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katadj

USA
315 Posts

Posted - 03/12/2004 :  09:57:34  Show Profile
Wonder if the Agent's E&O carrier has been put on notice. This "could" turn into a very nasty and coplicated deal.
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trader

USA
236 Posts

Posted - 03/12/2004 :  17:46:07  Show Profile
Why should an Insurance Agent (captive or Independant) be more expert on coverage than a vice president of an insurnace co.'s claim department.It appears this agent was correct. The falling rocks and water intrusion is "not a risk of loss" by definition. Please read the chapter in the Inland Marine text book on "non concurrent causation". "All bad things that happen to a homeowner are not covered by the Homeowners Policy"(mine). Before you ask this question again; wait until you ask: 1. was it a" risk of loss"? 2. was it sudden and accidental? Please read my post on "all risk" that was posted before Christmas. Pretend your are the student asking your instructor. Don't feel dumb... Many adjusters don't understand RISK OF LOSS.
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KileAnderson

USA
875 Posts

Posted - 03/12/2004 :  18:22:45  Show Profile
Trader, you are mixing apples and oranges. Many homeowners policies provide coverage for the interior due to water intrusion. Wind driven rain is one that comes to mind as well as a leak from a decaying roof. A hole in the exterior caused by a named peril is not required to open coverage for a leaky roof in many policies.

I don't feel we have enough information from this claim to extend coverage but I also don't believe we have enough yet to firmly deny it either.
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Catmandale

USA
67 Posts

Posted - 03/13/2004 :  13:58:36  Show Profile
Kile,

I agree with you...while I have great doubt that this loss is covered, I would not be willing to make any decision with what we have before us now.

How is the water getting in? What is the extent of the leakage each time? How many areas are open? How far does the leakage extend? Is there mold, rot, mildew? Bill said the homewoner told him the water entered in the top portions. Flashing problems, leaks from gutters?

Many more questions come to mind, and they need answers before any determination is made.

I once had a supervisor tell me that I should deny a particular claim because, although we were not sure yet as to the cause of the water damage, "any potential cause of this loss was excluded."

I told him "no thanks, you can sign that letter yourself, count me out."
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