Why Killing Mold is not Enough for an Insurance Claim

Michael A. Pinto and Jacob Kooistra | Property Casualty 360

The documents that comprise the current standard of care uniformly emphasize physical removal as the primary means of mold remediation.

Claims adjusters and managers recognize that most home and business policies have caps on the amount paid out to deal with mold remediation.

In the early 2000s, the mold remediation industry was still pretty new. Although some state regulations regarding mold remediation would develop later, no federal mold remediation rules ever came into being. The lack of government control left the industry to establish its own acceptable standards for the proper way to deal with mold contamination.

Who makes the rules for mold remediation?

With no overarching federal control on the growing industry, numerous government agencies, industry associations, and private organizations offered their recommendations related to mold control. Most state regulations have focused on some form of accreditation or licensing for the companies or individuals involved in mold inspections or the control of fungal contamination in buildings. The notable exception to that trend is the state regulation in Texas, which details the acceptable and not acceptable practices for mold remediation.

Over the past 20 years, numerous groups offered their approach to mold remediation. These included organizations such as:

  • American Conference of Governmental Industrial Hygienists (ACGIH),
  • American Industrial Hygiene Association (AIHA),
  • Environmental Protection Agency (EPA),
  • Health Canada,
  • Institute of Inspection Cleaning and Restoration Certification (IICRC),
  • Occupational Safety and Health Administration (OSHA),
  • National Organization of Re-Mediators and Mold Inspectors (NORMI), and
  • The New York City Department of Health.

The primary difficulty with this approach is that even the government agencies were only providing “guidance.” Without the force of law, people were left to pick and choose which recommendations they would follow; or not follow any at all. In response, numerous people reviewed the various guidance documents to identify specific consensus items.

The wide acceptance of common points of intersection from numerous reference materials directly impacted the insurance and legal liabilities associated with mold remediation. The areas of consensus from multiple documents quickly morphed into a de-facto standard of care for the industry. This provided insurance carriers and their clients a mostly level playing field concerning what was acceptable practice for mold remediation in the case of a covered loss.

Mold removal is still vital to remediation

Today, the mold control standard of care has been solidified and clarified for over two decades. However, many consultants and contractors have limited familiarity with the industry reference materials and follow a standardized procedure or practice for all mold projects without understanding whether that particular approach fits within the standard of care.

As many of the experts in fungal contamination control leave the industry, earlier problems of people not understanding or following the industry standard of care are being repeated for a second or third time, creating a serious potential problem for insurers. An agent or adjuster who unwittingly recommends a contractor whose work is outside what has been determined as acceptable industry practice could be liable for more than the covered loss.

The biggest risk in this area is the proliferation of remediation procedures based on some form of treatment of the fungal contamination rather than its removal. There is a constant promotion of products to industry practitioners that spray, mist, fog or foam to remediate mold. However, one of the primary principles of mold control that all of the reference documents and private mold experts agree upon is the need for the physical removal of the fungal contaminants.

This is a critical point, as the documents that comprise the current standard of care uniformly emphasize physical removal as the primary means of mold remediation. A great example can be found in section 4.4 of the current edition of the ANSI/IICRC S520-2015 Standard for Professional Mold Remediation:

Physically removing mold contamination is the primary means of remediation. Mold contamination should be physically removed from the structure, systems, and contents to return them to Condition 1. Attempts to kill, encapsulate, or inhibit mold instead of proper source removal generally are not adequate.

The requirement for physical removal of the fungal contamination is still the most assailed point within the industry. Many individuals argue that fungal contamination can be adequately mitigated through area fogging methods to either neutralize the fungal material or, in rare cases, even claim to chemically break down the physical components. While the advertising verbiage for such products uses terms like “kill,” “destroy,” “eliminate,” “disintegrate” or “obliterate,” they avoid the key phrase from the S520, to “physically remove” the mold.

A broad range of products are currently being sold as remediation alternatives. Some of the more common types of equipment and chemicals promoted for mold remediation that do not require physical removal include ultraviolet light, infrared light, chlorine dioxide, hydrogen peroxide, ozone, sodium hypochlorite (i.e., chlorine bleach), and a wide variety of essential oils.

These products can be applied via sprayers, magnet sprayers, ionized sprayers, binary ionization technology (bit) sprayers, “dry” particle sprayers, vaporizers, foggers, dry foggers, foamers, injectors, robotic light “droids,” ozone generators, hydroxyl radical machines, and more which are currently being peddled as mold remediation devices. Although such products and delivery systems often can be useful during a mold remediation process, none of them are an adequate substitute for physical mold removal.

Learning from past mistakes

Marketing materials describing the benefits of addressing mold contamination inside a wall cavity through a system that avoids removing and replacing drywall can be compelling. Such approaches may be a process a homeowner or business manager is willing to gamble on but should never be recommended or endorsed by someone connected to the claim on the insurance side. Encouraging improper mold remediation, or even appearing to recommend such practices, could easily lead to the client including the insurance company in a legal claim when the remediation efforts fail and lead to ill health effects of the occupants.

Despite the protections for insurers built into the standard policy language regarding fungal contamination, it is still critical for adjusters to understand that there is no “magic bullet” approach to mold remediation that eliminates the difficult task of physical mold removal.

Unfortunately, if mold contamination is on porous building materials, any remediation conducted under the current industry standard of care will require the removal of those finish surfaces. Trying to help the policyholder keep the project costs within the covered amount by steering them to some sort of remediation approach not recognized by the current standard of care is not helpful to the policyholder or the insurance carrier.

The key thing to remember is that chemicals and other treatments can be used in conjunction with physical removal but never as a substitute for real remediation.

When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes – please call Advise & Consult, Inc. at 888.684.8305, or email experts@adviseandconsult.net.

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