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Admin
547 Posts |
 Posted - 12/15/2002 : 07:59:37
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| Hurricane Lili causes a general power outage in the area. When the power comes back on my AC Unit no longer works. I called the people who installed it and they stated that when the power came back on a surge damaged the unit and now it needs to be replaced. I have a standard H0-3 and had no other damage to my home. Is the replacement cost of the AC Unit covered? |
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Newt
USA
657 Posts |
Posted - 12/16/2002 : 10:04:35
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This was not a covered peril, it was off premises.
Could not be considered an accident.
The power surge was created off site by an uncovered peril, reactivation of the system was deliberate. The power surge was not created on site.
Most likely this was not a surge, but a delay of getting one of the power legs on line, hence a system trying to run on low power will burn the windings up in the compressor and other motors.
Most outages that occur that cause equipment failure attributed to a power surge is normally on equipment that is very old. Equipment in present day equipment has protection devices, varistors, thermistors, zenar diodes etc. These devices have been used for the past twenty or thirty years.
The person that told them it was a power surge, could only tell this truthfully, would need an instrument on line to read the current, voltage or both at the time of the failure. |
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Newt
USA
657 Posts |
Posted - 12/16/2002 : 10:45:13
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In most cases when you open up a failed piece of electrical equipment you can spot the cause of the failure, wheather it is over voltage, under voltage or a mechanical failure.
Over voltage (surge): Look for arcs, insulation breakdown, relay contacts burned.
Under voltage: Usually caused by not having the two legs of power, or three legs if three phase, on line when you turn the equipment on. On 120 single phase the problem will be the neutral leg or the white wire. The results will be overheating of the windings, the insulation will melt and finnaly the wires will become discolored and melt together.
Mechanical failure will normally be a bearing or bushing and the results will be the same as the undervoltage. Over load will also cause the same results. |
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Darryl
USA
36 Posts |
Posted - 12/16/2002 : 17:22:57
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No coverage under HO3 for the power surge. Check covered losses and also exclusions. As with most things, covered loss - covered property necessary.
Darryl
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JimF
USA
1014 Posts |
Posted - 12/16/2002 : 22:26:46
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It's not a covered loss under the ISO HO-3.
But that 5 adjusters answered YES to the poll (so far), only shows how far we have yet to go in providing a basic claims education for adjusters, and even more so, improving the image of the profession as knowledgeable.
And in the real world, more than one out of three cat adjusters would have provided the insured the wrong coverage information and incorrectly reported the loss and estimate to the carrier; thus embarassing themselves, the vendor and carrier, and likely triggering an E&O event.
And we wonder why the carriers are quickly moving to other methods of claims resolution instead of utlilizing cat adjusters.
Think about it folks: More than one out of every three cat adjusters got the wrong answer to a simple basic coverage question.
It's not a shame it's A DISGRACE! |
Edited by - JimF on 12/16/2002 22:37:21 |
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CCarr
Canada
1200 Posts |
Posted - 12/16/2002 : 23:54:21
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There is a lot of bad things about this poll, and unfortunately even more things potentially hazardous about it. Jim's comments are all true, and his thoughts and probably mine don't make for pleasant bedtime reading.
This poll is a clear example of why at times (and this is sure one of them) this site should be restricted - I want to say to adjusters only, but it is a bad day to use that term loosely. The world is seeing our ignorance, and I'm embarassed and angry about it!
How can over 1/3 of the responding people get this basically straightforward and unambiguous question wrong?
Polls are a mathematician's fodder to spin their magic with. Can it be argued that 36% of the 2100 and some "members" can not read a policy adequately to develop the correct answer to the question? If that is anywhere close to accurate, what are you going to do about it?
Trying to find some good in every bad situation - and don't anyone dare suggest this thread is no big deal - is this not a sufficent wake up message?
Is it not time to get some real insurance and some real insurance claims education and training?
Does this not make you think that there is some merit to developing standardized levels of proficiency for 'cat adjusters'?
Just who are the 2115 "members" of CADO? Convince me that a 1000 or so are not just casual observers from the day shift at Walmart's around the continent, with a password. Who are the "guests" we see in large numbers (usually outnumbering the active and anonymous members) visiting these forums? Can they come in here and play picksie with the polls? If this site is free to members, what is the distinction from a 'guest'? Is the free access and membership to this site creating a false identity or picture of who the members are and their relationship to or involvement in any way to this profession?
You people (those that are and those that want to make a living from this profession) can no longer sit back and say to yourselves - not my problem. |
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Newt
USA
657 Posts |
Posted - 12/17/2002 : 08:13:30
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I do not pretend to be an adjuster, and have a long way to go. I have attended some classes with adjusters or so they think. It is sad, that many people got their mantle during the time when any one that could spell adjuster was handed a bunch of claims. That wouldn't be so bad if they had taken the time to continue their education in the lean times. This forum is an example of participation in education by those who profess to be adjusters. I would say less than 10 percent per week.
It is our problem, and all should be concerned that preception of who we are is reflected in polls such as this. We cannot cover our ignorance, if that is the case with an open forum as Clayton said. We may have many non-adjuster types participating, we don't know. IMHO, I don't think that is the case. From experience I can say that there is a gap in the knowlege of adjusters. I have seen it in classes, some of those adjusters have been semi employed since Andrew. With my limited experience I can tell who is blowing smoke, and if I can do it surely vendors and carriers can.
I try not to be a burden on those that know this business, but for the sake of education I will and do to a fault, ask questions in the form of an oppinion. That is mistakes I learn by. I am not going to make those mistakes on the job if I can make them before on this forum.
I am not an adjuster yet and don't claim to be, and you guys out there who claim to be and are not are giving those who are a bad rep. FOR SHAME!!!
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WrightClaims
USA
3 Posts |
Posted - 12/17/2002 : 17:44:10
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Hold on everybody!!! Lets not start bad mouthing anyone that got this question wrong. You all act like anyone in this business should know everything about every policy ever written. What you older, "seasoned" folk seem to forget is that new people are entering this field every day. I for one am very proud of the fact that our field is sought after by so many people. You can not expect a new person to our field to get every answer correct. Maybe they were testing themselves and just jumped in and gave it a try. Where is the harm in that?. Now if the people that got the question wrong are calling themselves "seasoned" adjusters, then there might be a problem.
Every time I log on and read the threads in the forum, I see the same "old folks" complaining about the "EDUCATION & TRAINING" that people are getting or failing to get. Let me remind you ladies and gentleman that it takes years and years to learn this industry and even you "seasoned" adjusters should be learning something new every day. If you are not, then you should hang up your boots and go play shuffle board in Florida.
Please quit badmouthing people who do not know as much as you (or in some cases) people who do not know as much as you think you do.
I agree that education and training are paramount for our industry, and I for one have completed just about every training course, IIA course and self-study course know to our field. I refuse however to get on the wagon and say that our profession is dying because to many "inexperienced" people are joining our ranks. For those of you who have a problem with this, WHAT DID YOU KNOW WHEN YOU FIRST STARTED".
Have a little compassion and stop talking about the bad in our field and focus on the good. |
Jason W. Wright, AIC |
Edited by - WrightClaims on 12/17/2002 17:47:08 |
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Justin
USA
137 Posts |
Posted - 12/17/2002 : 19:35:20
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Jason Wright, this questions speaks to the very basics of adjusting. If someone is in the field presenting themselves as an adjuster, then they should know this VERY BASIC part of adjusting. I guess to answer your question of "what is the harm in that", WELL the harm could be to the insured for an improper settlement, the adjuster who stands to have his/her E&O Insurance filed upon, and most important the harm is to ALL OF US WHO ARE PROFICIENT ADJUSTERS. Your laissez faire attitude of "what is the harm" is the harm. Jason, at which point do we say that it is OK for an inexperienced adjuster to just go out and "make mistakes" and the consequences be damned. I have not seen anyone here "badmouth" people for not knowing "as much as you do." I have seen people here badmouthing, and rightfully so, adjusters for going out into the world, ill prepared, unknowledgable, untrainable, and screw up a lot of claims. This is a direct affront to my and your occupation and a probable cause of many of the insurance companies having the attitude they have toward cat adjusters. If you do not know the policies and how to adjust them then you have no business being a can adjuster. A staff trainee adjuster, FINE, but in the heat of a CAT, no one has the time to wet nurse a new adjuster. I recently worked a storm where an individual received 115 new claims. While working cleanup on this storm, I had to work reopen(s) on this individual and received 103 of the original claims to readjust. Unfortunately this idiot was paying for items like this "poll" was tailored after, new TV sets, computers, a hot tub, and two sump pumps. Actually this individual will never work for this insurance company again NEVER, and that is too bad, because if he had an inkeling of what he was doing he could have probably had a "gig" with them for many years into the future. BUT, all I have heard from the recional managers is that they wish there was some way of KNOWING if CAT adjusters really know what they are doing. I would love to know what they are saying that I CANNOT hear, however, I fear it is not good. As for your compassion statement, over the years I have personally trained at least one new recruit a year in this business. Yes I do learn something NEW every day, and sorry shuffle board is not one of them.
PS Read the post just prior to yours by NEWT, who if you look has made many posts here. NEWT is by his own definition a new adjuster with THE RIGHT ATTITUDE, and one that will be very successfull in this business. As Clint Eastwood said; "A man has to know his limitations." |
Edited by - Justin on 12/17/2002 19:41:30 |
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CCarr
Canada
1200 Posts |
Posted - 12/17/2002 : 22:11:49
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Yah Justin! I sincerely wish at least 5 more like you would stand up and say something, give a sign, wave a flag; and show their concern like you have so nicely done.
One very very important point you raised that ties right in with my recent comments on the "supply and demand" thread, was your mention of regional managers saying they wished there was some way of knowing if the cat adjusters deployed really knew what they are doing. That is so valuable to repeat.
Remember what I have said about;
(a) the vendor - who are they marketing?
(b) "control" - and the carriers thirst for it
See how they apply now, with that very typical statement you echoed of a regional manager?
Jason, thank for weighing into this thread. Respectfully, I don't agree with much of what you have said, and I'll summarize;
Yes - badmouthing is bad, I'm guilty. I don't know if I would react differently today, but yesterday seemed to really bring some negatives to the surface relative to our CADO community. The individual is not my specific concern, as they are shaded by anonymity. However, it sounds no better today to say 36% got this basic question wrong.
No - I do not expect a new person to our field to get every answer right. Hell, I've been at it a long time and still don't and never will get every answer right. But, the question laid within the fundamental reading of a policy, no depth of interpretation was required.
Maybe - they were testing themselves, who knows who was testing themselves or playing pickse; that is a concern of mine that was expressed and has not been answered yet.
I sincerely hope - since I have been referred to as 'old folk' by others so I attach myself to that label you wrote - that I do not come across as "complaining" about training and education. I am a strong proponent and pusher of both. I'll concede that I'm likely a whiner about the 'lack of' training and education. I see a clear distinction in what I complain about and your view of it.
Yes - no doubt about it, it takes years to learn this business. What I have learned for sure, is that there is more that should be learned each day.
I do very sincerely feel this specific claims niche is dying, not directly because 'too many inexperienced' people are joining our ranks; but because 'too many inexperienced' people are being deployed. I see quite a distinction between the two.
Finally, I knew absolutely nothing when I first started as a 19 year old kid. But, I wasn't allowed to do anything that could impact a claim in any way, for quite some time. How I was 'brought along' is quite humorous looking back now, suffice to say I watched and listened for some months before I got a very short leash on a tight collar, to do some very minor first party claims. The collar was loosened notch by notch, with a periodic extra leash link added. The point is an adjuster should only be assigned a claim within their proven capabilities, to accept otherwise is wrong to all exposed; to deploy or assign inappropriately to an adjuster is wrong to all exposed.
Anyway, you cared enough to speak up, and I thank you for that. |
Edited by - CCarr on 12/17/2002 22:16:07 |
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WrightClaims
USA
3 Posts |
Posted - 12/18/2002 : 12:06:14
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Thank you Mr. Carr, I believe that you received what I was trying to get across in my post. I agree with you totally that if a person is going to be deployed on a CAT then they should absolutely know what is going on, what is covered and not covered, etc.. I also believe that way to many, inexperienced so called "CAT ADJUSTERS" have entered the ranks and are being called out for deployment. We must however remember that we were once "newbies" ourselves and that these "newbies" are people to and must be treated as such. I applaud them for their initiative and desire to enter the profession.
I have seen several posts in which some of the season professionals have expressed that they will no longer be aiding in the training or education of new-comers. WHY NOT? Are they trying to block the profession and corner the market? Rather than gripe about the level of expertise, education and training of a new adjuster, why not offer to take them under your wind and help them learn what is right and what is wrong? I for one will help anyone that takes the initiative to ask for help, and if I see someone that I think needs help, I will offer.
Mr. Carr thank you for the way you took my earlier post, I did not mean any disrespect to anyone. You replied like a true gentleman.
As for Justin, I think you missed what I was trying to get across. Please re-read the post and try not to get defensive about it. |
Jason W. Wright, AIC |
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Admin
547 Posts |
Posted - 12/18/2002 : 17:36:20
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A guest is someone who is visiting the site and has not logged in.
An “Active Member” in the stats above is a visitor that has registered and is currently logged in.
The main difference between a member and guest is that a member can post messages and replies. Guest can only view. The poll will currently only allow members to vote.
The “Anonymous Members” section has not been activated and will not show anything but 0 (zero).
As for the poll it was intended only to promote discussion. And it has. However, I was hoping to see more policy discussion. For example, Why do you feel it is covered? Why do you feel it is excluded. Can you provide policy quotes to support your position. |
Roy Cupps -
CatAdjuster.org :: Contact\Feedback :: Adjuster Roster :: Current Forum |
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Newt
USA
657 Posts |
Posted - 12/18/2002 : 19:29:45
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The power surge could cause the failure of a breaker on premisis, in turn one leg could cause the effect of under voltage( simular to overload). If the complete system became defective, this would be the case. If both legs of the breaker are ok, then the likelyhood of power surge is unlikely. I would check the breaker to determine if it failed or one leg became open leaving the other side closed.
Compressors have trouble starting up on 166 volts due to the head pressure.
The circuit breaker is on premisis, the surge caused the breaker failure if that is the case.
The power company maintain records of most power surges, you may have to prove that.
I don't think there would be any problem proving a power surge if the breaker failed.
The description of the unit failure due to a surge, I repeat is unlikely. Only one event can cause complete loss, loss of one leg of power. Either the power line or the breaker was the culpret. According to my interpretation of HO 3 Sec1, Exclusions par 4 (ISO) Titled power failure. My words,The loss must be caused by a covered peril ON premisis. Where no covered peril exists, there can be no coverage.
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inside man
45 Posts |
Posted - 12/19/2002 : 15:05:06
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Let me throw you all a curve.
This topic sparked my interest and so I did some research and came up with the folowing:
According to PLRB: "Section I exclusion for power failure does not apply, First, while the surge may well have originated off premises, a power surge is an abnormality in the power supply, not a "failure" of the power as required by the exclusionary language. No cases support the arguement that an excluded power "failure" included excess electical energy in the form of a power surge. A power "failure" would usually be understood to mean a cessation or outage of power, not a momentary excess. Second, the exclusion specifically excepts losses caused by the on-premises occurance of an ensuing Peril Insured Against. Thus, even if a "failure" occurred off premises, any ensuing on premises loss would be covered"
Hmmmmm...what do you all say now ??? |
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CCarr
Canada
1200 Posts |
Posted - 12/19/2002 : 15:32:22
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Strike one, with an inside curve!
Ruled a strike by virtue of the HO3 preamble language for Section I Exclusions as follows; (the capitals are the root of the called strike)
"We do not insure for loss caused directly or INDIRECTLY by any of the following. Such loss is excluded REGARDLESS OF ANY OTHER CAUSE OR EVENT CONTRIBUTING CONCURRENTLY OR IN ANY SEQUENCE TO THE LOSS"
The intent of the preamble language, is as important as the actual exclusion. The preamble clearly sets out the parameters for the individual exclusion.
They define 'home plate', and hence as an armchair volunteer umpire, I call a strike. |
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inside man
45 Posts |
Posted - 12/19/2002 : 17:15:20
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What if the indirect result of a power failure causes a fire?
Are you going to exclude coverage for fire damage? |
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Is it Covered?
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