Watch the full video at https://rumble.com/vqbcjq-mold-exclusionsconflicting-court-decisions.html and at https://youtu.be/Q1DnDWQE-x590 Insurance companies in most states have been allowed to exclude mold protection from new and existing insurance policies. There are hundreds (perhaps thousands) of ongoing lawsuits against homeowners insurance companies seeking coverage for losses incurred as a result of mold contamination. In many of these homeowners, damage "caused by" mold contamination is explicitly excluded from coverage. In the face of this exclusion, homeowners often take the position that their alleged damage was not "caused" by mold, but rather that the damage was caused by some form of water intrusion that resulted in mold contamination, or some other covered hazard, and therefore the loss is covered. Insurance companies often claim that the exemption applies to all alleged damages related to mold, arguing that the damage itself was caused by mold or some other excluded cause or event.
State courts that have faced this issue cannot agree. Some have considered that the exclusion "caused by" applies to all mold damage, while other courts have found an ambiguity in the exception. A summary assessment for either party is almost impossible because coverage decisions are determined by the facts presented at the trial.
The latest ISO forms, used by many insurance companies in their homeowners' insurance, include the following exceptions regarding mold:
We will not pay for loss or damage caused directly or indirectly by [mold]. Such loss or damage is excluded regardless of any other cause or event that simultaneously or in any sequence contributes to the loss. But if [mold] results in a covered cause of loss, we will pay for the loss or damage caused by the covered cause of the loss.
Courts across the country have reached different conclusions about its meaning and applicability. The video describes some of the cases involving exclusions of mold and the subsequent loss clauses.
By carefully writing their insurances, the insurance companies have been able to avoid most mold claims and the resulting litigation after the claim has been rejected. Some decided to provide coverage for mold claims but set low limits for liability while others formulated clear and unambiguous exceptions. These insurance companies have avoided certain litigation while most have found the new exceptions or limitations of liability to enable the insurer to successfully defend the lawsuits.
© 2021 – Barry Zalma
Barry Zalma, Esq., CFE, limits nu sin praxis. to serve as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance fraud and insurance fraud almost equally for insurers and policyholders.
He also acts as an arbitrator or media
for insurance-related disputes. He practiced law in California for more than 44 years as a lawyer for insurance coverage and claims management and more than 54 years in the insurance industry.
Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.
He is available at http://www.zalma.com and email@example.com. Zalma is the first recipient of the first annual Claims Magazine / ACE Legend Award. For the past 53 years, Barry Zalma has devoted his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurers and their claimants to become professionals in insurance claims.
Go to training available at https://claimschool.com; articles at https://zalma.substack.com, the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr Zalma on Twitter at https://twitter.com/bzalma ; Go to Barry Zalma videos at https://www.rumble.com/zalma; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ T the last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud- letter -2 / podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4