MODULE 3: PROTOCOLS & ESTIMATES
Submission & Clearance
Getting Paid on Mold Claims
Mold Claims Are Different
The submission package for mold claims is more comprehensive than water mitigation.
More Documentation
Protocol, clearance, photos, logs
More Scrutiny
Higher dollars = more review
More Delays
Missing items = payment delays
A complete package gets paid faster. An incomplete package gets questioned.
When to Submit: Option A
Pre-Approval
- Submit the estimate before you start work
- Insurance reviews and approves an amount
- Then you begin work
Advantage
Know what's approved before spending money
Disadvantage
Delays work - review can take days or weeks while mold spreads
When to Submit: Option B
Post-Clearance
- Do the work, get clearance
- Then submit everything together
Advantage
Faster project completion
Disadvantage
Risk - work might get reduced after the fact
Hybrid Approach
Many contractors use a hybrid approach.
- Submit a preliminary estimate so insurance knows what's coming
- Start work based on emergency authorization
- Submit final estimate after clearance with complete documentation
Whatever timing you choose: You need clearance documentation before submitting a final invoice. That's non-negotiable.
Submission Package: Cover Letter
One page summarizing the claim
- Property address, customer name
- Claim number, date of loss
- Brief description of mold issue and remediation
- Total amount
- List of attached documentation
Submission Package: Estimate
- Organized by sections (containment, equipment, work, cleanup, disposal)
- Line items matching protocol scope
- Quantities matching your measurements
The estimate you built following the 8-step process from the last lesson.
Submission Package: Protocol
Include the complete protocol document - all pages.
- This is your scope authorization
- Proves a third party determined what work was necessary
- Don't submit a summary - submit the full document
- If there were amendments, include those too
Submission Package: Photos
Organize photos logically
- Before work - showing mold extent
- Containment setup
- Work in progress
- Pre-clearance completion
- Disposal
Label them so it's clear what each photo shows.
Submission Package: Daily Logs
Equipment verification showing what was running each day.
Daily logs support your equipment charges.
No logs = harder to justify equipment days.
Clearance Letter is Essential
This proves the job was done right.
- Third-party verification that remediation was successful
- Without it, you're asking insurance to trust you
No clearance letter = No proof of completion
Many adjusters won't release final payment without it.
Final Package Items
Disposal Documentation
Receipts or weight tickets
Proof materials were actually removed and properly disposed
Work Authorization
Signed with mold addendum
Shows customer authorization and acknowledgement
Package Order: Cover letter, Estimate, Protocol, Photos, Logs, Clearance, Disposal, Authorization
Clearance Documentation Details
- Property address, date of testing
- Areas tested, testing methods used
- Results and clear conclusion that area passed
- Include the complete clearance report, not just summary
If you failed first clearance, include that too with explanation.
Transparency is better than trying to hide it.
Billing Timing
Wait for clearance before submitting final invoice.
- What if you fail clearance after billing? Now you've invoiced for incomplete work.
- Clearance proves completion. Invoice follows clearance.
Exception: Progress billing on large jobs ($50K+ over multiple weeks) - negotiate upfront with insurance.
Follow-Up Timeline
Mold claims take longer to process. Follow up systematically.
Day 3
Confirm receipt. Get the assigned adjuster's name.
Day 7
Request status update. Ask if they have initial questions.
Day 14
Push for decision timeline. When can you expect a response?
Day 21+
Escalate if no response. Ask for supervisor.
Expect Questions
Adjusters are trained to scrutinize mold claims.
- "Why this many air scrubbers?" → Answer with CFM calculation
- "Why did the job take 7 days?" → Answer with timeline breakdown
- "Why is this priced above guideline?" → Document access, conditions
Answer professionally with documentation. Reference the protocol. Provide calculations.
Recap
- Submission timing: Pre-approval, post-clearance, or hybrid (most common)
- Complete package: Cover letter, estimate, protocol, photos, logs, clearance, disposal, authorization
- Clearance is essential: No clearance = no final payment
- Follow up: Day 3, 7, 14, escalate at 21+
- Handle questions: Professionally with documentation
MODULE 3 COMPLETE
Module 3 Complete!
You can now read protocols, work within coverage limits, build complete estimates, and submit packages that get paid.
Coming in Module 4: Advanced Challenges
Denials, appeals, complex situations, and working with other parties.
ACTION ITEM
Your Next Step
Create a submission checklist from what we covered.
Use it on your next mold claim to make sure nothing is missing.
See you in Module 4!