Archive for the ‘Toxic Black Mold Insurance Claims’ tag
Is it Toxic Black Mold, Mildew or a Fungus?
I get a LOT of folks asking if the mold in their refridgerator is the notorious “Toxic Black Mold”.
Well, it may be Black, but I would assume it’s a fungus like Aspergillus or Penecillium!
Opening your refrigerator and finding colonies of fuzzy colors covering your food is all too familiar to many of us. Many are familiar with shoving your leftovers to the back of the fridge, only to find out weeks later that what was once spaghetti has now become an undistinguishable mass of mushy noodles and discolored tomato sauce, covered with green and purple fuzz.
This fuzz of course, is more commonly known as mold. Though there are several types of food molds, typically bluish-green to green molds are usually Penicillium or Aspergillus; black to dark brown molds are usually Cladosporium herbarum, Alternaria alternata, Aspergillus niger, Cladosporium sphaerospermum or Stachybotrys chartarum, which is highly toxic.
Lastly, the reddish or pink molds are usually Fusarium species. With a proper growing medium—in this case food—mold can grow anywhere as long as the conditions are livable.
The environment need only be sufficiently moist and warm to provide a home for these fungi.
Like mushrooms, molds reproduce by releasing spores into the air that can land on your food. Soon enough, if enough time passes, they will settle into their new home, creating thin roots called mycelium that spread throughout the food. Once the root is planted, the stalk portion of the mold fungus that appears on the surface of the food begins to produce spores and take its shape in the typical mold we see all too often.
Though there are some foods where mold growth is intentionally induced, such as cheese, most unintentional mold growth that is consumed in significant amounts can have dire consequences, ranging from sickness to diarrhea and even death. Even taking a whiff of a moldy piece of food can be dangerous if you are allergic to mold.
Undesirable molds produce mycotoxins, which are toxins produced by some fungi, though not all. Mycotoxins are produced around the mycelium of the mold, penetrating deeply into the food. Additionally, mycotoxins can survive for long periods of time in food and usually cannot be destroyed through cooking processes. Depending on the type of food, a different mycotoxin may be present.
So the next time you reach into your refrigerator for a piece of bread and find that it’s been overtaken by fuzzy green colonies, think twice about stuffing it into your mouth, even if it’s the last thing in your fridge.
Better safe than sorry folks! 
~ Jimmy
Toxic Black Mold - Your Home Insurance Carrier and the Facts YOU NEED TO KNOW BEFORE you file a claim.
The objective of the insured consumer is to have their property returned to a pre-damaged condition.
The objective of the insurance adjuster is to minimize the claim payout.
WE HAVE, THEREFORE, AN ADVERSARIAL SITUATION.
The quicker the consumer understands and accepts this fact, the better. Begin by examining the entire claim process exclusively in terms of MONEY. It is your MONEY, and your insurance company wants to keep as much of it as possible. Of course you have lost irreplaceable belongings — family photographs, letters, and heirlooms. You have no place to live, no food, no medicine, and little clothing. You are emotionally devastated. You can’t sleep, and fail to think in terms of the tragedy equating to nothing more then MONEY. Yet, MONEY is the focus of the adjuster; nothing more.
OBVIOUS FACTS:
The professional adjuster already knows the true damages and the total exposure of the company. Her objective is to minimize what is ultimately paid. The adjuster is required by State law to set “Reserves” (the amount they believe the claim will ultimately cost their company) immediately after inspection of the loss. The insurance adjuster wants the consumer to accept her recommendations on who establishes the building and contents claims. Why? Because the insurance company has control over what their “experts” determine the damages to be. The adjuster wants Contents Restoration firms she controls to immediately take possession of your personal property. Why? They now have “experts” on their side to establish what is and what is not “totaled,” and the condition of this property before they removed it from the loss site
HOW THE ADJUSTER SUCCEEDS
The adjuster must access the knowledge of the insured and play the game most appropriate to their end. The adjuster’s moves are dependent upon company “Guidelines” or “Claims Manuals.” Their objective is to keep the consumer off balance by creating confusion while appearing cooperative. (We describe it as: “smile a lot, utter nothingness, and place as little as possible in writing.”) To do so she will put as little as possible in writing thereby not committing to anything. This allows the adjuster to retain all options. The consumer is always in a defensive posture and usually does not know it. String the claim out as long as possible hoping the insureds will miss important time limits found in the policy which can invalidate all or part of the claim. Even when time limits do not pass, the consumer will be left with little time to properly establish damages when the adjuster finally discloses these limitations. The longer the claim goes on, with no commitments from the insurance company, the more options the company retains and hence, the better their negotiating position.
WHAT CAN THE CONSUMER DO?
1. The consumer must become the offensive player. They do so by:
(A). Establishing their own damages and presenting them timely and in a form required by the insurance contract, State Law, and current Case Law.
(B). Without properly presenting and itemizing your claim, the insurance company will never pay what the policy promises.
2. All communications are in writing; with verbal discussions documented in writing.
(A). The consumer needs to develop a documented “paper trail.
(B). Correspondence needs to be couched in verbiage found in the insurance policy, State Law and regulations, and be consistent with current Court decisions.
Mold: Volatile Organic Compound’s & Mycotoxins : A Primer for Homeowners
Introduction
You can find a lot of information on mold, but trying to understand it may be difficult to those who didn’t take biology and chemistry. Even after stumbling through the pronunciation of these words, not everyone can comprehend what was meant by the statement.
“Satratoxin, a low-molecular weight non-volatile organically derived agent, belongs to the macrocyclic trichothecene class of mycotoxins generated from fungal microorganisms.”
As an aid to the homeowner, this overview is intended to explain a few bad products of mold in a less scientific manner. It will focus on those types of mold that have been considered as problematic to the “indoor mold issue” and does not address other fungal organisms which may behave differently. Analogies presented are not intended to be scientifically accurate, but rather to illustrate complex behaviors in more simple terms.
The people who study mold (mycologists) have identified and described over 100,000 species and many believe that this is only a partial listing (estimates of 1.5 million species have been suggested). Try jotting down the names of the first 100,000 people you know then describe each person’s behavior in a specific setting. You will begin to understand the complexities of the problem facing these mold professionals.
Most people have associated mold with allergies and these reactions are certainly prevalent with most all species found indoors. In addition to causing an allergic response, molds can be irritating, infectious and even toxic to humans. Understanding the general behavior of mold provides insight into the adverse components produced by mold.
The Organism
Fungi can be considered nature’s garbage disposal. Without them, the term “biodegradable” would not be so significant to our planet and we would have mountains of leaves, dead trees, and other organic materials sitting around…all deposited since the beginning of time. This, in simple terms, is the ‘why’ of mold. For the moment, think of mold as a weed. This weed has a root system, a vegetative stalk, and a seed pod.
For mold, the root system is made up of hyphae (high-fee). As hyphae grows into a mass during the vegetative state,it becomes a mycelium (my-sill-ee-um). The spores, designed for reproduction, are similar to seeds.
Like a weed, mold needs food and water to survive (yes, both need more than that, however, we are simplifying things here). For mold, the food of preference is organic matter (things that once were living). Indoors, those things are wood, paper, organic dust and dirt, leather, skin flakes, body oils, etc.
When mold spores that are floating around in the air land on a food source, they sit there patiently waiting for water. If the item they land on should contain sufficient moisture, or water comes from another source (leaks, etc.), the spore germinates and hyphae grows. The hyphae branch out, secrete enzymes to breakdown the food, form the mycelium, and absorb nutrients to grow. As long as the food and water hold out, colonies will continue to grow. Note that individual hyphae and spores are very, very small and few can see them without a microscope. When you see visible mold, you are generally seeing that mass of mycelium.
Hyphae can intertwine into the fibers of the substrate, penetrating the pores. As it consumes the substrate, it can also create it’s own route by dissolving pathways into the material. This is one of the reasons it is so difficult to kill and/or clean up mold on organic substrates. If you remove the surface growth, those bits of hyphae within the substrate are ready for re-growth upon the return of moisture.
As the organism matures, it develops spores intended for reproduction. Spores vary in size, shape, weight and methods of distribution. Some are light and buoyant so they float easily through the air. Others are wet and sticky and may cling to insects, rodents, etc. as a mode of travel.
Volatile Organic Compounds
As mold “consumes” it’s food, the chemical reactions of enzymes, substrates and mold growth produce carbon dioxide, water, and volatile organic compounds (VOC’s). Because these items are a result of actions essential to the growth of the organism, they are classified as primary metabolites.
For mold, many types of VOC’s are produced and typically include aldehydes, alcohols, keytones, and hydrocarbons. They have complex structures and names like “2-methyl-1-propanol”, so if you are going to dig deeper into VOC’s, get ready for chemistry class.
They are called volatile in that they evaporate easily at room temperature and pressure. Fortunately, this volatility aids in dilution with fresh air to minimize concentrated build-up of these chemicals. Testing for VOC’s is often accomplished by using vacuum cylinders to obtain samples of the air with laboratory analysis obtained from sophisticated test instruments (gas chromatograph/mass spectrometer).
When you smell a “musty-moldy” odor, it’s generally the VOC’s you are noticing. VOC’s are often considered irritants to mucus membranes, however, are also capable of both short-term and long-term adverse health effects. If you do smell these odors, it’s a sure sign the mold is consuming and growing and you need to take action. (Note that VOC’s may also be derived from non-mold sources including natural materials used in cleaning agents.)
Toxins
Many molds are capable of producing compounds called mycotoxins which are toxic to other organisms, including people. Mycologists believe these toxins are produced as protection against competing organisms and therefore, humans are simply caught in the cross-fire of this fight for survival.
Since these toxins are not essential for growth, they are classified as secondary metabolites. Toxic secondary metabolites require extra work on the part of the organism so production does not occur at all times, or, with all types of mold.
Scientists have identified over 400 mycotoxins and unlike VOC’s, these compounds are usually non-volatile (don’t evaporate easily at room temperature and pressure). One strain of mold may produce multiple toxins and one type of toxin may be produced by multiple strains of mold. Research has indicated that the type of substrate (nutrients), the growing conditions, together with the species of mold, will impact which toxins are created.
Some of these toxic substances are considered extremely hazardous to people, unfortunately, quantified human dose-response data is limited. Lab and field studies have shown these compounds to produce severe toxic effects in both animals and humans and therefore, the general recommendation is to minimize exposure to potentially toxigenic mold. Symptoms from toxic exposure range from flu-like symptoms, skin rashes and lesions, bleeding, fatigue, difficulty breathing, depression, etc. to longer-term nerve and organ problems, altered immunity, and cancer.
Not all secondary metabolites are considered bad for people…the antibiotics such as penicillin have beneficial use. However, from the mycological standpoint, antibiotics are considered mycotoxins since they too are generated by mold to ward off microorganisms (i.e. competing bacteria).
When the organism is producing toxins, the toxins are known to be present in the cell wall of spores and hyphae. It’s relatively easy to test for spores and hyphae, however, testing these components to see if they contain toxins is significantly more complex. Whereas a single spore can be viewed under a microscope, identifying what compounds are contained in the cell wall is difficult.
In order to identify these toxic compounds, laboratories must have a sufficient quantity of toxin-containing spores and carefully process them through sophisticated and expensive equipment that is capable of isolating chemicals down to billionths of an gram (remember, mold spores are microscopic so what is contained within it’s cell wall is extremely small). This testing is made even more difficult since there are a few hundred toxins to analyze and the behavior of mold is such that a toxin-producing mold in the field doesn’t necessarily produce the same type and quantity of toxins in the lab.
Generally speaking, identifying a mold type that is known to be capable of producing toxins is sufficient information to warrant precautions and avoid exposure without submitting for toxic analysis. However, if trying to confirm specific adverse health effects, obtaining an analysis of both VOC’s and toxins can be beneficial but often expensive.
The Insurance Claim Game
The objective of the insured consumer is to have their property returned to a pre-damaged condition.
Tips to Handle your Insurance Claim Properly #1
The objective of the insurance adjuster is to minimize the claim payout.
WE HAVE, THEREFORE, AN ADVERSARIAL SITUATION.
The quicker the consumer understands and accepts this fact, the better. Begin by examining the entire claim process exclusively in terms of MONEY. It is your MONEY, and your insurance company wants to keep as much of it as possible. Of course you have lost irreplaceable belongings — family photographs, letters, and heirlooms. You have no place to live, no food, no medicine, and little clothing. You are emotionally devastated. You can’t sleep, and fail to think in terms of the tragedy equating to nothing more then MONEY.
Yet, MONEY is the focus of the adjuster; nothing more.
OBVIOUS FACTS:
The professional adjuster already knows the true damages and the total exposure of the company. Her objective is to minimize what is ultimately paid. The adjuster is required by State law to set “Reserves” (the amount they believe the claim will ultimately cost their company) immediately after inspection of the loss. The insurance adjuster wants the consumer to accept her recommendations on who establishes the building and contents claims. Why? Because the insurance company has control over what their “experts” determine the damages to be. The adjuster wants Contents Restoration firms she controls to immediately take possession of your personal property. Why? They now have “experts” on their side to establish what is and what is not “totaled,” and the condition of this property before they removed it from the loss site
HOW THE ADJUSTER SUCCEEDS
The adjuster must access the knowledge of the insured and play the game most appropriate to their end. The adjuster’s moves are dependent upon company “Guidelines” or “Claims Manuals.” Their objective is to keep the consumer off balance by creating confusion while appearing cooperative. (We describe it as: “smile a lot, utter nothingness, and place as little as possible in writing.”) To do so she will put as little as possible in writing thereby not committing to anything. This allows the adjuster to retain all options. The consumer is always in a defensive posture and usually does not know it. String the claim out as long as possible hoping the insureds will miss important time limits found in the policy which can invalidate all or part of the claim. Even when time limits do not pass, the consumer will be left with little time to properly establish damages when the adjuster finally discloses these limitations. The longer the claim goes on, with no commitments from the insurance company, the more options the company retains and hence, the better their negotiating position.
WHAT CAN THE CONSUMER DO?
1. The consumer must become the offensive player. They do so by:
(A). Establishing their own damages and presenting them timely and in a form required by the insurance contract, State Law, and current Case Law.
(B). Without properly presenting and itemizing your claim, the insurance company will never pay what the policy promises.
2. All communications are in writing; with verbal discussions documented in writing.
(A). The consumer needs to develop a documented “paper trail.
(B). Correspondence needs to be couched in verbiage found in the insurance policy, State Law and regulations, and be consistent with current Court decisions.
Negotiating a Toxic Black Mold Insurance Claim
Negotiating a settlement with an insurance adjuster demands a business like attitude and a good understanding of the claims process. And of course, it takes preparation. To prepare for such negotiations there are three things to remember: know your rights, have thorough documentation, and be able to verify your claim. By being prepared in this way your negotiating skills will be utilized most effectively.
The dynamics of good negotiation are characterized by six interrelated elements; preparation, common sense, objectivity, principle, communication, and compromise.
Preparation is a must! Have all your documentation close at hand in order to substantiate your claim.
Common sense or good sound judgment will always be your best ally. Recognize what is relevant vs. irrelevant, material vs. immaterial, fact vs. fiction.
Be Objective. Objectivity is the concentrated effort to see things clearly and without bias or prejudice. By being objective you can easily identify whether statements are made in good faith. How do you maintain this objectivity? The most effective way is by sticking to the relevant issues of the claim, recognizing how your views are similar or dissimilar to the adjuster’s, avoiding the sway of emotion or pressure, not relying on unsubstantiated statements, and verifying statements through qualified sources.
At times it can be very challenging to maintain an objective attitude while negotiating. Your objectivity will be borne out by your open-mindedness toward the issues and your ability to recognize others perspective.
When settling your claim use a principled approach. Be sure that you, the adjuster, and others involved maintain a professional attitude. Be straight forward in your communications and do not become emotionally affected by unreasonable assertions. Do not yield to pressure, intimidation, evasion or unreasonable negotiation procedures.
Effective communication is a product of accessibility, having a positive attitude, and concentration. Accessibility is maintained by first finding out the adjuster’s daily routine. Adjuster’s work schedules are open. They do not punch a time-clock and are usually available at any reasonable hour.
Speak optimistically as though your every statement is simply a breath away from happening. Show confidence, carry a look of success, and espouse an attitude that the claim will be resolved only through fairness, honesty and reasonableness.
Compromise is not compliance! It is the ability to recognize two differing viewpoints, finding the most reasonable value for each and comparing them. The following example describes how to approach a compromise on the value of personal property, in this case an antique clock.
Identify Issues
The antique clock is 102 years old. It is located in an area of the home where it was seldom seen. The adjuster may contend that its usefulness is very little, therefor its value is low. Your view of the antique clock is based on characteristics of the antique clock itself. It is of Swiss origin, was a limited production, is a collectors item, and has been a family heirloom for generations.
Determine Value
Having identified the issues a reasonable value can then be placed on each. Those issues that are irrelevant or remote should be set aside. In this case the adjuster’s opinion of the usefulness, and your view of it’s sentimental value can be eliminated since they are not relevant to the value.
Compare & Compromise
Since the issues are clear and accountable the value attached to each can easily be determined by simply attaching a reasonable value to each. At this pint you and the adjuster can go over the prices together and calculate the results. You are entitled to have the actual cash value of an antique clock with the same options as the original and the adjuster is assured that their will be no sentimental value considered in the process.
Appraisal
What happens when agreement over the value of property cannot be reached?
Most policies have a provision which sets out a method to resolve such disputes. It is called the Appraisal Clause. It is used to decide those value issues that you and the adjuster cannot resolve between yourselves. It does not resolve any other type of disagreement such as liability, policy interpretation, etc.
It is unlikely that you or the insurer will opt for an appraisal. However, it is useful to you in the event that a disagreement in price is so significant that you would be less than fairly indemnified.
The procedure for appraisal is where you and the insurer each select an impartial individual. These two people are referred to as appraisers. They can be any competent and disinterested person so long as they exercise good judgment and impartiality. For example, a contractor or someone who is familiar with construction would act as a good appraiser since they have knowledge of the costs for materials, labor, licenses, etc. However, a contractor who has submitted a bid to you for restorations would not qualify since they have a financial interest in the outcome of the appraisal. The same holds true for an agent or employee of the insurance company. If you have reason to believe that an appraiser is not qualified, competent or impartial, provide written notice to that affect to the insurer immediately.
Once you have accepted the insurers appraiser and they have accepted yours, the two appraisers will then select one other person. If they cannot agree on someone you or the insurer can ask a local judge to select someone. This third appraiser is called an umpire. He will be used to break any deadlocks between the two appraisers.
You and the insurance adjuster will provide a list of the unresolved items to the appraisers and they will determine a fair price and resolve the dispute.
If you or the insurer request an appraisal timely notices must be made. Firstly, a written notice of intent must be sent by the party initiating the appraisal to the other. Secondly, within 20 days after receipt of this notice each party must provide the other with the identity of their appraiser. Thirdly, providing there is no disagreement regarding the qualifications of either appraiser, the appraisers must select an umpire within 15 days. Once that is done the two appraisers, with the help of the umpire if needed, will resolve the issues and notify you and the insurer of the results.
If it has been more than sixty days since you filed your Proof of Loss and the insurance company has not notified you of any dispute they have with your claim they waive their right to the appraisal process and are obligated to pay the full amount as you indicated in your Proof of Loss.
The costs for the appraisal are shared by both you and the insurer. You pay for your appraiser, the insurer pays for theirs. And the umpire costs are split between you and the insurer. The three are normally paid on an hourly basis plus expenses, and never on a commission basis.