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trader
USA
236 Posts |
 Posted - 02/04/2004 : 12:26:16
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| OK under a HO 3 the questions ask by Jim Lakes several days ago. No this loss is not V & MM, which is a crime commited by persons. The tenants cats (domestic) did the damage, which is under the domestic animal exclusion. Other exclusions may also apply. Take lots of photos and write the animal exclusion letter. I write several dozen each year. |
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CCarr
Canada
1200 Posts |
Posted - 02/04/2004 : 12:33:59
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But Ray, the 'animal exclusion' found within an ISO HO3 (04 91) says; "animals owned or kept by an "insured"".
In Jim Lakes scenario, the animals (tenants cat), does not appear to be either owned by the "insured" nor is it kept by an "insured".
Unless you can fit the tenant within the HO3 policy definition of "insured" (remembering that the tenant's name is not typed or shown on the declaration page of the noted policy); it would be my opinion that the noted 'animal exclusion' could not be applied. |
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william s cook
53 Posts |
Posted - 02/04/2004 : 12:34:43
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| For my purposes of illustration I made him a relative of the insured. |
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JimF
USA
1014 Posts |
Posted - 02/04/2004 : 17:50:23
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I agree with Clayton that the homeowner (insured) is not the tenant nor is the tenant the insured.
Here is a shortened summary of the animal language and exclusion in the HO-3:
We do not insure, however, for loss:
(2)Caused by:
(8) Animals owned or kept by an "insured"
If any of these cause water damage not otherwise excluded,....
The one big policy item that Jim Lakes was looking for, which the carrier applied in this real claims scenario, was the use of multiple deductibles. Without knowing, my presumption being that once the carpet was removed, that there would be multiple "urine rings" evident on the subflooring.
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Catmandale
USA
67 Posts |
Posted - 02/04/2004 : 18:28:53
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JimF,
I would be judicious in the use of multiple deductibles, as once there is a non repairable stain in a particular room/area, the replacement of the carpet is triggered.
If the rooms are such that they can be seen as separate areas regarding line of sight/continous flow issues, I would limit my deductibles to one per room (or continuous area.)
These types of claims fall within the small percentage of our work load that causes the most work and time involvement. Rarely is everyone pleased with the outcome.
Dale Strain |
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JimF
USA
1014 Posts |
Posted - 02/04/2004 : 19:37:02
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Dale, I agree with you that the application of multiple deductibles should be done judiciously, cautiously, and with the informed consent of the carrier.
Having said that, I would like to throw out the following questions for your thoughts:
(1) Does the repeated exposure of a cat urinating on the carpet (where it is known by an insured that the tenant is keeping pets) not constitute normal (and expected) wear and tear?
(2) Could the carpet not be cleaned professionally were it a matter of a cat only urinating one time in one room of carpet? The point of this question being, is there some point where repair (cleaning) becomes unrealistic and replacement is required.
(3) It would seem to me that the greater evidence of damage in Jim's scenario is that the subflooring is actually swelling from exposure to water (urine) while also holding in a urine odor/smell. And with that as visual evidence, would it not be fair to suggest that each 4' x 8' sheet or perhaps each "puddle of urine" of subflooring required to be replaced would be indicative of a separate loss event?
Last but not least, would the scenario which Trader described wherein a mean man threw the cat into the insured's risk as a VMM loss, constitute one occurrence/event (VMM) or multiple occurrences/events (continual urination event damage from an animal)? |
Edited by - JimF on 02/04/2004 19:40:55 |
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Catmandale
USA
67 Posts |
Posted - 02/04/2004 : 21:18:00
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JimF,
Boy, you are wearing me out. (Just kidding.)
(1) Possibly. It may be that since the insured owner knew of the pet, it was likely addressed in the rental agreement and with a hefty security deposit which would respond to the cat damage.
(2) Possibly. My visual inspection would help me decide whether that route had potential.
(3) Sure. Loss # 1 - Carpet damage...Loss # 2 through # x - subfloor repairs (where they can be performed separately - some T & G flooring present an obstacle to piecemeal repairs.)
Lastly, I would track down the mean man (neighborhood canvas - a great tool) and ask him why he did such a heinous thing, and did he force the cat to drink quarts of water to soak the carpets. OR...it could be that he was merely trying to find a good home for Kitty. Seriously, if the cat was thrown into the house, and was not a resident pet, the exclusion does not apply UNDER THAT SPECIFIC POLICY. The rest of the policy does apply though, and I would consider it for coverage based on the conditions and limitations of that policy.
I would like to point out that we have discussed the ISO H0-3 policy, the old SF rental dwelling 3 policy, and an Allstate policy. I referred to a AAA policy and found its language different still. I think a key point is that, while these policies all had similar intentions, the verbage of the policy may leave it to differing interpretation. It is imperative that we read the policy at issue in a particular claim matter, rather than draw from past experience without review.
Dale Strain |
Edited by - Catmandale on 02/04/2004 21:29:08 |
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trader
USA
236 Posts |
Posted - 02/04/2004 : 21:52:37
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| How could any adjuster consider the Cat damaged floor covered as a "risk" Its not a risk. any animal kept or owned by an insured is excluded, as well as any domestic animal. If its a house cat its domestic and will discharge in the house if you do not have a box, training etc. If its a tiger, lion, or other exotic no underwriter would insure the premisis, and the general public would rise up if their Insurance Co. paid claims like this. If this keeps up I will get all the P--- claims. |
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CCarr
Canada
1200 Posts |
Posted - 02/04/2004 : 21:55:52
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Dale, your closing comments in your last post should be pasted to the tailgate of every adjuster's truck.
Turning to the last 3 1/2 questions raised, my thoughts would be;
(1) No, repeated exposure of a cat urinating on a carpet could not be considered as normal, nor be considered as expected wear and tear.
(2) Yes, a one time 'flow', in one room of carpet, could be cleaned professionally. I'm sure that happens in millions of households each year for Pussnboots and Duke, when they can't squeeze it off any longer. Yes, there would be a point after repeated occurrences, where it would be a waste of money to clean the carpet yet again.
(3) Yes, that would be a reasonable way to calculate the number of occurrences. An interesting logistic to this (again, if the adjuster wasn't clear in their mind regarding coverage yet) would be how the adjuster got to see the subfloor. Who asked for the carpet to be lifted, and in what context? Being that I am on the "covered" side of this, I'd be telling the insured to have the carpet lifted so that I could assess the subfloor; and that - as JL mentions - is where the number of occurrences should present themselves.
On to Ray's scenario of a cat thrown into a dwelling as an act of vandalism, that one act of vandalism would constitute one occurrence for any resulting damage done by that cat. |
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JimF
USA
1014 Posts |
Posted - 02/04/2004 : 22:11:45
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quote:
Originally posted by Catmandale
JimF,
Boy, you are wearing me out. (Just kidding.)
Dale Strain
Dale, I think it may well be that this topic has worn us all out. Jim Lakes where are you for the "wrap up"?
Seriously, those following and participating in this thread should be recognized as being well versed in "cat claims adjusting."
Now would any of you "cat" adjusters like to explore "collapse" in greater detail? |
Edited by - JimF on 02/04/2004 22:45:32 |
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Jim Lakes
USA
37 Posts |
Posted - 02/05/2004 : 00:30:10
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James,
I agree with you in that I think we have had many good posts, questions and answers.
I thank all of you. I can not explain why there was an HO-3 policy on the house. I asked the same question and was told. "We sold it, we cover it." Oh well.
Like all of you I enjoy these type posts and threads and love hearing from everyone on the positive side of education.
Lets keep these going, and, yes, James, lets hear what you have for us on "collapse."
Thanks Again to all,
Jim Lakes, RPA |
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trader
USA
236 Posts |
Posted - 02/07/2004 : 12:20:42
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Years ago the New York standard 165 line policy was the "Fire & Extended Coverage for building, contents, or household goods. Texas had its own 163 line policy. In the event of a loss the policy was reduced by the amount of the loss, and the pro-rata returned premium was tendered to the insured in the loss check. If the loss was a total loss to insurance, the policy was canceled and all of the pro rated premium was returned to the insured. The policy could also be
REINSTATED for the full amount if the insured and carrier agreed. Most small loss were reinstated by wording on the loss check. "The policy is reinstated" The inland marine coverage on many buildings
(special class) and contents had the language "in the event of a loss all premium is earned" unlike the fire policys. When the Homeowners policy started in 1959-1960 the reinstatement clause was in the contract. Today this clause not in the contact and the policy is a combo of fire and inland marine policys. Which is good.
Because the clause does not appear in Homeowner policys is the reason more than policy limits can be paid for seperate losses on differant loss dates. ie: one claim reported, adjuster finds several covered claims, differant times is apparent, but takes the quick & easy route- seperate deduct of each. Disregards the date of loss on each, and waives the "must occur in this policy period"
humm |
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Bill Hill
USA
10 Posts |
Posted - 02/08/2004 : 11:34:26
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| I'll throw my two cents in on this one relative to the original post. Frankly these claims are tenuous and generally have coverage, under V & MM, that is obvious, some that is obviously not covered, and some grey areas. If you are looking at V & MM then one of the first things I look for is a police report since the damage is criminal damage to property. What do the cops think about the damage. What is the relationship between tenant and landlord? Then you can look for signs of criminal intent, i.e. baseball bat sticking out of the drywall, etc. A dirty filthy mobile home does not equate to criminal intent. Most often you have a landlord simply trying to get the insurance company to pay for cleaning. Then the grey area. I can recall one such claim when the tenant and insured/landlord were not on the best of terms. The tenant moved out and the place was very clean except the tenant had painted the walls a sunburst yellow and also painted a very nice 8" red border around the ceiling perimeter. Is this vandalism or malicious mischief or just bad taste? These claims are most always tenuous and have elements of coverage, no coverage, and questionable coverage. |
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trader
USA
236 Posts |
Posted - 02/08/2004 : 19:26:27
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Excellant Post. With concurrance from the carrier the landlord got SOL letter on the bad wall treatment, as well the destruction of plants the tenant did not like.
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Renters abuse of a Mobile Home
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