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JimF
USA
1014 Posts |
 Posted - 01/30/2004 : 17:24:26
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Patrick, you make several excellent points in differentiating between rough living and vandalism, which are important for adjusters to understand. I appreciate as well your suggestion of insisting that the landlord file a police report. It is difficult at times to make the distinction between normal wear and tear, and thanks for adding a new idea to our toolkits.
BTW, what is your take on damages and coverage from the smell of a decaying corpse under the scenarios presented above? |
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CCarr
Canada
1200 Posts |
Posted - 01/30/2004 : 17:38:17
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This post is related solely to the struggle concerning the abuse or vandalism of the mobile home. The struggle appears to be over coverage, but I see a darker underlying cause to the struggle; and it relates to how the carrier chose to handle this matter.
First, Dakota, this is in no way meant to be critical of you, or your handling of this matter. You have made your assigned level of involvement in this matter clear, and on this particular file you were not asked to act as an adjuster.
At some point in time a new FNOL hit the carrier's desk. It would contain coverage details, it would say it is a mobile home (if it didn't, the amount of coverage on the structure would be a good clue), it would indicate that the risk is (or was) tenant occupied, and there would likely be some comment as to the insured's belief that he was presenting a vandalism claim.
So, who is charged with the investigation of cause on this matter? Who is responsible for determining what was abuse and what was vandalism? I don't think it is Dakota, he made it clear what his function was - "take pictures and do an estimate".
The carrier who allowed this claim to be assigned simply as an "appraisal", deserves all the grief that comes with such a decision. For the carrier to later ask Dakota what he thought, is another example of the free ride, and wrong way to do things. Dakota is paid little enough for this "appraisal" function, than to be asked for comments wearing his free "adjuster hat".
There is so much information missing, not required of Dakota to determine or report on, that how can anyone evaluate and distinguish between what was abuse and what was vandalism; and then apply that claims investigation against the available coverage?
I can't dwell on this, it is so wrong in my view. This claim warranted an investigation of cause, not just an "appraisal". |
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Dakota Kid
USA
30 Posts |
Posted - 01/30/2004 : 21:43:35
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Hi,
I am back. CCARR thanks for your comments. I thought about this more as I left the computer. I was trying to get all this information in and got caught up in the other comments people were making. A lot of these mobilehome insurers have gone to this format where we can not commit on our estimate with the insured. I really like this company and some of the others I do work for. They very easy as you can see. The company just wanted to know if I had come across something like this before. I also want to thank those who kind of aw were I was going with this. Abuse or Vandalism? The insured filed as Vandalism which to her it was. I did ask the insured if she called the police, she stated that she had and that claimed there was nothing they could do that it was a small claims court case. I think we have a lazy cop here. So to have a vandalism claim we must have a crime. No charges had been filed and more then likely will not be filed. I wish we could of had a full assignment but, most companies do not want to be the bill for these. The claim is small in their minds and just saw it as vandlism and went and paid on that. I really felt it was abuse, because the majority of the claim was how dirty and how trash was all over the place. The oven door was the only thing really damaged and the carpet in the kitchen which the insured claims the tenant left on. This claim I feel needed a lot more follow up and maybe that is why it was hard for me just to pay the claim and think twice. I just put it on to see what people thought as you can see it got some response. Thanks to everyone on what they had to say. Jerrad |
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Cecelia
USA
25 Posts |
Posted - 01/31/2004 : 16:30:16
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Vandalism is an intentional act that, in our insurance scenario, damages the insured property.
Excessive, caked, built-up dirt and schmutz in a sink, on a stove, in a refrigerator (you get the idea) is not vandalism. These are things that occur over a period of time and the cleaning would be covered by the deposit. These things occur over a long period of time are not necessarily intentional acts; some people see nothing wrong with living like dirty pigs. The "intent" here was not to damage the property. There was no "intent", just lack of good (and sanitary) housekeeping.
An oven door ripped off, holes in walls, cabinet faces removed and missing, bleach spilled throughout the house on the carpet - these are all caused by ACTS that are done intentionally by a person or persons.
The key word is usually "intent". This does not make any matter black and white when dealing with vandalism in a rental (house or trailer).
Carriers will be liberal or not in their view of "intent" depending on the insurance climate at the time.
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GRoos
USA
8 Posts |
Posted - 01/31/2004 : 21:34:22
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| Going back to the original question concerning vandalism damage to a mobile home, I used to work for a company who insured mainly mobile homes. If there were no signs of forced entry, the carrier may have paid since they could not prove that the tenant caused the damage. Also, the damage you described, aside from the filthy home, could have been considered to be covered. In the state of Texas, mobile home policies, for the most part, provide coverage for direct, sudden and accidental losses. The carrier may have provided coverage since the described damage was not considered vandalism. Cleaning up the property for hard living would be normal wear and tear and not covered. You stated that the oven door was ripped off. It would be a separate occurrence and subject to a separate deductible and the carrier may not have broken the claims out. |
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J G Cournoyer
USA
19 Posts |
Posted - 01/31/2004 : 22:59:43
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| Does one time adpl ring a bell? |
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Manmut
USA
26 Posts |
Posted - 02/02/2004 : 11:20:47
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quote:BTW, what is your take on damages and coverage from the smell of a decaying corpse under the scenarios presented above?
Originally posted by JimF - 01/30/2004 : 22:24:26
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JimF,
Well, I can honestly say I've never had the "pleasure" of handling such a claim. Under the so-called "all-risk" policy, I suppose there would be coverage since there is no exclusion for rotting corpses. Under a named-peril policy there is no peril of rotting corpses. I would not consider a rotting corpse vandalism or malicious mischief.
As regards the issue of committing suicide, that would depend on the manner of the suicide. I'm not trying to be morbid, but, rather, seriously trying to address this issue. If someone commits suicide by shotgun, the peril would actually be explosion. Though, thankfully, there isn't an abundance of case law on the subject, in the one case I could find the court majority opinion held that suicide in this manner constitutes an explosion and therefore there would be coverage under this peril. |
Patrick W. Laws |
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Steve H
Switzerland
30 Posts |
Posted - 02/02/2004 : 13:34:28
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These claims can be pretty touchy.
From the landlord's POV, all the damage looks like vandalism. Selling the perspective that there is a coverage distinction between vandalism and hard living can be challenging. When that is combined with multiple occurrences, oy. At that point, I want to be on T&E. |
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Jim Lakes
USA
37 Posts |
Posted - 02/02/2004 : 19:59:30
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Along the same lines:
The insured had a HO-3 on a rental piece of property that the carrier wrote. The tenants moved out and upon inspection by the insured, she found that all the carpet throughout the house was destroyed by the tenant’s cats depositing urine all over the carpet. It was so bad that it even soaked through the particle board sub floor and the smell was very apparent. The carpet had to be replaced throughout the house and the sub floor repaired. .
Is this vandalism? Was it intentional? These were not the insured’s cats. Is this covered? Why or why not? There is one thing that I am looking for that is very evident and is only common sense. What is it?
Jim Lakes, RPA
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CCarr
Canada
1200 Posts |
Posted - 02/02/2004 : 22:02:14
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Jim, "vandalism or malicious mischief" is not defined within the policy wording.
At law, vandalism, is willful or ignorant destruction of property.
Malicious mischief, are wrongful acts done intentionally, without legal justification or excuse.
The scenario you presented with respect to the cats owned by the tenant, would be difficult to substantiate as willful destruction to property within the rental property through any act of the tenant, or as a wrongful act done intentionally through any control of the tenant.
Jim, if I might add by edit, I would appreciate any comments in regards to "repairs" that you mentioned.
If the urine saturation was to the extent that you portray, including sufficient to damage the subfloor particle board; what "repair" method or technique could deal with that effectively?
I understand the necessity to replace the carpet, but the particle board is a pretty good spong for the acidic fluid. I wouldn't have thought the saturation into the subfloor could be "repaired". Is it a type of sealant? |
Edited by - CCarr on 02/02/2004 22:16:41 |
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Jim Lakes
USA
37 Posts |
Posted - 02/02/2004 : 22:54:04
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Clayton,
I agree with all you have said, so far.
The repair I was referring to is to replace those sections of floor where the urine soaked through the carpet and either swelled the sub floor or the smell could not be removed or sealed.
This really doesn’t have a bearing on the question asked though. I was asking more for coverage why or why not. If so, under what peril, if not, under what exclusion. There is also one other big common sense answer. What is it?
Thanks for you response.
Jim Lakes, RPA
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ruckover
USA
3 Posts |
Posted - 02/02/2004 : 23:33:39
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| Dakota Kid, you were right. I have worked mobile claims for years and none of the policies specifically written to cover manufactured homes cover this damage. There is a specific exclusion for damages caused by anyone in legal possession of the home, ie. renter. Had one just two weeks ago and the damages were over 10k and this was denied. Vandalism is another issue though, this is why the cause of loss would have to be tied down, the dirty construction items would of course be wear and tear and neglect and also be excluded. Must have been a large agent the claim was through. |
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JimF
USA
1014 Posts |
Posted - 02/03/2004 : 00:11:35
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Vandalism and Malcious Mischief are both covered causes of loss under most Named Peril and "All-Risk" Mobile Home policies.
Please advise the name of the carrier and the policy wherein you suggest that a loss caused by the intentional act of a tenant/renter would not be covered.
Could you please quote the applicable policy language which causes you to make your statement that this type of loss is not covered. It would be helpful to everyone here to see such exclusionary policy language. |
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william s cook
53 Posts |
Posted - 02/03/2004 : 04:03:07
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How can one have an HO3 on a tenant risk?
William S Cook
Public Adjuster |
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JimF
USA
1014 Posts |
Posted - 02/03/2004 : 08:00:49
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Memo to Bill Cook:
Jim Lakes and I discussed his claims scenario yesterday, and we discussed the question you ask now, which is an excellent question (and underlying point that would infer). I don't mean to speak for Big Jim, but in discussing his real claim scenario, we were both able to point out certain items that neither had thought about.
Jim's is an actual claims scenario which involves a major carrier claim. At least one major carrier will extend HO-3 coverage to an insured who rents to a tenant.
I suggest, that this same HO-3 situation might also occur, when an insured buys or builds a new home, and decides to keep his/her old home as a rental investment, and the policy renewal term hasn't occurred. Under that scenario, the HO-3 coverage is a 'holdover' coverage.
Jim's claims coverage question has several interesting 'twists and turns' and the answer is not as simple as might first appear. Watch out for the dead ends and mine fields in the HO-3 policy.
If you argue for coverage or denial, please make sure you point out the reasons for your recommendation and watch out for Jim's big huge surprise factor which he suggests most folks will miss!
It's going to take a top notch adjuster with his thinking cap on to "nail" this one! Good Luck!
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Edited by - JimF on 02/03/2004 10:58:07 |
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Renters abuse of a Mobile Home
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