Storm Season and Mold: What Insurance Actually Pays

The fourth named storm of the Atlantic season, Dolly, showed up on the maps Friday morning while a cold front pushed showers and thunderstorms across eastern Maine. Dolly is weakening on her way to the Leeward Islands, so she is not our problem. The calendar is. September is the busiest stretch of hurricane season, and the same forecast has another low pressure system aimed at New England for Tuesday and Wednesday.

Good weekend to answer the question people ask us three days too late: if water gets in and mold follows, who pays for it?

The answer depends entirely on how the water arrived

Insurance does not care much about the mold. It cares about the water that came before it. Two buildings can end up with the same stained drywall and the same smell, and one claim gets paid while the other gets denied, because the water took a different route in.

The Maine Bureau of Insurance puts the main line plainly. Flood damage, meaning rising ground water and overflowing waterways, is not covered under a typical homeowners or renters policy. It is covered only if you carry a separate flood policy through the National Flood Insurance Program. Water that comes at the building from above is treated differently. The Bureau says damage from wind or rain, such as water through a leaky roof, is typically covered, subject to your deductible and your policy terms.

Then there is the middle ground, which is where most Maine basements actually get wet. A sump pump that quits during a downpour is neither a flood nor a roof leak. The Bureau notes that some insurers offer optional coverage for sump pump failure in limited circumstances. Optional means you do not have it unless you asked for it and paid for it.

Flood insurance usually does not pay for the mold either

This one surprises people. Buying a flood policy does not buy mold coverage. The Standard Flood Insurance Policy excludes loss from water, moisture, mildew or mold that results from a condition within the policyholder’s control, and it names failure to inspect and maintain the property after the flood recedes as one of those conditions.

FEMA publishes its appeal decisions. In appeal decision B15, a homeowner was paid roughly $69,000 for building damage and $84,000 for contents after a September 2019 flood. Months later an odor turned up in one room, an environmental company confirmed mold in two rooms, and the insurer denied that part. FEMA upheld it, on timing. Mold found five months after the flood is not covered even when the flood is what started it.

The Superintendent of Insurance made the same point from the other direction in a column on protecting property against storm damage. He describes a Mid Coast homeowner denied coverage for storm damage after the insurer and an independent adjuster concluded the house flooded because of improper window installation and pre-existing rot and mold. The storm was real. The prior condition is what sank the claim.

What we see when we walk in behind an adjuster

The buildings that get paid look different from the ones that do not, and the difference is rarely how bad the damage is. It is what the owner can prove about the first two days.

When we open a wall on a claim job, the moisture meter tells us how long that cavity has been wet. Sheathing damp for a season reads differently than sheathing soaked last Tuesday, and staining has a grain to it. Old water leaves hard tide lines and rusted fastener heads. An adjuster arriving three weeks later reads the same evidence, and if the only story available is the one the wall tells, the wall usually says this has been happening for a while.

What holds up is boring. Dated photos taken the day the water appeared, before anything gets moved. A photo of the water line against something with known height, a door casing or an outlet. Receipts for the fans and the dehumidifier. A note of when the drying started and when it stopped. EPA guidance is that wet materials dried within 24 to 48 hours will usually not grow mold, and that same window is what a carrier is measuring you against when it decides whether the mold was within your control.

Three things to do before Tuesday

Pull your declarations page and find the water damage section. You are looking for the flood and surface water exclusion, and for whether you carry a sump pump or water backup endorsement. Most people have never read this page.

Call your agent, not your insurer’s claims line, and ask two questions. What would you pay if my basement took two feet of water, and what would you pay if my roof leaked into a ceiling. If you want flood coverage, ask how long the waiting period runs before a new policy takes effect, because it does not start the day you buy it.

Put a charged phone and a tape measure where you would grab them. Documentation costs nothing and is the only part of this you fully control.

If you own rental property, the paperwork matters more, not less. Maine’s warranty of habitability now reaches chronic moisture and mold conditions, and we went through what the rental mold law expects of landlords earlier this month. Your dated response file serves both purposes at once.

Small wet spots caught fast are a homeowner job, and we say so on every call where that is true. When the water sat, or got into cavities, or keeps coming back to the same corner, that is when to have someone open it up. Our free assessment exists for that call, what remediation costs in Maine is published so nobody is guessing, and if a contract follows, read what Maine law requires that contract to say before you sign it.