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A PAP customer’s engine was damaged by water in the fuel. The adjuster has tentatively denied the claim, citing the wear and tear and mechanical breakdown exclusions. Do you agree? If not, what argument do you make to get this claim covered…if it should be covered?
The temperature got so cold that the vinyl flooring in an insured travel trailer cracked. Is this damage excluded by the “freezing” exclusion in the ISO Personal Auto Policy or does “freezing” only refer to the liquids in the vehicle?
An insured backs into his wife’s car, damaging both vehicles insured under the same policy. The deductible provision says no deductible applies if an insured vehicle collides with another vehicle insured by the same carrier. The adjuster says this means an insured under a different, not the same, policy. Is that what the policy actually says? Interestingly, it depends on which edition of this insurer’s policy you have and where you live.
Your insured declines to purchase physical damage coverage because his vehicle “isn’t worth much” and “I’m a good driver.” His vehicle is totaled by another vehicle whose insurer denies liability. What now?
I've often said that it's inexcusable when a claim is denied for no other reason than 'It's not covered.' The insured is owed a reason for a claim denial, by contract or law. However, sometimes when I hear the reason, I think perhaps that it's better I didn't know because, to paraphrase Art Linkletter, 'Adjusters sometimes say the darnedest things!'
A Corvette was stolen by a scam artist that gave the insured a counterfeit check for $41,500. The bank didn't find out that the check was counterfeit until a week later. The PAP was still in force, but the adjuster denied the claim. She said that, since the insured signed the title to the Corvette over to the criminal, he no longer owns it and has no insurable interest. Is the insured just out $41,500?
Question: I am in a debate with an underwriter concerning an antique auto. We have the stated amount endorsement (PP 03 08) on the policy and the insured has an appraisal supporting this stated amount. The endorsement states that the company will pay the lesser of stated amount, ACV, or cost to repair. Our debate is this: Is the appraised amount the same as ACV? If not, what is the point of the endorsement?
The PAP defines 'collision' to involve impact of an insured auto with another auto or object. Comprehensive, or 'other than collision' (OTC) coverage applies to contact with a bird or animal. So, if you hit a pedestrian, is it a comprehensive or a collision loss?
Not infrequently, an auto suffers a physical damage loss. There's no question that the loss is covered...the only issue is whether the loss is covered as a collision or an other-than-collision (comprehensive) loss. In this article, we'll examine several 'Ask an Expert' claims, and we'll show a simple (if incomplete) solution to this problem.
Your insured had a tire blowout. The tire came apart and the tread came up into the fender housing, damaging it, the hood, and part of the firewall. The adjuster denied the claim on the basis that blowouts aren't covered. Do you agree? If so, why? If not, what is the basis for coverage and is it a comprehensive or collision claim?
Rain water entered an insured's camper trailer during a rain storm. Apparently the seals on the roof of the trailer had deteriorated and water leaked into the interior, causing damage to the ceiling, walls, and cabinets. The insurer has denied the claim based on the 'wear and tear' exclusion in the policy. Do you agree?
In 1973, the insured had a 1967 Chevy Corvette stolen. It was reported to the police and the insurer paid $2,500 for the claim. The car was recovered last October, completely stripped. The police called the insured and released the car to him. The insured sold the car to a friend who restores Vettes. The insurer now wants the insured to reimburse them for $14,000, the current value of the car. The insured wants to reimburse the carrier the $2,500 paid over 30 years ago. Who's correct?
An insured backed one of her vehicles into another one. Both are insured under the same PAP for the same $1,000 deductible amount. The insurer's claims department set up two separate claims and is charging two deductibles. The policy appears to clearly state only one deductible applies, but the adjuster says their 'procedures' require two deductibles.
A couple divorce, the wife moves out, and, although her auto is declared on the policy, she is not a named insured. Does she have physical damage coverage? (Note: One court says NO.) Or, your resident child's car is titled in her name, but declared on your policy. Does she have physical damage coverage? (Note: One adjuster says NO.)
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Alexandria VA 22314
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fax: 703.683.7556

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