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Last Post 03/24/2007 10:31 AM by  jggauthreaux
House Fire--A simulated claim for discussion
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CATdawg
Member
Member
Posts:96


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01/05/2007 4:44 PM
Under the HO3, isn't an additional 5% of COV A limit available?  (Section 1, E Additional Coverages, 1a. Debris Removal)
Lee Norwood, aka "CATdawg"
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Ray Hall
Senior Member
Senior Member
Posts:2443


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01/06/2007 2:25 PM

I thought the debris removal was covered in the $60,000 contract price to move in-set up and remove that was negotiated by the adjuster. Do not understand your last question Lee come again.

I have rethought my original answer to my own question. In regards to the $8,000 rebate on the $25,000. upp lein. This would go to the carrier, unless the insured was not paid the total of $36,000 if the upp loss was this much or more.

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Ray Hall
Senior Member
Senior Member
Posts:2443


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01/06/2007 2:44 PM

This post was to give some thought to the "insurance restoration contractors" who purport to save money on losses for the carriers. I have found over the years this rush to save money is{often time} pouring good money after bad.

A bad fire, flood coverage or water loss will not suffer much additional loss in  the first 48 hours, but thousands can be spent on contractors who will do work that will not save, but cost the carrier additional money in that short time between smart and stampede thinking.

Just remember the "mold gold days" and the 35 years before the 21st Century. 

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CATdawg
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Member
Posts:96


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01/06/2007 10:27 PM
Thank you, Ray, for the qualifications. I have a much better grasp on what you were looking for in this scenario. It is not the first of your exercises that has made me think (and consult a policy LOL).

I haven't had to deal with "restoration" contractors yet. I can't wait!
Lee Norwood, aka "CATdawg"
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dparsons
Guest
Guest
Posts:32


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02/22/2007 2:20 PM

I am surprised no one has mentioned delivering a Reservation of Rights letter with Proof of Loss form as the first order of business before jumping into the investigation - Look up Waiver and Estoppal.

Why would the neighbors be paid?  Where is their insurable interest under the insured's policy?  The guy with the burned hand has a Premises Med Pay claim but the insured has to be legally liable for any other payments.  If it is proven that the insured committed a deliberate act, then the only one getting paid is the mortgage company.

This case sounds like a righteous fire with possible subro against the contractor who did the work or the maker of the cook top.  This would be good news for the two neighbors. 

As far as contents, a digital recorder is great - make a .wav file and burn it onto a cd.  Also take LOTS of pictures.  If it is a big fire in a nice neighborhood where there's a lot of stuff, get a digital camcorder and video the house, narrating it as you go.  This can be made into a DVD but keep the tape, if it is a tape.  Juries love pictures.

Don't try to get everything the same day.  If this fire is big enough, you will make several trips to the scene.  If you have some "restoration" company not known to you, this may be a case of justifiable homicide in the right precincts.  Just remember you are hired by an insurance company to work a fire claim for a specific insured.  If there is a question of additional liability claims, that is a decision for the insurance company to make.  If the carrier wants you to work the neighbor's house and he has a liability claim and his son, who is a lawyer meets you at the scene, DON'T DO IT.  If you do, check your E&O limits.

Also remember that Fire Marshals can really blow a C&O.  They think they are on CSI and can come up with some real winners.  Look for the low burn and remember that the laws of Physics still apply.  Multiple points of origin mean stop what you are doing and call the carrier and advise them that this fire may be of incendiary origin and ask for further instructions.  The decision to hire an independent C&O is theirs and they may want you to suspend until they can get him out there with you.  If a fire was incendiary, I wanted to know it immediately, not at the end of the day. 

Also remember, arson is easy to prove, what is hard to prove is who set it.  Mail fraud is where you usually get them.

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jggauthreaux
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03/24/2007 10:31 AM

Please disregard

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