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Dakota Kid
USA
30 Posts |
 Posted - 01/30/2004 : 14:59:07
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| Vandalism according to Dakota Kid. Vandalism is an intentional act of damage to anothers property. I know I know I know. These claims just really bug me. I am just trying to think of a way it could be denied. |
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Dakota Kid
USA
30 Posts |
Posted - 01/30/2004 : 15:02:44
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| I guess the only way would be if the property was vacant for more then 30 days and even then if the renter still left a bed or couch is the property considered vacant? |
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JimF
USA
1014 Posts |
Posted - 01/30/2004 : 15:03:54
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Why would you "try to think of a way" to deny a claim which is rightfully owed? That is fraudulent claim handling and a springboard to a bad faith claim.
Is your E & O insurance up to date? |
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Wes
USA
62 Posts |
Posted - 01/30/2004 : 15:07:23
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| Hey Jim what does OSHA say about sewer backups? I would think the guidelines would be very near the body fluids guidelines. Anything else I need to be specifically aware of when handling a claim with some sort of human matter. I hate to get off track here but this thread is raising alot of questions. What if a tennant in a rental property passed away and was not discovered until a severe odor had developed. Would this be a covered peril? Sorry guys its gruesome but interesting. |
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Dakota Kid
USA
30 Posts |
Posted - 01/30/2004 : 15:16:41
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JimF,
I am saying now I am trying to think of how it could be denied. Have you ever had a claim that you are paying for but, wonder if it border line. I have not seen a lot of these types of claims up here. I am just trying to see if any one else has denied a claim like this our have they all been paid. |
Edited by - Dakota Kid on 01/30/2004 15:20:21 |
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waconia
1 Posts |
Posted - 01/30/2004 : 15:19:16
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| Ok Dakota Kid. It's obvious you are struggling here on what constitutes a vandalism claim. Vandalism is intentional damage or destruction to another person's property. If the renter intentionally damaged the landlords's (insured) personal property (i.e. the oven door), that is vandalism. It is no different than someone damaging another's rural mailbox, for example. If the insured pays a premium for a policy that covers vandalism, the carrier owes for the repair/replacement of said damaged property less the deductible and any applicable depreciation. That being said, if would be your responsibility to investigate this claim and attempt to find out if the oven door was damaged at the same time the water was left on. Why? Because if the damages occurred on different dates you have now two vandalism claims, not one; and therefore, a second deductible would apply. Further, it would be your responsibility to the carrier to find out, if possible, the new address of the renter and forward that information to the carrier for possible criminal charges. The carrier has the right to try to reclaim their payment made for this vandalism through the legal system. I have done many claims such as you proposed and have never had any problems with carriers regarding this type of coverage |
Edie Watson |
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trader
USA
236 Posts |
Posted - 01/30/2004 : 15:19:48
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| Just reread my Texas Named Peril Policy with V &MM endorsment. Looked up V &MM in Blacks Legal Dictionary. Then read all three Mobil Home policys, then the 148 end, and the DP1, 2 and 3 and still cant belive property adjusters would consider the filth and tenant abuse a valid V&MM claim. |
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JimF
USA
1014 Posts |
Posted - 01/30/2004 : 15:20:30
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Damn good questions Wes. Damn good.
Now for the first one, I can see why you might ask the question about sewer backups, and I must admit that I am not an expert by any means on OSHA requirements. Since Ghostbuster has been taking college classes in this subject matter, perhaps he can shed some light or do some research to answer your question.
Now, to me, the more interesting question is your second one involving a death of a tenant in a rental house. What a question. Never in a million years would I have thought of that scenario.
If the tenant died as a result of a named peril, then in my opinion, the resulting smell from a decaying body not discoverd for days would indeed by covered.
If the tenant died from an act of malicious mischief or vandalism, then I think the damages you describe would be covered.
If the tenant died of some other cause, then coverage becomes less certain. I have seen one case closely related to this, wherein the argument for coverage was that the horrible smells had contaminated the home, and that the smells were the result of airborne contaminates, which led to quite a discussion among a lot of people at levels much higher than I. For the record, personally I thought the claim was a non-covered event, but in the end, the carrier decided to pay it.
I would love to hear input from others on one of the most interesting claims scenarios I have ever heard of anywhere.
Thanks for asking Wes. |
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Dakota Kid
USA
30 Posts |
Posted - 01/30/2004 : 15:28:40
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Waconia,
This was just an appairsal for this company. I thank you for your points on the different dates seperate claims. The insured did not realize the property was like this or that the tentant had left the property. I know the company will not go after the subro. To small of a claim. This company I take photos and do an estimate and that is all. I Know the adjuster there well and they just asked me what I thought. I don't claim to know everything. That is why I purposed this question on here to what the seasoned adjusters thought or how they would handle this situation. |
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Admin
547 Posts |
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Wes
USA
62 Posts |
Posted - 01/30/2004 : 15:33:18
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| Just for the record when I was thinking of the above scenario I had it in my mind that the renter passed away of natural causes and lay in his recliner until discovered. I did not realize that perils may play a part in this as I was thinking the horrific odor may be a covered peril of some sort. |
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KileAnderson
USA
875 Posts |
Posted - 01/30/2004 : 15:35:03
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Dakota, I believe you are going at this whole scenario backwards. Don't look for a denial. Look for coverage. If you can't find any coverage then it is not covered. If you go around looking for denials I believe you are in for a world of heartache and may wish to consider another profession.
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Dakota Kid
USA
30 Posts |
Posted - 01/30/2004 : 15:41:53
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Kile Anderson,
This is the only claim that I have had a hard time with. I have done insurance adjusting for 8 years and have never had a complaint. I love what I do. This here is why I love what I do. The discussion on topics such as these. I am sorry that I can't just role over and pay and think anything of it. I believe to many times we pay for things that are interpruted differently. And no I am not accussing you of this practice. I am not making this personal. I believe this is what makes us better and more educated. |
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JimF
USA
1014 Posts |
Posted - 01/30/2004 : 15:42:27
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Wes, the reason for a focus on whether the death was caused by a named peril in the example you provided, is because of the difference in exclusionary language which applies to airborne contaminates when the result is or is not the result of a named peril.
What if the insured under an HO policy had died of a heart attack during a hurricane and the body wasn't discovered until several weeks later?
What about the exclusions for intentional acts of an insured, if the insured commits suicide but blood, guts and gore damages as well as shotgun pellets to walls, ceilings and floors causes damages of several thousand dollars? What then? |
Edited by - JimF on 01/30/2004 15:44:29 |
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Manmut
USA
26 Posts |
Posted - 01/30/2004 : 17:07:38
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Do you have access to PLRB? If so, I would suggest you enter "tenant vandalism" in the search engine there and read through it. The courts have ruled, fairly consistently, that there is a fine line between vandalism and so-called "rough living". Rough living cannot be said to be vandalism, but rather wear and tear as excluded under the policy. As a rule, I require a police report to be made by the landlord. If the police report indicates that they believe the house was vandalized, then the coverage is a slam dunk. Often the report will equivocate or even state outright that the officer does not believe there is sufficient evidence to find vandalism. If the report does either, I think you have a sufficient grounds to deny the claim. After all, if the police don't think or can't prove vandalism occurred, how are you supposed to do so? And more importantly, how can the landlord?
The reality is that wear and tear is a normal part of being a landlord. I think that sometimes landlords are simply trying to find a way to avoid paying for the repairs.
In your case, I believe there was some vandalism involved. That being said, I think your instincts are correct. I believe that you may be justified in separating the obviously intentional damage from the normal wear and tear of a tenant. |
Patrick W. Laws |
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Renters abuse of a Mobile Home
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