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My insurance claim was denied. I had water damage from my hot water heater which leaked causing extensive damaged to several rooms in my house. The garage, laundry room, my guest bathroom and dining room. The person who replaced the heater recommended a restoration company that he'd worked with before. I called them and made an appointment for them to come out and assess the damages. I asked if they worked with my insurance company and they said yes. I did give them permission to start the work knowing they accepted my insurance. The company came in cut out my walls, carpeting and my floor to ceiling mirror. My insurance company denied my claim saying it was long term water damage. My walls are cut open in several rooms, my carpet is ripped up and my floor to ceiling glass mirror is all broken. Now I'm left to pay for this out of pocket. My question is, the restoration company which is a reputable company shouldn't have cut up my walls, carpeting and mirror until they got insurance approval. I think they knew this was long term water damage and tried to get rid of the evidence. I certainly wasn't aware of the policy of not covering for long term damage, but I'm sure the restoration company knew and they were just trying to get money from the insurance company. Is there anything I can do to resolve this without paying for the entire restoration process?

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Not sure this is a specific question to a situation regarding aging. Perhaps you might want to try a legal online site. There might be a charge but it could be minimal.
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Not a question for a caregiver forum
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You need to talk to a lawyer.
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not really the place for this but...
Gut reaction is it is your responsibility to see that the insurance company approves the repairs and the cost before you do or have any work done.
You might want to contact the insurance company again. If they can separate the previous water damage, that you acknowledge is there, from the current damage the current damage might be covered. Even if it isn't water damage is not something to fool with and it should be taken care of
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Did this company provide you with a written quote, including an outline of what it planned to do as well as the planned duration?  Or did they just start the work?   What are their payment terms?  Longer projects that typically span weeks are in my experience usually ones in which the contractor is paid monthly, and submits and AIA (American Institute of Architect) forms.

(This explains how construction draws are usually handled, giving you an idea of how this company might approach the work, even though it's not doing construction or building work.   This would also lend insight into whether or not it was following that procedure or was just out to get as much done as quickly as possible.

https://www.porterwright.com/media/construction-loan-draw-procedures-residential-and-commercial/

I raise this issue b/c it kind of surprises me that an extensive project such as you mention wouldn't be prefaced by some type of agreement, or at least an appraisal of what was to be done and what the costs were.


You're in kind of a bind, especially given that the insurance company denied the claim.  I won't mention names, but some insurers have reputations for behaving in this disgusting manner.

I don't know enough about water damage to determine whether it's short or long term damage, but I do know that some insurance companies are dishonest about treating their clients and do try to avoid paying claims if possible.  I do know as well though that long term damage can be reflected in the tones of the underlying wood, and the permeation of the wood.  If the wood was rotten through, to me that would suggest long term damage.  

You might read your policy closely to see what the terms and conditions are for long term damage, and in turn what your rights are.   Water damage can be an "iffy" subject though.

The terms of the contract you presumably signed should address payment, i.e., whether it's in a lump sum or periodically.    Have you given this contractor  a formal "stop work" order?  If not, do so, ASAP.  

What you might consider is hiring an independent contractor or appraiser, someone familiar with water damage.   The This Old House specialists, such as Tom Silva,  are the kind of guys I'm thinking of, but I don't know if they'd take this kind of project as a referral estimate only. 

What I would do though is post on building forums, or specifically a plumbing forum, or the This Old House forum if it's still in existence.   You might get more directed information on specific aspects if you send detailed photos.   I don't know whether or not you could legal advice though, and I think that's what you're looking for.

Your project though sounds like something contractor Mike Holmes might take on, as a tv project.   I don't know anything about his terms of arrangement, and it may be that the publicity alone is his "payment."  My sense is that he takes on projects that other contractors have "screwed up."  

You can also contact these other home improvements shows, but focus not on the home improvement aspect but the repair work gone wrong and more specifically, how to correct it.

https://www.ranker.com/list/best-home-improvement-tv-shows/ranker-tv

It might be worth a try to contact Ask This Old House.  It might be that a plumbing expert could come out and show you how to fix some of the worst damage.  

https://www.thisoldhouse.com/ask-this-old-house

I'm sorry to read that you're in this uncomfortable and unsettling position.   I hope you can find some way to address the situation.
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You should have had the insurance adjuster come out and look before approving any work, The insurance company is denying probably partly because of that,
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I think you messed up big time by doing everything in the wrong order, but at this point I'd say you need to hire a public adjuster to look at the situation. A public adjuster looks at the damage, then goes after the insurance company to get them to do the right thing and pay out for the damage. The adjuster works on contingency and receives a percentage of the payout.
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