It is the letter every Florida homeowner dreads. You file a claim for a burst pipe or a roof leak, expecting your insurance company to cover the repairs. Instead, you receive a denial letter citing a confusing clause: “Long-term seepage” or “Neglect.”
The insurance company’s logic is usually simple: “We found mold. Mold takes time to grow. Therefore, this leak has been happening for weeks, and you failed to fix it. Claim denied.”
This logic is often wrong. In the tropical climate of Fort Myers and Naples, mold doesn’t take weeks to grow—it can bloom in 24 to 48 hours. At Florida Mold Consultants, we provide the scientific evidence homeowners need to fight back against unfair denials.
The “Sudden and Accidental” Trap
Most Florida insurance policies cover “Sudden and Accidental” water damage (like a burst pipe). They specifically exclude “Gradual” damage (like a slow drip under a sink).
When an adjuster sees mold, they immediately categorize the loss as “Gradual.” They use the presence of fungal growth as proof that you ignored the problem.
But here is the truth: If a pipe bursts on Monday and you are out of town until Friday, you will come home to a flooded house and mold growth. That is still a sudden event. The mold is just a symptom of the intensity of the humidity, not the duration of the leak.
How an Independent Protocol Helps Your Claim
You cannot fight an insurance denial with anger; you have to fight it with data. This is where a Licensed Mold Assessor becomes your best asset.
We create a technical document called a Remediation Protocol that serves two purposes:
1. Establishing the Timeline
Through microscopic analysis, we can often determine if the mold growth is “fresh” (active spores caused by the recent water event) or “chronic” (old growth from years ago). Proving that the mold is fresh can be the key to reversing a denial.
2. Defining the Scope (Stopping the “Lowball”)
Even if they accept your claim, the insurance adjuster will try to pay the minimum amount possible. They might write an estimate for “Spot Cleaning” and “2 Days of Drying.”
Our Protocol is based on IICRC S520 Standards, not the insurance company’s budget. If we write a protocol stating that the drywall must be removed 4 feet up and the room requires 5 days of negative air pressure, the insurance company has a much harder time refusing to pay for it. We provide the professional justification the contractor needs to get paid correctly.
Don’t Let the Adjuster Be the Only Expert
The insurance adjuster works for the insurance company. Who works for you?
If you are facing a claim involving water damage and mold, do not rely on the adjuster’s opinion. Get an independent assessment to document the true extent of the damage.
Fighting a Denial?
You need proof. Contact Florida Mold Consultants for a forensic mold inspection and protocol that stands up to scrutiny. Call 1-800-352-6653.