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Dakota Kid
USA
30 Posts |
 Posted - 01/30/2004 : 22:53:21
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| I know I am just throwing in my 2 cents in on the matter it has been beat to a bloody pulp. I pay the contents cleaning under contents if no contents coverage. It goes under the structure for moving the contents to repair the structure. I have never seen it under ALE. I really like the pet question. I too would not pay for the pet. |
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Catmandale
USA
67 Posts |
Posted - 01/31/2004 : 02:39:39
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Total loss fire....house destroyed along with all contents.
The insured has to relocate to another neighborhood. As the whole neighborhood burned, competition for housing is stiff. They are able to find a 3 bedroom condo 10 miles further from his workplace. The house which burned was a four bedroom single family dwelling in an nice middle class area.
By renting the condo, has he maintained his normal standard of living, or something slightly less?
Will you pay for the increased mileage for his work commute as ALE?
The new temporary housing is in a zip code that causes the insureds auto premium to increase, would you pay that as ALE?
How many ways will we peel this banana? |
"When we thought that we had all the answers,
suddenly all the questions changed."
Mario Benedetti (1920); Uruguayan writer.
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JimF
USA
1014 Posts |
Posted - 01/31/2004 : 05:34:15
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You ask:
Will you pay for the increased mileage for his work commute as ALE?
Answer: Yes we will. This represents an additional living expense.
You also ask:
The new temporary housing is in a zip code that causes the insureds auto premium to increase, would you pay that as ALE?
Answer: Yes, for the period of restoration, as again, this is an additional living expense.
You also ask:
By renting the condo, has he maintained his normal standard of living, or something slightly less?
Answer: Yes, it may, but there is no allowance to equalize a precise balance or imbalance of available housing stocks for an insured to rent for the restoration period. Market forces in real estate and the nature of location (urban versus sparsely rural) become factors beyond the control of either an insured or the insurance carrier, and may limit selection of more or less equal housing.
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Edited by - JimF on 01/31/2004 05:41:44 |
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Catmandale
USA
67 Posts |
Posted - 01/31/2004 : 12:58:28
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Jim,
I agree with your responses.
Further, regarding kenneling the pets....
Were it not for the fire(covered loss), the Insured would not have needed to board his pet. |
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JimF
USA
1014 Posts |
Posted - 01/31/2004 : 13:15:10
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Dale, I agree with your comment about providing a kennel for pets.
Again, this is an item of additional living expense incurred as a result of a covered loss, therefore it is eligible for indemnity under the policy ALE provisions.
The items which could be covered under ALE is limited only by the imagination as long as they are necessary as an additional living expense for the insured to maintain his customary standard of living. |
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trader
USA
236 Posts |
Posted - 01/31/2004 : 13:21:43
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Direct loss: was ignored again. Ever loss has consequences. All bad things( consequences) are not entended to be paid or should be paid. Take the whole Homeowner buying community, take the perils, then the premium and then the insured perils. Why would it be more fair/equitable to board Fido in a AC kennel, than to board the auto buffs favorite classic car in an AC garage off premisis when both claims was damage by fire, and both are excluded property under the policy. See how the pet haters and classic car haters would rise up when the rate increase begins. God bless NSOL its not long lived for US policyholders if this ignorance is as wide spread as it seems. REMEMBER Mold & Seepage ?? By the way the ZIP code increase is a (consequence) not direct.
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JimF
USA
1014 Posts |
Posted - 01/31/2004 : 13:38:31
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Trader, with all due respects, I think you are confusing the elements of the policy.
I agree and acknowledge that there is no coverage for an insured's automobile or pet from a covered loss such as fire. If the fire or some other peril damages or destroys either an auto or pet, the insured has no recovery for replacement under an HO policy.
That exclusion notwithstanding, the insured is entitled to a continuation of his customary lifestyle as nearly as is possible as a result of having to vacate his insured risk during a period of restoration.
The exclusions for property not covered under the HO policy such as automobiles and pets have absolutely nothing to do with provisions for additional living expenses under the policy ALE.
As a for instance, let's suppose the insured owns a 3 bedroom house with a 2 car garage which is damaged by fire. If the adjuster is able to identify two nearby 3 bedroom homes available for rent, and one without a garage rents for $1,000.00 per month, and the other, a 3 bedroom room home with a two car garage rents for $1,200.00 per month, all things being equal, the carrier owes the difference in living expenses to allow for the insured to rent the 3 bedroom home with 2 car garage.
If the insured cannot rent a home or apartment which allows pets, then the carrier also owes pet boarding for the period of restoration so as not to penalize the insured nor lessen their customary standard of living.
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Edited by - JimF on 01/31/2004 18:25:56 |
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JimF
USA
1014 Posts |
Posted - 01/31/2004 : 13:57:53
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Just so we are all on the same book and page, I am posting here the applicable language from the HO-3 (04/91) relating to ALE coverage. (Note emphasis is mine).
COVERAGE D - Loss Of Use
1.a. Additional Living Expense, meaning ANY necessary increase in living expenses incurred by you so that your household can maintain its normal standard of living.
Now Trader, please show me ANY exclusions in the policy AS IT RELATES AND APPLIES to ALE COVERAGE D - Loss Of Use, which would support not covering for kennels for pet boarding or providing garage for an automobile under ALE.
I can't find any. |
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trader
USA
236 Posts |
Posted - 01/31/2004 : 14:06:22
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Jim. You are just plain wrong... coverage/ indemnity always always follows/flows to insured property...neither is insured property. Call a property underwriter, or claims manager for a large carrier. Also ask about tenant abuse.
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JimF
USA
1014 Posts |
Posted - 01/31/2004 : 14:10:40
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Trader. Ok, let's pretend I am an obstinate insured.
Please defend your position that there is no coverage and do it by showing me the policy language exclusions. Pull out an HO-3 policy and show us the language of exclusion for boarding the pet and providing automobile storage under the ALE provisions of the policy.
I suggest you simply can't show us policy language exclusions.
Prove me wrong if you can. But at least do it by showing the HO-3 policy language exclusions.
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Edited by - JimF on 01/31/2004 18:25:03 |
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trader
USA
236 Posts |
Posted - 01/31/2004 : 15:29:07
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| Your prayers are not timely. I have escaped detection, and brandisment since 1957 when I was first introduced to ALE for INSUREDS. Many many repeat claims for about 100 insurance companies in the US and Europe. Possibly 1,000 or more. Its not my theory, but I can read. Good day. |
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CCarr
Canada
1200 Posts |
Posted - 01/31/2004 : 15:40:52
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Ray, big fella, let me try and shed a bit more light on this, or perhaps in part; another light.
It all boils down to the policy language, as has been quoted above, in part; ".... your household can maintain ....". Over the years whenever I had to address this particular point, I emphasize the operative words "your household".
"You" and "your" are defined in the policy, but "household" is not. However, "household" has taken its beating through litigation. What is clear, is that a "household" encompasses by definition, "all the people who live together in the same house". Seems simple, but the courts have embellished it somewhat over the years.
Therefore, what is normal to the specific affected household of the claim in your hand? In the case of a family with a dog, that dog undoubtedly is an integral part "together in the same house". Don't come back to me with the Blue Tick in the doghouse out in the backyard, that is not "together in the same house". If a kennel is needed to board Fido who normally sleeps in the house, while reconstruction is ongoing and the "household" is displaced; that is a reasonable additional living expense.
Conversely, while I can only recall being confronted about twice with the "classic car" in the garage issue over the years - and actually they were motorcycles both times - I quickly laughed off any claim for the "boarding" elsewhere of these units; and declined any consideration.
My logic for not allowing vehicles, is that I can not relate them to any definition of "household", or anything that would allow me to think of ".... who live together in the same house". |
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Cecelia
USA
25 Posts |
Posted - 01/31/2004 : 16:16:25
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Just for fun - when we were lucky enough to find a house for an insured that DID allow the pets there was a pet deposit of anywhere from $300-$700. Usually a portion of the pet deposit is refundable and a portion is non-refundable. Most people would rather have their pets with them than boarded. Just be sure to follow up when the insured moves back into their restored home and get the portion of the pet deposit that is refundable sent back to the carrier. The adjuster should also follow up and be sure that the deposit paid for the rental house is reimbursed to the carrier. Most of our insureds out here don't have that $1200-$2000 deposit required for a house (California). The carrier will pay that deposit, but the if the insured doesn't leave the rental in the condition it was in when they moved in, the amount NOT refunded will be deducted from the claim in another area. Make sure the insureds understand this before they ever move into the rental; I've found putting it in writing is a very good idea.
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Jim Lakes
USA
37 Posts |
Posted - 01/31/2004 : 16:38:07
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To All;
I am glad to see this kind of conversation going on. I am sure, and have heard, Roy say many times that; this is why he started this site. Education of adjusters.
I would like to add a few comments about ALE to this discussion.
I am really surprised that no one has used the phrase, “ALE is anything over and above what you would normally spend at home.” This means that if you normally drive 20 miles to work each day and the house/apartment that you are staying at during the repairs is 40 miles per day, the insured is incurring an “additional” 20 miles per day that they don’t normally spend at home and has incurred an additional expense that they should be reimbursed for. In my 30 years of working for carriers as staff and independent, I do not know of one company that would not compensate an insured for this.
The same is true for boarding pets. If, as has been mentioned in other posts, an insured had to board a pet due to a covered loss, they have incurred an expense that they “normally” don’t have and should be reimbursed under the ALE. Again, I have never had a carrier tell me otherwise.
I will throw out another scenario, for everyone to ponder. An insured has a total loss fire and all of their contents are also destroyed. They escape from the house in the middle of the night with only their clothes on their back. They go to a 24 hour Walmart and buy some clothes to wear. They don’t normally buy clothes at Walmart. They shop at Sears or Kohl’s or the like. Are the clothes that they bought at Walmart contents or ALE? Just so we don’t start another line of back and forth, the answer is, ALE. I have had many carriers pay for those items and charge it to the ALE, even though the insured had suffered a loss that far exceeded their UPP limit.
These types of expenses are “Over and above what they would normally spend at home.” There are many different situations that would present grey area questions; however, I contend that if we keep that phrase in mind, it would answer many of your questions.
Jim Flynt is correct and I have never known him to answer a question without first, backing it up with policy language. If we have a question we should go to the policy and search for the answer. If the answer is not there, then the carrier makes the final call.
If we all would take the time to study coverage’s and afforded the insured everything they had coming under the terms of the policy, my good friend and very knowledgeable PA, Mr. William Cook would have a hard time finding work.
Let’s keep these type conversations going instead of the back biting and grumbling.
Respectfully Submitted,
Jim Lakes, RPA
V. P. RAC Catastrophe Services
513.894.2000
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JimF
USA
1014 Posts |
Posted - 02/01/2004 : 01:11:08
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I am posting a reprint (unedited) below from the National Underwriter Homeowners Coverage Guide. National Underwriter is recognized by most insurance carriers as the definitive guide to policy coverage and interpretation matters in the United States, through their advisory services including FC&S.
I believe this article clarifies the issues regarding all pet boarding including pets normally living in the back yard. So as not to overwhelm anyone in digesting ALE coverages, I will post further information from FC&S regarding providing garage protection for classic automobiles at a later date.
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National Underwriter
Homeowners Coverage Guide
1999
Page 17
Boarding a Pet - Additional Living Expense
HO-3 insureds recently suffered a substantial fire loss to their home, which required them to find other living quarters during restoration.
The insureds have owned a dog for some time. The dog is an "outside" dog, but with the family living away from the home while it is being repaired, the question arises as to the cost of caring for the pet during this period.
The additional living expense clause covers "any necessary increase in living expenses incurred by you so that your household can maintain its normal standard of living." In this case, it would appear that the additional costs related to caring for the dog, including boarding costs, would be compensable.
As mentioned, the loss of use coverage of the homeowners policy promises to pay for "any necessary increase in living expenses incurred by you [the named insured] so that your household can maintain its normal standard of living." Keeping a pet is a part of this household's normal standard of living and the cost of maintaining the pet when the residence cannot be occupied is a legitimate living expense.
The fact that the dog is an outside dog rather than a house pet would not seem to alter the situation. With no one able to occupy the house, the animal could not be cared for if left at home. Finding an outdoor alternative less expensive than a kennel - leaving the dog with a friend for a modest fee, for example - would seem inappropriate because the animal might very well attempt to go back home, with harmful consequences.
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So there you have it folks. Straight from the real experts at National Underwriter. That is their interpretation of the pet boarding coverage issue under Coverage D, with which Jim Lakes and I happen to agree.
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Edited by - JimF on 02/01/2004 01:34:06 |
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PE vs ALE - Which Coverage does this fall into?
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