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mgkmrp
USA
27 Posts |
 Posted - 02/24/2004 : 11:21:51
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thanks for the attention to this issue. The policy simply states,"fallen tree"--according to the Bureau of Insurance in Richmond, this means, in the State of Virginia, the whole tree-of which the rootball is part of, as well as the trunk and the branched canopy. I am trying not to "read into" what this might or might not be saying or implying.
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thanks for the statement
"language is sorely lacking in difinitive clarity"
---Isn't this exactly why many of the companies interpet and hold to what they think the policy states or means? For an adjuster working for many different companies on the same storm, it gets kind of confusing.
---I thought, by finding this Virginia Minimum standard, and by virtue of the simple policy language,"fallen tree" , this would exclude any other interpetation, and would more or less standardize coverage for tree debris removal(from damaged structures) among all the Insurance Companies writing HO policies in the State of Virginia.
---The policy wording regarding this issue is the same from the HO3 FORM to the BASIC FORM.
---I do not have any "tree removal" issue's remaining on this storm-but as i worked along i determined to get this issue resolved at least here in Virginia. Hopefully,in the future, as i work from state to state, I can learn to streamline the effort, and quickly learn and know difinitively how the "Tree removal"(generic terminology) is handled in that particular state.
thanks again |
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JimF
USA
1014 Posts |
Posted - 02/24/2004 : 11:56:02
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Mike, I am going to follow up with the Bureau of Insurance in Virginia to inquire as to how they interpret this language, and will post any response I receive. I like to have things of this nature in writing.
I can only say that I worked in Virginia as well, and with several large well respected carriers, two of whom are based in Virginia. Obviously, both of the Virginia companies have wise legal counsel directing them in policy application, yet each of these two companies read and interpreted this specific language from the Virginia BOI quite differently. One of the questions which begs to be asked of the Virginia BOI, is how so many different companies can have such widely divergent views on tree removal language, if what indeed you suggest the Virginia BOI told you is the Virginia tree and debris removal "standard."
I'll keep you posted. |
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KileAnderson
USA
875 Posts |
Posted - 02/24/2004 : 17:21:49
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| Just wait until you get to Pennsylvania. They have a completely different endorsement for tree debris. It's loads of fun. |
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mgkmrp
USA
27 Posts |
Posted - 02/25/2004 : 17:55:47
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Thanks for the feedback.
Jim i think it is a good idea to get it in writing. However, as i said, i was there in person,twice for the same thing. more or less holding thier feet to the fire on what it meant by "fallen tree", and i got alot of wriggleing, and about 2.5 different answeres. Finally, a fellow came out of the back and spoke with a degree authority-according to this fellow, it means the whole tree, and the Insurance Companies that did not comply with this would be caused to "payup" after the storm audit this year.
---Upon rereading the material, i think there are two things that are crucial to understanding this issue.
1.) The title of this document is STATE OF VIRGINIA MINIMUM STANDARD OF CONTENT FOR HOMEOWNERS POLICY--in my estimation, the keyword is, CONTENT
1.) This document is found in the State of Virginia Bureau of Insurance website under LAWS/ORDERS and then INSURANCE REGULATIONS----to me, this means the content of this document is a State Law,Order and an Insurance Regulation.
thanks for the consideration, it very helpful. |
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mgkmrp
USA
27 Posts |
Posted - 02/25/2004 : 18:02:38
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well that looks goofy, not sure how i did that lining out of the "keywords" and that counting thing is a problem sometimes[:I]
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mgkmrp
USA
27 Posts |
Posted - 03/02/2004 : 10:24:54
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i recieved an answere from the Virginia B.O.I. regarding "fallen trees"!
---B.O.I. says Their interpetation is the whole tree from stump to canopy, and that means take that tree away from the premise. There is no limiting language such as, "remove tree off the structure" and limits such as tree debris removal of $500. This is because they have broadened the policy/coverage to read simply the whole tree(fallen tree) in the first place. The representative i spoke with said He had discussed this around the B.O.I agency, and that this conclusion is a concensus within the agency. Therefore, anyone there within that agency should have the same conclusion.
---The Insurance Regulation that states "MINIMUM STANDARD OF CONTENT FOR HOMEOWNERS POLICIES" is a regulation that establishes standards. This Insurance standard falls under a Virginia Code statute title 38.2-2108, signed into law by the Governor back in the early 1980's.
---However, somehow, Insurance Regulations are not actual law whereby a lawman could show up and slap the cuffs on some defiant cat manager and/or adjuster's not in accordance with this standard.
---The B.O.I states that if a consumer/homeowner calls and complains, then the B.O.I. would recommend to the "offending"(my word) Insurance Company they comply with the Virginia Minimum Standards of Content. ---Then, if the issue went on to court, the Judge would be informed that said company was not in compliance, either by way of misinterpetation of Code Minimum Standard regulation, or, that Insurance Company POLICY CONTRACT offered more restrictive coverage/language compared to the broadened coverage offered by State of Virginia Minimum Standard of Content for Homeowners Policy. The representative at the B.O.I. would not speculate on what or how a judge might rule, but the outcome would probably be in favor of the broadened coverage and interpetation(i could go on about this issue of liberal powermad judges,but i won't).
---i recon as an adjuster with knowledge of this Minimum Standard of Content, the adjuster would bring it to the attention of the Cat Manager and let that person make the final decree--A reversal/or misinterpetation of this broadened coverage could cost a whole lot of holdback money for adjusters doing what they are told to do(i personally, on thankfully rare occasion, have lost holdback money for lesser reason's) (please note that i have not "carried on" about this issue, excuse me while i pause for 5 minute's and have a rage attack.)
---once again, i brought this to the attention of the Forum in an attempt to ascertain the correct answere to this issue. i dont think there is a correct answere until some Judge decrees in a Judicial Mandate handed down that makes everyone comply. Or, maybey there has been one. Neither i nor the B.O.I. knows of one, and i dont have time to follow up. My experience on Hurricane Isabel is that some Companies had already broadened thier policies in the first place,some had not, or were not in compliance for any number of reasons--other reasons for non compliance comes from Adjusters themselves.
---Jim You mentioned You would get an answere from the Va. B.O.I. "in writting"--i am deliberately not saying who the person was at the B.O.I. i spoke with(surpizingly, He called me on my cell phone) so that You might get a separate or even more authoritive answere. However We can match sources later on if there is a contradiction.
i'm drumming the fingers in anticapation of Your answere.
This sure helps the depth of my general understanding regarding alot of insurance issues.
thanks, good luck out there |
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mgkmrp
USA
27 Posts |
Posted - 03/02/2004 : 10:34:16
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i forgot to mention that according the Virginia B.O.I, this regulation does not apply to Surplus lines policies, nor some Mutual Fund policies.
hmmmm, i wonder what that means? (its a hardroad to hoe bein ignorant). |
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JimF
USA
1014 Posts |
Posted - 03/02/2004 : 19:49:30
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Surplus lines (as in Excess and Surplus lines or ESL) are policies which are generally used for specialty coverages and/or specialty coverage properties. They are also "non-filed" which is in contrast to the "filed" policies (ISO) under which most homeowner policies fall.
By their very nature (and the lack of any requirement for "filing" a form, ESL policies would be exempt from any state's requirements for policy form approval or compliance. ESL's are generally used for commercial and inland marine type exposures in the property sector.
I suspect that you are confusing a mutual fund policy (which I have never heard of) with a mutual insurance company and perhaps specifically a county mutual insurance company. |
Edited by - JimF on 03/02/2004 19:52:08 |
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mgkmrp
USA
27 Posts |
Posted - 03/03/2004 : 09:33:07
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Thanks for the clarification on the Mutual Insurance companies. The B.O.I did specifically mention a local mutual company, Northern Great Neck Mutual, which is out on the Bay coast Northeast of Richmond.
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Herbc
USA
3 Posts |
Posted - 03/03/2004 : 13:34:50
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I hate to jump into the conversation this late, but it appears that a few issues are getting muddled and that the thread has lost site of the original question.
Going back to the original question, cutting down the trees is not coverage applicable to debris removal. That is to say, the trees themselves are not debris. The branches that were felled in your question are, and can be allowed removal under coverages for tree debris. The trees themselves are covered property but typically for named perils (incidentally, windstorm and hailstorm are not among the named perils for tree damage – so since the thread has escaped the question to include hurricane damage, trees damaged by windstorm are typically not covered).
Thus, to allow coverage for cutting down the tress, the trees must be covered property damaged by a loss insured. If this is the case, then we look to policy limits that apply – and the variety of carriers/regulators approach this issue differently. Some use a percentage of Coverage A, for example, while others provide a specific limit. Either way, the coverage involved is not debris removal.
The muddled issues include some form of additional insurance (5% has been suggested), coverage requiring building damage, and root balls. Taking these independently (pun intended), we have to make a few generalities, but please realize that there is no one answer here as jurisdictional considerations must be made. Nonetheless, let’s keep to the question and consider trees felled by a covered cause of loss doing damage to covered property (notice “property” and not “structure” or “building”).
The property damage can be said to have been actually caused or proximately caused by the original peril that felled the tree. Thus damages to the covered property, including the removal of the felled tree (or part of the tree) from the damaged property, must remain within the limits of liability for the damaged property. If that damaged property requires debris removal, and the cost of repairs of the covered property plus the cost of the debris removal exceeds that limit, then an additional amount of insurance may be available. But that has nothing to do with the tree debris removal. The cost of taking the tree off the damaged property fits within the limit of the damaged property; cutting up the tree and hauling it away has a specific limit – that is the tree debris coverage – without additional insurance.
As for the root ball – well that is simply interpretation and certainly no one would expect the policy to define the word “tree”. I have always seen this as a “customer service” issue rather than a “policy language” issue. If my carrier needed market share, I would pay as liberally as reasonably possible and base an ad campaign on my service – but that is just me.
An interesting “reach” on the initial question is the suggestion that the state of the trees following the event increase the hazard that the covered property is exposed to. It is certainly sound logic – the risk of further damage appears present – but has nothing to do with the contract of insurance. There is nothing in the policy that says the carrier must preserve a “risk-free” environment for the insured. Life is risky, that’s why we have insurance. Reducing the amount of risk we are all exposed to is our own responsibility. Don’t like broken bones? Stay off your skateboard. Worried about a leaning tree? Cut it down. As carriers, we have the responsibility to reduce the amount of financial risk that we are exposed to. Thus skateboarders and leaning-tree-people would be deemed more risky and should be charged more premium. If the individual’s risk of loss is too great, we should pass on insuring them. So back to the question, homeowners insurance does not insure against immanent danger. It does insure against accidental direct physical loss.
Sorry for the long answer, but the thread appeared to have strayed a bit off topic. And be careful when suggested oversimplified rules for the adjuster to follow. I applaud the idea of assembling tree debris requirements for every state you think you will be working, but would suggest that you assemble reference points for each state instead. Trust me; it is a full-time job following policy interpretations. It is far more gratifying to have a place to go with your questions than to assume to have every answer.
Herb Carver |
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trader
USA
236 Posts |
Posted - 03/03/2004 : 15:53:56
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| Good post Herb... but MOST storm adjusters can remember MOST states ISO Homeowners Contracts will limit the "tree debris" to $500.00 for a single wind event,( but not Virginia). Also a good explanation of "risk of loss". |
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JimF
USA
1014 Posts |
Posted - 03/03/2004 : 22:27:20
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Excellent post Herb. No one here could have said it better nor made this issue more clear, and as always, it is obvious you can see not only the trees, but the forest as well.
Good to see you posting and please share more of your insights and knowledge so we all may learn. |
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mgkmrp
USA
27 Posts |
Posted - 03/04/2004 : 12:16:08
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| Great Forum! Thanks for the knowledge and bigpicture perspective. |
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leoncrow
USA
16 Posts |
Posted - 03/10/2004 : 09:13:09
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| If you do not have any structure damage, just down trees, and you pay only debris removal do you take a deductable? |
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LarryW
USA
126 Posts |
Posted - 03/10/2004 : 11:38:53
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| So, if we listen to the state of Virginia, if a small limb is torn from a very large tree and damages one slat on a fence, then the carrier owes to remove the entire tree, rootball and all. Whether or not the homeowner elects to have the work performed doesn't matter. Whether or not the tree is still healthy and viable doesn't matter. The insurer would still owe the removal cost as the state interprets it? I guess there will be lots of re-opens from that cat. Or maybe not. |
Larry Wright |
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Tree Debris Removal
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