Can my insurance company be liable for neglect?

UPDATED: Oct 2, 2022

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Can my insurance company be liable for neglect?

On the morning of May 27th Memorial day 2019, we had a plumbing issue at our home. The outside water spigot cracked and had been leaking into the house. It had soaked the carpet in our daughter’s room and into the hallway. I did the repair myself and contacted our insurance company. We tried to use a shop vacuum to clean the water damaged rugs but it was no use. We pulled the carpets up and removed some furniture. The insurance company sent an adjuster to our place to inspect the damage. Using a moister reader, the adjuster said he detected moister. The adjuster said he was going to write up a report and our insurance company would get back to us. We did not hear anything from the insurance company for a couple of months. On August 8th 2019 I tried sending an email to them regarding the claim with no response. On August 22, 2019, I called the insurance companys claims department to see what was going on and was told they forgot about us that they have been very busy. The insurance company said the damages that the adjuster saw total $5,000 and they were going to cut a check minus the deductible, for us to make repairs. While talking to the gentleman from the insurance claims department he realized that no one was sent from a mold mitigation company to check for mold since it was a plumbing leak. So, a company was scheduled and came out the same day. We do have mold growing on the walls of the bathroom and probably in the walls as well. We have a $10,000 mold/fungi clause in our policy. Since the insurance company neglected to send a repair or mold mitigation team sooner are, they now liable? For weeks the family has been complaining of headaches and such. I, myself have been very fatigued and with joint pain, possibly a result of mold in the home.

Asked on August 22, 2019 under Insurance Law, Florida


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 years ago | Contributor

The insurer is probably not liable, since the insurer's obligation is to pay for the repairs, not to make them or to protect your health. If you and your family were suffering headaches and the like, you could have brought in your own mold specialists and then sought to have the insurer pay for it--you had no obligation to wait on the insurer, just as they had no obligation to investigate, find, and deal with this issue on their own. 

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