Wildfire Attic Insulation Replacement – Denial of Coverage Todd Levine asked 1 week ago
Wildfire Attic Insulation Replacement – Denial of Coverage

My home was directly impacted by the Eaton Fire, with neighboring houses completely destroyed. While my home did not sustain direct physical damage, char, soot, and ash permeated the interior. My insurance company engaged a third-party hygienist to assess contamination levels, specifically testing for soot, char, ash, and asbestos.

Based on their findings, my insurer approved general cleaning for the home but denied coverage for attic insulation replacement.

The hygienist’s report states:

• “Observation revealed evidence of suspect wildfire particulates and a smoke odor in the attic.”

• “Odors consistent with smoke were noted by the investigator in the interior of the Subject Property.”

• Test results detected 1% char, less than 1% soot or ash, and no asbestos in the attic.

Despite these findings, the hygienist only recommends specialty cleaning if 3% or greater of soot, char, or ash is detected. Since the threshold was not met, they determined that wildfire particulate concentrations do not justify specialty cleaning or attic insulation replacement.

Is there a way to push back on the insurance company to require coverage for attic insulation replacement? What options are available to formally dispute the denial?

1 Answers
Answer for Wildfire Attic Insulation Replacement – Denial of Coverage Alexis Ricci Staff answered 1 week ago
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Hi Todd, you are in a tricky grey area, where the observations noted by the hygienist on your report appear in contradiction to the findings, and ultimately, the carrier’s position on coverage regarding the replacement of your attic insulation. Things to consider:

1) Challenge the Testing Methodology and Threshold:

-Request documentation showing how the 3% threshold was established as the industry standard. You may not receive this information from the carrier or the hygienist without multiple follow ups.

-Ask if this threshold accounts for cumulative effects of soot, char, and ash together or are these threshold accounts considered for each soot, char and/or ash.

-Question whether the sampling method captured a representative picture of the entire attic, meaning where were the samples taken? It seems suspect that the hygienist noted smoke smell and observed residue and the carrier is not replacing the insulation, as it is impossible to clean insulation (it is porous and will absorb the toxins, chemicals, ordor and soot from a wildfire) and the smoke smell/ash residue will remain in the insulation.

-Investigate whether other testing companies use different thresholds

Unfortunately, you will need to be vigilent with the carrier regarding their insulation coverage position. This will mean that you may need to do your own research and may want to consider getting an industrial hygientist’s second opinion. Reach out to your adjuster to discuss why the hygienist’s observations have not been considered in their coverage decision; the hygienist definitely noted debris needing cleaning.

UP provides the following resources related to smoke restoration and cleanup:

https://uphelp.org/claim-guidance-publications/smoke-and-ash-damage-from-a-wildfire/

https://uphelp.org/claim-guidance-publications/thermal-extreme-heat-damage-from-a-nearby-wildfire/

https://uphelp.org/claim-guidance-publications/smoke-restoration-guide/

If the matter becomes too taxing or complicated for you, you can consider:

-Professional help, such as a public adjuster or attorney…possible options are listed here: https://uphelp.org/sponsor-location/california/

-Filing a formal written appeal with your insurance company:

https://uphelp.org/claim-guidance-publications/speak-up-how-to-communicate-with-your-insurance-company/

https://uphelp.org/claim-guidance-publications/sample-letter-protecting-your-legal-rights/

-Filing a complaint with the California Department of Insurance; https://www.insurance.ca.gov/01-consumers/101-help/