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Where there is fire, there is smoke.
But in California, some insurance companies are trying to treat forest smoke damage separately from fire damage so they can limit coverage illegally, according to nonprofit Consumer Watchdog and the Department of California Insurance. California insurance companies denied the allegations and said they follow all applicable laws.
With forest fires growing in severity and frequency, insurers are modifying policies “to restrict investigations into the extent of forest fire damage, reduce the benefits they pay under the policy, and create often insurmountable obstacles for homeowners.” that they seek payment for their legitimate claims, “he said. in Smoke, ”a report released this week by Consumer Watchdog, which oversees the insurance industry.
California law requires insurers to cover all fire losses.
The California Department of Insurance wrote a critical report in late May on the limits of smoke damage claims in the Fair Plan, California’s last resort insurer for homeowners who can’t find policies on the private market , a growing problem for people at the urban-wild interface. areas. The agency said it is actively pursuing this issue with Fair.
In addition, he said he has found and dealt with several cases in which other insurers inserted illegal provisions to limit smoke claims. However, he disputed Consumer Watchdog’s claims that it had turned a blind eye to insurers’ practices and opposed some of the specific claims in its report.
For people whose homes were affected by the conflagrations in California, the small print of insurance policies can become a “gotcha”.
Sarah Maple’s home in Boulder Creek survived the 2020 CZU Lightning Complex fire, but was uninhabitable due to smoke damage. Maple, who now lives in a San Francisco apartment, said his insurance, the California FAIR plan, refuses to pay him, despite reports he commissioned about the damage.
Gabrielle Lurie / The ChronicleThis is what happened to 37-year-old Sarah Mapel. When he saw the 1898 house nestled in the Santa Cruz Mountains, Mapel felt he was at home. He bought it in 2018, the first house he had ever had, and fixed it by doing his best “to preserve history, beauty and uniqueness,” she said. It was his safe haven during the pandemic.
Then came August 2020 CZU Lightning Complex Fire.
His Boulder Creek home survived, but many of his neighbors’ homes did not. Smoke, ashes and rubble from houses and burned trees permeated Mapel’s house. He was out of town for his father’s funeral. When the evacuation order was lifted after about three weeks, he returned home with an inspector from Fair, his insurance company. The power was still off, so they used flashlights.
“Everything was covered in ash, debris could be seen in the air,” he said. “Being there for any length of time made me feel sick.”
The Fair report took months to arrive and said the house only needed cleaning and odor treatment with ozone, according to a lawsuit that Mapel has filed against Fair. The insurer sent him $ 1,150.79 and closed his case.
Sarah Mapel tried to preserve the historic character of her 1898 home in Boulder Creek in the Santa Cruz Mountains.
Taught by Sarah Mapel
But the house still made her feel sick, Mapel said. He hired a public adjuster and an industrial hygienist, who said he needed extensive repairs, including the replacement of all insulation. Fair dismissed those reports, he said, pointing to a political language that limits its smoke coverage to damage “visible to the human eye without help” and detectable by the “helpless nose of an average person.”
Fair’s refusal to consider expert reports or pay for lab tests “is the ostrich approach to investigating insurance claims; he’s saying, “We don’t want to know,” said Dylan Schaffer, an Oakland attorney representing Mapel.
Fair said he cannot comment on the pending litigation.
“The Fair Plan will pay to correct the direct physical loss caused by a covered hazard to the properties it covers,” it said in a statement. “Our policy language in this matter was negotiated and approved by the California Department of Insurance.”
However, this department detailed several issues with the language of the Fair’s policy.
Fair may have obtained approval of the policy changes “by erroneously characterizing and / or omitting relevant material facts,” a letter sent by insurance commissioner Ricardo Lara to Fair in January 2021. The letter noted that, while Fair told the department he had made changes that would not affect smoke coverage, he told his brokers something completely different.
“These changes are substantial and, in some circumstances, there has been a reduction in limits and removal of coverage,” Fair told runners, according to Lara’s letter.
The insurance department’s report on Fair said it had received 173 complaints from 2017 to early 2021 about handling Fair’s claims for smoke damage. Among them, he found 59 cases in which Fair illegally denied or limited coverage for smoke damage, he wrote.
However, the issues about smoke coverage are not just Fair.
The Boony Doon home where Emily Mastellone-Snyder lived with her partner, two young children and an elderly mother was also infused with smoke from the CMZ Lightening Fire, which burned many of her neighbors ’homes as well as trees and dependencies of his property.
“There was black soot everywhere,” he recalled when he saw the house weeks later when evacuation orders were lifted. “I had just screamed smoke. It was the most putrid smoke, not like the sweet smoke of the bonfire, but the nasty, pungent, chemical and plastic smoke. After a couple of minutes I felt bad and nauseous with a bad of head; it was horrible. “
The fires burned down under the roof of Boony Doon, California, home of Emily Mastellone-Snyder and her family. He said smoke permeated the entire house.
Provided by Emily Mastellone-Snyder /
Her insurer, Nationwide, paid for the cleaning and removal of fumes, but said it turned out to be insufficient, as the odors were still terrible.
“We felt sick every time we went home,” Mastellone-Snyder said. He hired outside experts who recommended that they break and replace all insulation; sealing attics, basements and ceilings; and paint the interior. Nationwide said it would not cover those expenses.
In its denial letter, Nationwide said it would not cover “any smoke, soot, coal, ash, particles, matter, material, other by-products or waste, or odor that is produced, emitted, or released during or directly as consequence or after a forest fire or a rubbish fire that is undetectable by the human senses without help “.
Nationwide did not comment on the Mastellone-Snyder case, but reacted to the Consumer Watchdog report.
“This report appears to be based on an incomplete sample of obsolete policy language submissions,” he said in an email. “We are fully committed to complying with all laws and regulations of the states where we do business.”
The Personal Insurance Federation of California, the industry’s trade group, sent an almost identical response to the document.
“The report is also based on an incomplete sample of language submissions of obsolete policies,” he said. “In any case, PIFC members are fully committed to complying with all laws and regulations of the states where they do business.”
Sarah Maple shows off her grandmother’s bowl that was saved from her old home in Boulder Creek. The house survived the 2020 CZU Lightning Complex fire, but was uninhabitable due to smoke damage.
Gabrielle Lurie / The Chronicle
Both Mapel and Mastellone-Snyder said they spent countless hours managing the situation of their homes and asking for help from their insurers. They both ended up paying tens of thousands of dollars out of pocket to repair their homes and then sold them to recoup some of their expenses and because they no longer felt comfortable living in them. They both think they got lower prices because of the smoke histories of their homes.
“We feel compelled to sell the house of our dreams,” Mastellone-Snyder said. “We had the heartbreaking decision, if the insurance won’t help us clean this house, we will never feel comfortable bringing our young children and my mother here.”
Both women also had to discard almost all of their possessions because they were too polluted to save them. Mastellone-Snyder said her daughter, now 7, broke down crying the other night when she had to throw a stick and said, “I’ll never get it back, just like my favorite Teddy Pearl.” .
The two former owners now live in rented accommodation and as housing costs have risen, they both think they may never be able to afford a house in the bay area.
“It would probably have been better if my house had burned in a forest fire,” because that would have been clearly covered, Mapel said. “The amount of trauma and pain (to fight for compensation) was as if any base and stability had been torn from under your feet.”
Carolyn Said is a writer for the San Francisco Chronicle. Email: csaid@sfchronicle.com Twitter: @csaid