Post Number: 23
|Posted on Wednesday, February 13, 2002 - 7:00 am: |
O.K., got a couple of emails.
1. This was a Cat situation.
2. Claims were sent in by the gazillion.
3. This carrier "normally" sends "specific" instructions, ie, appraise, no agreed,no copies of estimates to anyone, basically a 'straight' appraisal (However, This time it was only a Loss accord)and when file was assigned no other specific instructions were given (not worried about my part) just wondering about vendors position
4. A "New" Supervisor!!!
5. Estimate has more than standard disclaimer!
6. Ironically, the first conversation with claims supervisor,(after 1st report) was disccussion about E & O.The insured had been pressuring him on a daily basis about their position.
7. Breaach of Contract has to be a situation either verbally or written, which did not occur, I think
"You know I posted back in April a question about "when do you place your E & O on notice,etc, however, no answers. all were busy at that time.
anyway, appreciate the fine responses from my learned friends.
Post Number: 26
|Posted on Tuesday, February 12, 2002 - 8:11 pm: |
You wrote "sued Vendor and Me for "Breach of Contract" as there instructions on loss assignment "normally" states "do not give copy of estimate to anyone,etc".I did not give copy until after the fax advising to get an agreed price."
What do you mean by normally? Were the "do not give" instructions on the claim assignment?
Did your estimate have the standard disclaimer "this estimate is subject to insurance company approval"?
Post Number: 22
|Posted on Tuesday, February 12, 2002 - 7:44 pm: |
O.K. got a problem and want some "good" input from all the "great" adjusters out there, you too, mr. dww!!!
Handled claim, did the right deal, contact, scoped, wrote, sent status to carrier. (did not know was not supposed to give copy of estimate to insured) advised insured I would report to carrier and they would make final decision,etc.that I only was doing appraisal only and Company would make decision" ( this is specific and insured's statement confrims)
After Co. gets reports,faxes back and says get an "agreed" price with "Insures" choice of contractor. Gave him a copy and obtained an agreed price. Sent report.
In meantime, a phone call from Supervisor and said "you better place your E & O on notice, I asked why and he said you committed to repairs prior to our review" I did not, but at the time, I advised that I was not placed on notice "formally" by carrier or insured of a E & O claim. So hence, did not notify. At any rate, Carrier (wrongly) denied claim and insured sued. Pending now. Carrier sued Vendor and Me for "Breach of Contract" as there instructions on loss assignment "normally" states "do not give copy of estimate to anyone,etc".I did not give copy until after the fax advising to get an agreed price.
Does anyone know of an Arkansas law as far as furnishing insured with copy of any estimates "if" he requests. Or what is insured entitled to in an ongoing claim investigation??
Where do I stand as far a breach of Contract?
My E & O has been notified and believe our defense is o.k. But do I and vendor not have cause of action against carrier for suing us ?
Also, can they sue prior to any payment being made to insured?
This is the first for me after 31 years, so I am real curious as to the deal.
**They did pay our invoice
The insured only has a denial letter stating cause of loss was due to rot,etc. We had 2" ice,9"snow, 3" ice all on top of roof and leaking.
An engineer looked and only saw 1/2 slope as insured went ahead and replaced roof oh, yeah, tenants moving out, apartment complex, 620 units, 95 moved fast.
Start thinking and lets see these good minds work.
obviously, i summarized this if you need details, just email me and ask.
no virus please
Post Number: 25
|Posted on Tuesday, February 12, 2002 - 12:07 pm: |
Occassionally carriers require the adjuster to have the insured sign a Non-Waiver Agreement form prior to inspection. I need to develope a list of the reasons the carriers give for wanting the form taken.
If you have taken one, please post the Carrier's reasoning here and DO NOT post the Carrier's name.
I'll start the list of reasons.
1. Late reporting of claim.