Hello.
Long story made short…my claims specialist is denying coverage for three separately located sections of water pipes bursting within my bathroom on a -4 degree day at the end of January. The reason is "my policy has language about fungus"…and "I looked at pictures from the mitigation report and see mold in there". I've sent a plumbing report from the day of with statements and photos directly from the plumber.
…this is a desk adjuster out in California, where I am located along the east coast. State Farm never sent a physical employee to my situation once, nor expressed the option as needed when I jave asked, and has under instruction, communucated via phone and submission of information by my mitigation/tear-down/rebuild company only. The company'a report mentions nothing of mold, and they have provided me with a written statement to place on file, along with obvious ongoing backup, to state that they have not declared any evidence of mold within their proceedings, findings, statements, photographs, etc, and that any claims of mold are unfounded.
The claims specialist refuses to escalate my case, provide contact for a manager/supervisor, and has left voice messages to my phone about it "being a good idea if I would acquire a portapotty as my paid hotel stay is being pulled immediately and the case closing". That last part isn't in the least true, for the record, and I find that to be harassment and unnecessary…I have the voice recording.
I've found my claims specialist's supervisor's contact info on my own and am waiting for a callback, and am providing my local agent with information so they can speak on my behalf and start looking for a higher up as well to speak with..they're upset about my situation and its handling. Basically, everybody involved is in disbelief over this…but me. My sister went through the same thing with Allstate and eventually won.
I have most recently eceived a request for my mitigation team to resubmit/reorganize their line items so that my claims specialist "can better understand" information about the next room over which is connected to the affected bathroom area, my claims specialist has not drafted a formal letter/sent a formal letter citing specifix language of contractual denial tied to the decision yet, and has strangely already sent me a check for $1k to cover things that I can not explain…not cashing that.
Upon the vsry first call, this claims specialist openly brought up that my contract does not include mold coverage. I responded that the issue is over multiple burst pipes and that they would need to discuss matters with the professional mitigation team for further information should anything that they find, such as mold, be of concern. My claims specialist also referenced this conversation with me as part of their decision, while refusing to play back a recording…there is no verbal, written, visual, or scientific evidence of mold, with a determination upon photos without specification being my only, verbal, explanation.
This disaster is only getting started…but just curious if I can land some advice on the above situation. I'm convinced that this is all within bad faith, along with everybody else who has been involved. The groundwork for this ridiculous decision was laid immediately…
State Farm Water Damage Denial Over Pipes Bursting…
byu/Hopeful-Display-8575 inInsurance
Posted by Hopeful-Display-8575
3 Comments
Send them something in writing. “There is no mold and I am not seeking coverage for mold. The pipes froze and I am seeking coverage for my frozen pipes and water damage per my policy and contract with State Farm.” Wait for a written response to what ever you send. Escalate to your state insurance department if they formally deny it in writting.
I mean, it sounds like somebody from the mitigation company said something about finding mold, even if it’s not in any documents you are receiving. I’m not sure specifically about SF, but most insurance companies have somewhere in their agreements with mitigation companies – if more than 10 sq ft of suspected growth, it could indicate long term damage and not a sudden pipe burst.
GET AN ATTORNEY