The client has a summer home that was vacant from 11/2/23-5/29/24 when the damage was discovered. Wind blew the rear roof section up allowing water to get into the second floor. There is mold throughout the home now and water damage. Insurance is denying mold damage based on the HO-9R(02) (07-08) pages 17-18 and HO-NY (04-13) page 1 which modifies the fungus language. They are currently covering repairs to the roof and repairs to the second story, but no repairs to the first. My question is whether their denial of mold would be accurate due to the exclusion second language? They originally intended to deny the claim based on the 14-day repeated seepage language which I pointed it was not applicable in this instance of a weather-related loss.

New York Subscriber

The water damage exclusion on page 17 includes a list of various causes of water damage from floods, water backup, overflow of dams, but it does not mention rain. While the list of excluded items is preceded by language excluding water from any act of nature, the principle of ejusdem generis should apply. That principle states that when a list of terms shows specific terms and then refers to them generally, then general terms only refer to items of a similar nature. The policy specifically states that "water damage consists of" and then provides the list, which does not include rain water or water from other acts of nature. What is excluded as water damage is what is listed, not the acts of nature listed in the opening clause. The water damage should be covered.

As far as the mold/fungus damage, the HO- NY (4-13) is removing the additional coverage for fungus, wet or dry rot. First it removes the additional coverage: ADDITIONAL COVERAGES 16. Fungus, or Wet or Dry Rot is deleted.

Then in this section: SECTION I – LOSSES WE DO NOT COVER

It's replacing the exception listed here: "i. "Fungus", or Wet or Dry Rot, or Bacteria other than as provided in ADDITIONAL COVERAGES, "Fungus", Wet or Dry Rot". with a direct exclusion " i. " Fungus", or Wet or Dry Rot, or Bacteria. "It's removed the exception for additional coverages.

So the carrier is correct. There is coverage for the damage to the roof and second story, but no coverage for the mold and fungus.