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Newt
USA
657 Posts |
 Posted - 01/21/2003 : 09:45:02
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You are right about one thing, it does require some thinking and reading all the twists. I am comming to understand we need to do our homework before committing to anything. Thats why I stated before, no claim should be viewed as simple until you are sure you don't have a bend in the road that you don't see. Play the devils advocate if you must. New people should do this even on what appears to be the simplest of claims IMHO
I think most agree with your summary, I know thats not good enough, but better than most. See we can't even agree on this:>)
I would like to hear more on this, different twists that maybe we overlooked.
The personal property or hobby craft is the only thing I can see that would cause a problem, in that there would have to be a covered peril. If you asked the insured how it happened first, and it wasn't a covered peril it would be easier to deny the claim. He would understand hopefully, his declaration was what got the claim denied. If it was a covered peril, I would like his statement in the record, for the carriers benifit. They make the ultimate call, and I had rather they know beyond a doubt this was not my biased opinion. My report would be factual, and the carrier should be satisfied.
Like you said this would in most cases be a staff adjuster handling this claim, maybe by telephone. I am looking forward to the day I can work for a vendor or carrier doing daily claims under the guidance of a top hand. I may decide to remain an apprentice if they will let me for a period. When I do accept more responsibility, I want the employer to get his moneys worth. |
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CCarr
Canada
1200 Posts |
Posted - 01/21/2003 : 13:23:44
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Mr. Flynt sir, following my 1/20 post, wherein I repeated and hopefully correctly stated, ".... James felt otherwise regarding the liability issue - solely due to the damaged T/P property being an automobile ....", then later commented to Newt that I doubt we all agree - that was your cue big fella. Could we hear from you again Jim on this, following the explanation I provided in favor of the liability coverage for the damaged neighbour's car?
If you still feel the same, I would appreciate knowing the 'chapter & verse' background for your thoughts; thanks. |
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JimF
USA
1014 Posts |
Posted - 01/21/2003 : 19:13:07
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Clayton (and Newt):
I have read your reasoning with regard to liability coverage to the neighbor's automobile, and understand the policy interpretations which you use in arriving at your coverage conclusion.
I am not prepared at this time to concur with your policy interpretation position, nor am I prepared to outline the whys and why nots, until such time as I have had the opportunity to do some additional research.
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Edited by - JimF on 01/21/2003 19:14:56 |
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JimF
USA
1014 Posts |
Posted - 01/21/2003 : 20:12:42
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Ok, I have done the research needed to be comfortable with a policy interpretation decision, and I agree with Clayton's position that the automobile would be covered under this specific scenario up to the $500.00 limits under the HO-3 (91) and up to $1,000.00 under the HO-3 (2000) policies.
I do however suggest that there would not be coverage in the first scenario (a) which Clayton outlined above, if the grandson was 6 years old. |
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Newt
USA
657 Posts |
Posted - 01/22/2003 : 07:57:38
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The only mention of age is :Sec II Additional Coverage C "damage to property of others" 2.b Caused intentionally by an "insured" who is thirteen years of age or older.
This is in section II and I assume this would be the one we would use to justify or deny the claim.
I know there are laws, statutes and cases of 'temptations' to minors, however I don't think this would apply to the sceinerio mentioned by Clayton, even if the kid was six years old.
One such case, a pool built after a policy was written and not fenced, is a violation of most ordinances. It would also be something you would need to note on a claim for " Risk Management".
There may be something I don't understand in the policy, so please correct me. |
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JimF
USA
1014 Posts |
Posted - 01/22/2003 : 21:36:57
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A 6 year old does not have the mental capacity to be negligent. ('Tender Years')
Without negligence there is no liability.
Without liability, there is no Section II (Liability Coverage) from the HO-3 policy for (liability) loss coverage.
(Newt: This 'rule' is not in the policy, it is a fact of tort law).
A simple (liability) rule to remember is this: Negligence= Duty Owed + Duty Breached + Proximate Cause + Damages = A Tort.
DO+DB+PC+D=N |
Edited by - JimF on 01/22/2003 21:46:43 |
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Newt
USA
657 Posts |
Posted - 01/22/2003 : 22:15:05
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Thats good to know, I learned something.
My policy has a section II Additional coverage, We cover the following in addition to the limits of liability. C. Damage to property of others.
I am lost without the other policy. (ISO HO3 /91). I plead ignorance because I are. |
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JimF
USA
1014 Posts |
Posted - 01/22/2003 : 22:28:04
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Newt, NO insurance policy means anything with regard to LIABILITY coverage when a party of 'tender years' (under age 13, depending on state law) is responsible for the damage.
When a party is within or under the 'tender years' (as defined by state laws), there is no culpable negligence. |
Edited by - JimF on 01/22/2003 22:29:37 |
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Newt
USA
657 Posts |
Posted - 01/23/2003 : 06:25:22
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That is good to kinow, I was never exposed to that law. I knew about the attraction law regarding the little ones. As I say I learn something every day here on CADO.
My wife has some good reference material, books on property laws. She packed them when we decided to move. These books have lots of the statutes we have intrest in. There are a lot of statutes on fences which I found to be strange, however they could really help in determining ownership. I know the wording in the policy would prevail in most cases, but when the claims get into litigation it seems to me that case law prevails. Just as the tender years you mentioned. |
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HO 3 03 10 00/MODEL Airplane (repost)
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