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CCarr
Canada
1200 Posts |
 Posted - 01/29/2003 : 19:00:27
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| My 1/22 post chose between whether this was a homeowners or commercial, and commercial was chosen because the client's lawyers was using the words 'co-insurance'; which in its proper everyday usage applies to commercial risks. |
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LarryW
USA
126 Posts |
Posted - 01/30/2003 : 06:03:25
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| Let us adjusters adjust and the lawyers practice law. There is nothing wrong with a policyholder receiving a 10.23 check and I know of few adjusters who are given the authority to pay anything extracontractual. It is up to the policyholder to purchase the amount of coverage he wants or needs and it is up to the insurer to sell the amount of coverage they want to. Suppose there were multiple policies in force in this situation? Does the Wise Claims Mgr. still write a check of $985.? |
Larry Wright |
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CCarr
Canada
1200 Posts |
Posted - 01/30/2003 : 07:27:06
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Larry, given the scenario to the point of your post, then adding in the ingredient from your post, ".... suppose there was multiple policies in force in this situation ...."; the result is whoever that wise CM is - he would not write a check for $985.
You have entered an ingredient into the mixture, that does not blend well with the scenario elements that were present. Certainly, that is not to say it has never happened, but it happens much less frequently than it used to 20 and 30 years ago.
On the slight chance there was the minimal possibility you were referring to the 'multiple policies' as subscribing policies; which would result in a Subscription policy, then each carrier is free to do what they want with their subscribing percentage to the 'one' written policy. For example, if the lead carrier was the same company that the wise CM worked for, and they subscribed to 50% of 'the policy'; he may still write a cheque for 50% of the $985, that he thought was the best course of action for his company.
However, if there is in fact more than one policy in force, i.e. multiple policies; the math changes. But, not enough information is at hand to decide what math would be applied.
I'm not sure what you would properly call it in the USA, but here we have a "Guiding principal regarding multiple policies", which basically has two parts; one for concurrent policies and the other for non-concurrent policies. This is an 'inter-company' agreement that the signatory carriers use to resolve their contribution issues to troublesome situations like this.
Therefore, without the details of the "multiple policies in force in this situation" - which would have to include details of the 'first' policy we imaginarily worked with, the 'wise CM' can not yet make his final conclusions regarding the disposition of this matter.
Feel free to detail out all the multiple policy information, and the essence of your concurrent and non-concurrent 'guiding principal'; and we can all have a look at that 'new chapter'. |
Edited by - CCarr on 01/30/2003 07:32:34 |
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JimF
USA
1014 Posts |
Posted - 01/30/2003 : 08:23:57
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| Clayton, they are also called the Guiding Principles here in the States. I'm sure they mean and serve the same function as in Canada. |
Edited by - JimF on 01/30/2003 08:28:53 |
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Newt
USA
657 Posts |
Posted - 01/30/2003 : 12:00:34
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This topic is very interesting, one I had questions on before. Under isurance and co-insurance.
The explaination by Clayton was top shelf, and I think we can all agree with his version.
The fuse for a suspected tort is the check.
No liability can be placed on the carrier until either,
failure to act can be proved or an action is taken, and the check was the action.
It seems to me that before a check goes out there should have been a settlement reached first to avoid what may cost a lot more in the end. Surely this must have looked like a strange settlement
to the CM. Its hard to justfy spending a lot to save a litle.
I am going to read up on "Guiding Principles". I studied "Other Insurance Clauses" which covered Prorata, Escape Clause and excess, and I don't remember the one mentioned, now if I can find it.
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wfkelley
8 Posts |
Posted - 02/01/2003 : 21:42:40
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| Just to let you all know how that story ended, in an exercise of goodwill, the agent (agency) made up the difference. Another happy ending. Thanks. |
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Attorney - Part 2- Damage Multiples
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