Claims Handling and Investigation of the Mold Claim of Bodily Injury or Property Damage
Because multiple exclusions in a CGL policy or other liability policy may involve an adjuster, an insured or the attorney for either, the adjuster starting an investigation of a mold claim should protect the insurer from potential misunderstanding or inadvertent waiver of the insurer’s rights. In that regard the adjuster should make immediate, but no later than 24 hours after notice is received, contact with the insured. The insured should be asked at the first meeting to sign a non-waiver agreement that is a contract where both the insured and the insurer agree that the investigation of the claim will not waive any of the rights the insured and the insurer have nor will either be estopped as a result of the investigation.
The first contact by the insurer with the insured should advise the insured of the following:
- the full name, address, and telephone number of the adjuster;
- a description of the coverages available to the insured;
- a statement of the periods of time the insurance is effective;
- the insuring agreements that may provide coverage to the insured;
- the conditions with which the insured must comply;
- any forms the insurer requires that the insured submit to the insurer;
- the investigation the insurer intends to conduct;
- the request for a non-waiver agreement; and
- the need to submit a sworn statement in proof of loss no later than 60 days after the request unless the time is extended in writing.
The brief description of available coverages should be made orally at the initial telephone contact and followed up with a written description.
Further investigation details are in the video.
© 2020 – Barry Zalma
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 52 years in the insurance business. He is available at http://www.zalma.com and firstname.lastname@example.org.
Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.
Over the last 52 years Barry Zalma has dedicated 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 make it possible for insurers and their claims staff to become insurance claims professionals.
Read posts from Barry Zalma at https://parler.com/profile/Zalma/posts
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