim Service Bureau, XX
From: Kellie
I believe your statement regarding the date of loss to be only half true…It is recommended to use the claim reported date as the date of loss when a claim is presented and the date of loss is unknown and cannot be determined. However, in this case a date of loss can be determined due to the growth rate of the mold.
From: Fidelity
I understand your concerns about these serious issues in your home. As documented in the claim file and as XX explained, the loss was discovered on June 11, 2009 between the time the first policy lapsed and the new policy was issued to replace it.
We reviewed this loss with our coverage attorney in California and he advised us that California Courts have ruled that when there is a progressive loss, the date of loss is the date the loss is discovered. We will discuss Alliance Professional Results’ statement to you concerning when the loss might have commenced, but in light of the information our coverage attorney shared with us that is specific to this progressive loss situation, it is doubtful Alliance’s opinion would alter the date of loss determination for progressive loss as set forth for us by our attorney.
Have you checked with Wells Fargo to determine if they had in place a policy protecting their interest in repairing the property in the event that a homeowner policy was not in effect? I do regret we cannot assist you further since the policy wasn’t in force when the loss occurred.
We wish to advise you, you have the right, if you so desire, to have this matter reviewed by the California Department of Insurance, Claim Service Bureau, XX
From: Kellie
I received your recent correspondence dated September 9, 2009 and it is obvious there I some confusion. So I am hoping this email might help clear some things up. Please review and advise as to where we go from here. Thank you.
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