It Grows on You

At a hearing next week (LBJ library, Oct. 16), the Texas Dept. of Insurance will attempt to establish a compromise between insurance companies and homeowner policyholders over the much-debated coverage of mold-damage claims. Like most compromises, the TDI's current proposal to cap mold-damage claims in standard homeowner policies at $5,000 (with the option to purchase additional levels of coverage) hasn't satisfied either side.

Fearing that the insurance industry's promise to offer additional levels of mold coverage will prove hollow, consumer advocates say the cap is inappropriate and unfair. While TDI has the authority to require the extra levels to be offered, the Insurance Commission has the authority to set rates for only 5% to 10% of the Texas market. "Insurance companies can ensure that no consumer will ever purchase additional coverage by pricing it out of sight," says "Birny-- Birnbaum, executive director of the Austin-based consumer advocacy group Center for Economic Justice. (CEJ specializes in insurance and utility markets.) "This simply shifts the responsibility from the companies to the consumers."

But insurance companies balk at the $5,000 cap as well; most would prefer to drop mold coverage altogether. "We don't believe the standard policy was ever intended to cover mold damage," says Texas Insurance Council spokeswoman Pearl Jurak. The Council is preparing a few alternative proposals to put before the TDI at the hearing, she says, such as to eliminate mold coverage from standard policies but allow policy buyers to purchase the coverage separately.

According to industry spokespeople, the dramatic rise in number and amount of mold claims filed against Texas insurance companies in the past two years has thrown the industry into crisis. Before 1999, for instance, State Farm Lloyds -- the largest homeowner insurer in Texas -- dealt with mold claims only as a minor part of water-damage claims. By August of this year, more than 1,100 claims had been filed against the company. In September, State Farm announced a net operating loss for the year of $504 million.

"Our costs for mold-related claims are skyrocketing," State Farm Senior Vice-President Ron Dodd said in a statement released Sept. 18. "On average, a claim involving mold costs substantially more than one that doesn't, and we're seeing about five times as many claims involving mold this year as we did a year ago."

In June, a Travis County District Court jury awarded a Dripping Springs family $32 million from Farmer's Insurance Group after finding that the company's neglect of a water damage claim caused potentially toxic strachybotrys atra to spread in their home. The jury also found that the company committed fraud in the handling of the claim. Following that expensive case, Farmer's led other insurance companies in requesting that TDI remove mold-damage coverage from standard homeowner policies. In response to the rising claims, State Farm and Farmer's insurance groups have stopped writing new homeowner policies in Texas until further notice.

Whether mold actually poses health risks is still being debated by the national Centers for Disease Control, the Texas Dept. of Health, and the Environmental Protection Agency. Meanwhile, building evacuations and the use of toxin-defensive moon-suits have become common. Combined with the costs of extensive air sampling and clean-up, however, these procedures have driven insurance company costs even higher.

Texas Insurance Council Executive Director Rick Gentry blames the rise in claims on "an entire new industry that has emerged to cash in on mold claims," including "public adjustors, testing and remediation firms, restoration firms, and plaintiff's attorneys."

Seemingly in agreement, TDI asked the attorney general's office early this month to inquire into pricing practices of mold clean-up firms in the Corpus Christi area. Data from Nueces County for Texas' three largest insurance companies shows that mold damage costs per policyholder in the area are five times higher than the state average. (Earlier this year, the Legislature rejected an attempt to regulate the mold remediation industry.)

"We can't overlook the possibility that some companies may be taking advantage of consumers' fear of mold by charging excessive prices," says TDI Commissioner Jose Montemayor.

But Birnbaum, a former associate commissioner and chief economic advisor at TDI, believes the rise in claims may be attributed to the public's growing awareness of mold and its potential health risks. "The fact that there haven't been mold claims in the past could be because consumers didn't know enough to file claims," he says. "That there are mold claims now doesn't mean that there has been a conspiracy of lawyers."