Insurance

[gemini5362]

Killer B I went back and looked at your profile. I deal with about ten contract cases a week that are sent to arbitration. This thread is exactly what I find happens in almost all legal arguements. No matter how clearly the language is written there is invariably someone that will look at the same words and get a different opinion of it. You read the language one way and if I am understanding your point of view you read it another. I will gladly admit your experience in this issue. I think that you have probably had occasions where you look at a claim one way and a different adjuster sees it a different way. I know in the past I have been in a situation where I had a claim on my motorcycle from where it was stolen. I moved before I had a chance to finish processing the claim. When i got to the new location the adjuster there interpreted things different and paid a lot more on the claim than the original adjuster. The words may not be esoteric but I am sure that you know that context is everything. My opinion and I will be happy to admit it could be wrong is that you seem to be taking the one sentence out of context. You are using it as a stand alone definition of the whole clause. On a fairly regular basis I hear arbitrators talking about people doing that when they rule. I am going to have an attorney that deals with insurance claims on a daily basis look at this thread and see how they intrepet that clause.

 

[Killer_B]

I am going to have an attorney that deals with insurance claims on a daily basis look at this thread and see how they intrepet that clause.

Can't wait to hear his take on it. If he differs with me, I may have to look up some old insureds and ask for my money back .

KB

 

[gemini5362]

Can't wait to hear his take on it. If he differs with me, I may have to look up some old insureds and ask for my money back .

KB

Yeah actually I was thinking about this and I am not sure why I am differing with you. An adjuster that is saying they should pay should be left alone and encouraged to go ahead with buisness

 

[Racer71]

I challenged him on this not more than 2 months ago, and he assured me that if I was helping a neighbor, hit a gas line with the backhoe and burned down his house, I would be covered under the liability provisions.

QUOTE]

Dave,

That would be a great statement to have in writing. Everyone I talk to are very clear that "Liability" is not covered. You may have a great policy though.

 

[CurlyDave]

That would be a great statement to have in writing. Everyone I talk to are very clear that "Liability" is not covered. You may have a great policy though.

I asked him about getting that in writing, and he quite reasonably said that I already had a written policy and that he would get his donkey in a crack for modifying that in a letter.

I looked at the policy and I think I am OK, although I have to admit that there is room for confusion there.

We live in a very rural location, and I am not really very worried about it. The agent will stand behind me because a lot of his business is built on personal relationships. If he doesn't about 2/3 of the town would know about it in the first 24 hours.

The only neighbors I would ever help are good friends. The risk of anything going wrong in the first place is low, and the risk of them suing is even lower.

I an not inclined to turn in claims for anything under about $10k anyway, because I know they will get it all back in the form of a rate increase over the next few years.

Actually, the more realistic question is one he didn't have an answer for. We have a private road, where ownership is shared by 4 properties. Now, if my tractor is on that road, is it on my property or not?

My homeowners policy definitely covers theft from my property, I am willing to be uninsured against theft if I leave the tractor overnight on my neighbor's property, but what if I leave it in the road right-of-way (a lot wider than the actual asphalt) overnight?

Dave

 

[Red55]

My homeowners policy definitely covers theft from my property, I am willing to be uninsured against theft if I leave the tractor overnight on my neighbor's property, but what if I leave it in the road right-of-way (a lot wider than the actual asphalt) overnight?

Dave[/QUOTE]

That just one more reason NOT to walk home at night! -ED

 

[ray66v]

Keep in mind that if you have a claim, (more than a few bucks), the agent has NOTHING to do with it, other than submitting it. This is for a reason, he would give away the store to keep a good client. Your claim goes to an adjuster who does not know you from Adam. And unless you agent is having adult relations with them, and he has no influence on them what so ever. The adjuster has to answer to his boss NOT your agent. If you can prove your agent said your covered and you find out your not, they do have insurance that will pay for his mistake. If you can't prove he told you that you were covered all you will get is a letter saying there sorry.
After 30 years of dealing with insurance bureaucracy everyday, I can tell you they are always trying to get out of paying when they can.

 

[ultrarunner]

I would be more concerned about a little old lady slipping and falling. -Ed

Little old Lady slip and fall happened to me last November and my Insurance paid out $5000.

My city has curbside recycling and for years this woman would poach soda cans and bottles from the neighborhood bins. My property has a Redwood tree that is protected by City Ordinance and a root lifted a section of the sidewalk three quarter of an inch... the sidewalk is stamped 1923.

The woman carrying her purloined recyclables trips and the side of her face is Black and Blue. The City passed an Ordinance making Home Owners responsible for the city sidewalk adjoining their property and my Insurance Company says it is worth 5K to make her go away???

The irony is the City Sidewalk Inspector couldn't even find the section of sidewalk in question because my sidewalk is in better shape than all the others in the Neighborhood... INCLUDING THE SIDEWALK IN FRONT OF THE WOMAN'S HOME WHO GOT THE 5K!!!

 

[rimshot]

Little old Lady slip and fall happened to me last November and my Insurance paid out $5000.

My city has curbside recycling and for years this woman would poach soda cans and bottles from the neighborhood bins. My property has a Redwood tree that is protected by City Ordinance and a root lifted a section of the sidewalk three quarter of an inch... the sidewalk is stamped 1923.

The woman carrying her purloined recyclables trips and the side of her face is Black and Blue. The City passed an Ordinance making Home Owners responsible for the city sidewalk adjoining their property and my Insurance Company says it is worth 5K to make her go away???

The irony is the City Sidewalk Inspector couldn't even find the section of sidewalk in question because my sidewalk is in better shape than all the others in the Neighborhood... INCLUDING THE SIDEWALK IN FRONT OF THE WOMAN'S HOME WHO GOT THE 5K!!!

==========================

This is a typical example of one of the biggest frauds that we just seem to accept in this country. When are these crooks going to take responsibility for their own clumsy actions. If they are truly the victims,why does the architect attorney get 33% of the booty.

It no longer counts when it comes to saying whose actually at fault here. What seems to count is who gets hurt and who has the money. That is just plain wrong.

That stuff never really got written into the constitution. The lawyers adjudicated it that way.

I will always be committed to any kind of action that can be taken to control abusive lawsuits and the tremendous waste that takes place everytime a trial attorney takes his 33% outrageous cut off the top of a skewed lawsuit .

Shame!

rim

 

[Killer_B]

After 30 years of dealing with insurance bureaucracy everyday, I can tell you they are always trying to get out of paying when they can.

But Ultrarunner says they pay exorbitant amounts on even questionable claims. You can't both be right.

KB

 

[horse7]

The insurance company basically bought a quit claim from the old lady. This is cheaper (on average) then having the potential claimant pop out of the woodwork 1 day short of the statute of limitations claiming that horrible health problems were due to the injury-- one does not know how the jury lottery will end up, poor sick defenseless old lady against the evil greedy insurance company protecting a negligent property owner (the plaintiffs lawyer will make things sound worse than this!).

Most ins companies seem to pay 1000-5000 to make potential liability go away. But if there is a clause excluding the injury, they walk away [I know of a person who had a woman claim they were scratched by the dog the person owned-- then found out that the ins policy did not cover "dog bite"! The owner would not pay and the ins company washed their hands (won't go into details about the gold bricker), subsequently they could not get homeowners insurance since the claimed injured party hired a lawyer and filed a suit for several thousand-- talk about a racket... lawyer knows ins will not renew if suit is filed, so almost everyone would just bend over (this guy didn't have a mortgage so he went w/o insurance! If you have a mortgage, you HAVE to have insurance, so either pay the lawyer or pay for assigned risk or whatever it is for homeowners insurance-- reamed either way.). I don't know what finally happened in the end, and I wasn't there when the events transpired so take it for what it is worth]

 

[LBrown59]

After 30 years of dealing with insurance bureaucracy everyday, I can tell you they are always trying to get out of paying when they can.

Yeah an they're real crafty at it too.

 

[ultrarunner]

I'm not happy about it... never had property claim...

My agent is a straight shooter, known him since 1983. He said exactly what horse 7 said... basically the insurance company was looking out for "ME" in the event this resulted in a larger claim later. He also said they could try to make me responsible for any number of "Ailments" at her age.

Her lawyer demanded 10k for pain and suffering. My company said she was "At least 50% at fault" and offered her 5k to settle.

Still not happy about it...

 

[dmccarty]

We live in a very rural location, and I am not really very worried about it. The agent will stand behind me because a lot of his business is built on personal relationships. If he doesn't about 2/3 of the town would know about it in the first 24 hours.

I doubt he will or can back you up much. Getting close to 20 years ago I had a car stolen. I get riled up thinking about it today. Not that the car was stolen but how Nationwide Steals stole my money for years and lied to me over and over and over.

The car was stolen and run ragged as the POlice chased the thief. It took them about 30 minutes to catch him and they only did because the car turned off on him.

I did not know how much damage had been done at the time but the car should have been totaled. I did not find out about the car chase until months after the fact.

Driving from the impound lot I almost crased the car because the brakes where gone. Then the car overheated because the water pump was broke. The tranny was shaking like a leaf in a hurricane because some of the mounts had been broken. After the car was taken out of the shop to fix the above I noticed the AC was now gone as well. Back the car goes for repairs. At this point, in two test drives, I had spent maybe 10 minutes drving since the car was stolen. Maybe 5-6 miles total. The first drive lasted less than a mile.

Unfortunately the car was stolen while I was on a short term work assignment and I had to drive the car 3-4 hours back home. In the summer time. On Friday the 13th. Across Alligator Alley.

At the time the Alley was two lanes straight as an arrow and a death road. They where widening the road which was a blessing because they had built two over passes. The car broked down, cracked head, and I managed to get to one of the overpasses so we where at least in the shade. It took 4-6 hours before AAA would tow us back home. None of the trucks wanted to tow from the west coast to the east coast. We had some water but not a lot.

I dont travel anymore with less than a gallon of water.

Once home the car was in the shop for two months. Nationwide The Liars kept telling me they would go see the car. They never did. Talked to the manager. She just bold faced lied to me over and over. I had Nationwide Not On Yourside as a carrier because my mother had a great relationship with an agent. Sent him lots of buisness. He tried to help but nothing happened. I found out that Nationwide Lies had an 800 number to help resolve problems so I called.

No help from the calling the 800 number and according the agent I did not help myself by calling up Nationwide Lies OWN 800 number to get help. They have a number to help resolve problems with their customers but if the customers use the number it reflects badly on the customer!

I would not count on the agent being able to do much with a claim. But I will talk about how Nationwide Stole and Lied to me until the day I die. They earned it.

Later,
Dan

 

[ray66v]

But Ultrarunner says they pay exorbitant amounts on even questionable claims. You can't both be right.

KB

Why can't you understand that in order to make money, they have to screw the people they can, in order to pay the ones they can't.
Personal injury claims, (slip and fall, etc.), and property damage claims, (what this thread is in reference to), are two completely different things. For example I know, and you possibly might also, of several different personal injury claims that ended up with jury trials that settled for millions of dollars. How often in comparison does a property damage claim even end up in court, let alone settling for many times what the claim is worth because of a sympathetic jury. The insurance companies can tell you, they know these statistics, they live and die by them. It is a numbers game and they are very good at playing it.
Insurance companies make billions in profit each year, not by being generous, but by being shrewd. You only need to have sat in my chair, and had one of them call you one time, to argue over a couple of bucks, to get the picture.

 

[gemini5362]

Why can't you understand that in order to make money, they have to screw the people they can, in order to pay the ones they can't.
Personal injury claims, (slip and fall, etc.), and property damage claims, (what this thread is in reference to), are two completely different things. For example I know, and you possibly might also, of several different personal injury claims that ended up with jury trials that settled for millions of dollars. How often in comparison does a property damage claim even end up in court, let alone settling for many times what the claim is worth because of a sympathetic jury. The insurance companies can tell you, they know these statistics, they live and die by them. It is a numbers game and they are very good at playing it.
Insurance companies make billions in profit each year, not by being generous, but by being shrewd. You only need to have sat in my chair, and had one of them call you one time, to argue over a couple of bucks, to get the picture.

I am not going to argue about having the adjuster call you and quibble over dollars. I personally feel that the whole situation there is the adjuster. I have been lucky enough to have had adjusters that treated me well and settled my claims with no problems. My favorite one was the adjuster that came out to see my old farm truck after a tree limb broke off in a storm and fell across the hood denting it. It was mostly used on my property and did not hurt the running of the truck. The adjuster took one look at it and said that I was not going to have that fixed it ran fine just did some more damage to the looks of the truck (which was a long way from pristine in the first place) He said he saw no reason to make the check out to me and a body shop, he was just going to make the check out to me and I could spend it however I wanted.

Then on the other hand you have the adjuster that took care of my sons car wreck. A guy made a left turn in front of him and my son totaled his truck when he hit them. My son just had liability on his truck so he was on his own with the other persons insurance. The person that he hit claimed my son had his left turn signal light on and that confused him because he thought my son was turning. I talked to the adjuster about it. I pointed out arkansas law said that basically it did not matter even if my son had his turn signals on ( he didnt) You have to yield the right of way to oncoming traffic no matter what.
The adjuster decided that my son was 25 per cent at fault and was withholding 25 per cent of the claim because of that. If I did not like it my son could just hire a lawyer. I am sure he figured the lawyer would charge 33 per cent and that we would settle for the 25 per cent. I have a friend that is an attorney and owes me some favors in return for computer work. He took the case and filed the lawsuit. The other company kept on playing games until an hour before court then settled it for the original amount we asked for. But the point I am trying to get at was the adjuster was the one that started all of this and like every other buisness in a service industry you have people that do good work and try to give the service their customers deserve and you have some that are trying to get ahead by cheating their customers out of what is due them

I have chatted with Killer B in a couple of emails and I think that his customers are lucky to have him for an adjuster he honestly wants to do the right thing for both his customers and his company.

 

[ray66v]

Its not about one person its about an entire industry. Sure there are some good adjusters/appraisers, heck there might even be one or two lawyers out there, that are out to do the right thing. There are plenty of people out there who can tell you horror stories. If you deal with them on a daily basis, and not just as a claimant, see the side of the industry where they operate with an exemption from the antitrust laws all other American companies have to follow. Where they fix prices and at times refuse to pay enough to do the work properly. See them insist on using used or inferior after market parts on a car because its a year old. See the side they don't want you to see. And you will have a different understanding of how they really conduct business.

 

[ultrarunner]

My Pregnant Sister in Law was hit broadside when an on-coming car ran a stop light. There were plenty of witnesses and the driver admitted not paying attention.

My Sister in Law's new Volvo Wagon was totalled. The other parties insurance company towed the car to 3 shops and they all said totalled. After some back and forth, she was received everything she paid for the car, less a deduction for the 3000 miles she had driven it.

Her medical claim languished for 11 months before they offered 10K for lost wages and pain and suffering and nothing for medical bills because her health plan covered her several weeks in the Hospital. The adjuster for the other company refused to take my Brother's calls because they only speak to Lawyers???

My brother had spoken with several attorneys who wanted 40% of any settlement awarded once the trial started...

On my advice, my brother filed his own case in Superior Court for 80K... without an attorney... Within 24 hours, his phone was ringing off the hook... the adjusters that would not talk to him and their supervisors wanted to schedule a settlement meeting.

My Brother refused and told them he had tried for the better part of a year to do just that and was now putting his faith in the Jury System...

1 Day before the Trial was set to start, they settled for the full 80K.

Later, we learned that it is standard operating procedure to delay and ignore claims because some people will simply give up and for others the cost of getting an attorney is too great...

My Brother has no previous experience and did all his research on the Net..

 

[gemini5362]

Its not about one person its about an entire industry. Sure there are some good adjusters/appraisers, heck there might even be one or two lawyers out there, that are out to do the right thing. There are plenty of people out there who can tell you horror stories. If you deal with them on a daily basis, and not just as a claimant, see the side of the industry where they operate with an exemption from the antitrust laws all other American companies have to follow. Where they fix prices and at times refuse to pay enough to do the work properly. See them insist on using used or inferior after market parts on a car because its a year old. See the side they don't want you to see. And you will have a different understanding of how they really conduct business.

I know several attorneys who try to do the right thing by their client. I am not sure about insurance companies being exempt from anti trust laws. Where do you get your information about that. I do not see them fixing prices at all. Just check out the posts on TBN about where people talk about their prices on insuring their tractors. To be honest about it the majority of the time insurance companies dont need to cheat. If you know what an actuary is they are probably the best mathematicans you can hire. Insurance companies employ them to figure the odds on different events happening and then charge their rates accordingly. It is kind of like Las Vegas the insurance company is the house and the odds are in their favor. I think everyone would agree that the casinos in vegas make tremendous sums of money without cheating. There are cases in my opinion where the insurance company is trying to get out of their obligations. New Orleans being the one that comes to mind first. But by and large they dont have to cheat because the odds are in their favor.

 

[gemini5362]

See them insist on using used or inferior after market parts on a car because its a year old. See the side they don't want you to see. And you will have a different understanding of how they really conduct business.

I think the laws in different states might differ. Arkansas law is pretty specific about parts. If it is your car and you are responsible for the wreck the insurance company can use Non- OEM parts. If you are in a wreck and it is the other persons fault you have the right to demand OEM parts. My wife was in an accident that was the other parties fault. They had to replace both head light assemblies. They told me they were going to use aftermarket rebuilt parts. I had a fit about that and they gave me the name of the company they use. This company makes replacement lights for most cars at about half of the price. The difference is that the company warranties the headlight assemblies against any defect for as long as you own the car. I would not have gotten that good a warranty from toyota for new parts. There are parts out there that are as good as or better than OEM parts you just have to be careful and do the research