High-Rise Supply Line Failure, Mold, and Master Policy Layers
A 12th-floor unit owner in a Honolulu high-rise retained you after a toilet supply line failed while she was traveling. Water ran for several days before the building engineer shut it off. Her HO-6 policy has $250,000 Coverage A, a $10,000 mold sublimit, $5,000 loss of use, and $1,000 emergency mitigation. The AOAO's master policy covers the building shell and common elements; the unit owner's policy covers her improvements and betterments. Three neighboring units and the common hallway were damaged. The owner first called the AOAO, then her insurer five days later. Mold is now visible in her bathroom and closet. The carrier says the mold is excluded and that the delay in reporting prejudiced its investigation. The owner wants you to get the master policy to pay for everything and to include her hotel and meal costs for three months while repairs are made.
1. What investigation steps are needed to establish the cause, date of loss, and notice issues?
Read the worked answer
Begin with the physical cause. Obtain the failed supply line, the building engineer's shutoff log, the AOAO incident report, and any work orders for the toilet or valve. Interview the owner about when she left, who had access, and when she returned. Secure the unit's smart-water or building leak-detection data if available. Photograph and moisture-map all affected areas, including the hallway and neighboring units, and get the AOAO's contractor report. Establish the probable date of loss from the first wet materials, neighbor complaints, and the shutoff record. On notice, do not concede prejudice automatically. The HO-6 and Hawaii claims practice require prompt notice, but the carrier should identify what evidence was actually lost because of the five-day delay. If the unit was wet for days before the owner returned, the carrier already faced a deteriorated scene; document what you preserved and what the carrier inspected. Get the carrier's reservation-of-rights letter and its specific mold exclusion language. Separate the mold investigation from the water-damage investigation so the carrier cannot use the mold denial to avoid the covered supply-line loss.
2. How should coverage be allocated among the HO-6, the AOAO master policy, and the neighboring owners?
Read the worked answer
Read the HO-6 and master policy definitions rather than assuming the master policy pays everything. The HO-6 typically covers the unit owner's improvements and betterments, personal property, loss of use, and any assessment charged by the AOAO for master-policy deductible or common-element damage. The master policy typically covers the building shell and common elements, but it may exclude unit interiors or betterments. Obtain the AOAO's governing documents and the master policy declarations. Determine whether the failed supply line is a unit-owned fixture or a common-element line; that fact drives liability and subrogation. The three neighboring units may claim under their own HO-6 policies, and their carriers may seek subrogation against the unit owner or the AOAO. The owner's demand that the master policy pay for everything is likely overbroad. Present a matrix: HO-6 pays covered interior damage, personal property, and loss of use subject to limits; master policy pays common elements and any covered building shell damage; the AOAO may assess the master deductible back to the responsible unit if the governing documents allow. Document each layer and request written coverage positions from both carriers.
3. How should the adjuster evaluate the mold sublimit and the three-month loss-of-use claim?
Read the worked answer
The $10,000 mold sublimit applies to mold remediation arising from a covered water loss, but the carrier must first determine whether the mold is excluded entirely. If the supply line failure is covered, mold that ensued from that covered water damage is usually subject to the sublimit rather than a complete exclusion. Get a hygienist's protocol and an itemized remediation estimate. Separate remediation of building materials from cleaning of personal property, because the sublimit may apply only to mold remediation and not to the direct water damage. On loss of use, the policy limit is $5,000, so a three-month hotel and meal claim cannot exceed that limit. Test reasonableness: obtain the repair estimate and timeline, the owner's hotel receipts, and evidence that the unit was uninhabitable. Three months may be longer than the necessary repair period; compare the estimate to the actual schedule and document any delays caused by the carrier or the AOAO. The $1,000 emergency mitigation limit may be low, so confirm whether it is a sublimit or an additional benefit. Present the covered water damage, mold remediation within the sublimit, and loss of use within the $5,000 limit as separate buckets.