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The consumer noticed a crack to his kitchen island, so they removed the kick plate and found mold beneath the island. There was no free water present on the surface, no active leak, and no continuous leak.
The insurer denied the claim citing continuous or repeated seepage or leakage of water, as well as damage caused by mold/fungi which are both exclusions in the consumer’s insurance policy.
The consumer disagreed stating this was a one-time instantaneous event and no free water was present. The dishwasher was used on a daily basis and there were no signs of water coming through or seeping into the basement.
GIO’s Investigation Officer reviewed all documents provided by both the consumer and the insurer.
The insurer was relying on their professional’s internal report, which stated the damage was caused by a slow leak that was ongoing for some time.
The Investigation Officer discussed the file with the insurer, and the possibility that it could have been a sudden one-time leak since there was no visible damage to the underside of the subfloor as noted in the insurer’s Final Position Letter.
The insurer advised that the consumer would have to submit evidence to counter their decision.
As there was no resolution during the investigation, the file proceeded to mediation.
Mediation was successful and the insurer agreed to resolve the claim for $4,500 to repair the damage
GIO is an independent body set up to help Canadians find a fair resolution to disputes with insurance providers. GIO can provide advice on dealing with your insurance company as a first step. If you are not satisfied with the decision from your provider on your claim, GIO can help resolve your claim.
If you’d like to submit a claim visit here.
