Strategic Planning
Mold Remediation Claim Success
Project Overview
Mold Remediation Claim Success
A mold remediation contractor in San Jose was hired to address a severe mold outbreak in a residential property caused by an undetected pipe leak. The contractor documented widespread mold contamination and submitted a comprehensive remediation plan. Despite clear evidence and a link to a covered water loss, the insurance company delayed action and issued a low settlement, citing pre-existing conditions and excluding several necessary remediation steps.
Challenges and Our Process
Challanges
The insurance company responded with a minimal settlement of just $9,200, denying coverage for essential remediation steps. These included containment barriers, negative air pressure systems, HEPA filtration, and post-remediation verification. The insurer also argued the mold was due to poor maintenance, labeling it a pre-existing issue. This put the contractor in a difficult position, unable to proceed with industry-standard protocols, facing homeowner dissatisfaction, and risking project delays and non-compliance issues.
Our Process
We stepped in to defend the contractor’s scope and push for a fair mold claim settlement.
Correlated mold growth to the original covered water loss and supported the claim with moisture mapping and air quality test results.
Developed a line-by-line estimate based on mold remediation standards and successfully negotiated with the insurer to approve full remediation and testing.
Results
Outcomes and Insights
Our expert handling led to a significant increase in the settlement and full coverage for necessary remediation.
- Final payout raised from $9,200 to $28,900
- All excluded items, including testing and air filtration, were approved
- Homeowner health concerns were resolved, ensuring compliance and safety
- Contractor was paid in full and completed the job without further delays
- Final payout raised from $9,200 to $28,900
Key Takeaways
This case proves how The Claims Ninja protects mold remediation contractors from underpaid or denied claims. With detailed documentation, technical insight, and policy knowledge, we ensure our contractor clients receive the funds they deserve, so they can do their job right, without compromise or financial risk.