Ombudsman Orders Higher Compensation From Insurer Over Mould Dispute
Ombudsman Orders Higher Compensation From Insurer Over Mould Dispute
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The Australian Financial Complaints Authority (AFCA) has directed insurance provider Hollard to enhance its compensation payout to a homeowner following a failed attempt to remediate mould contamination in the owner’s property.
Despite previous repair efforts by Hollard, lingering mould issues persisted, prompting further disputes.
The homeowner, dissatisfied with earlier repair efforts concluded in May 2023, cited an expert analysis revealing ongoing mould contamination. The analysis detailed "moisture migration" from damp materials on the ground floor contributing to mould growth on the upper levels of the home. A mycologist’s inspection in August 2023 uncovered significant fungal spore concentrations throughout the property, including in the insulation and air-conditioning system.
Subsequent investigations indicated elevated spore levels within key areas such as a bedroom and bathroom. The mycologist conclusively stated that the property was not adequately remediated for mould.
Hollard refuted these findings, asserting repair work was satisfactory and contested the reliability of the homeowner's assessments, which were conducted six to ten weeks after Hollard’s expert, WEC, had reportedly verified the mould issues as resolved. Hollard suggested that any ongoing mould presence could be attributed to external factors, such as the homeowner’s pets or workers.
Conversely, the AFCA panel criticised Hollard’s WEC findings for their lack of specificity, primarily relying on generalized airborne mould testing. In contrast, the complainant's experts provided more comprehensive evaluations evidencing persistent mould issues.
The AFCA noted a contradiction in Hollard’s stance, linking the return of mould to non-claimable factors, as this was not in alignment with its own investigations which attempted to undermine the homeowner's findings of mould.
The authority concluded that Hollard had inadequately addressed the mould issue, likely exacerbated by insufficient containment and delays, allowing its spread to the upstairs area of the property.
In light of these findings, AFCA recommended a fair resolution involving a cash settlement to encompass a renewed scope of works with a 15% contingency increase. Moreover, Hollard is required to fund alternative accommodation while the property remains uninhabitable, compensate for any damage from its repair work, and cover the homeowner’s expert costs.
Additionally, Hollard has been mandated to pay a total of $5,400 in damages-$2,500 for the unresolved mould issue and $2,900 for failing to adhere to an earlier AFCA dispute outcome.
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Loss Ratio: The ratio of claims paid by an insurer to the premiums earned, used as a measure of profitability.
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