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Lon Sterling
68 Posts |
 Posted - 09/10/2002 : 11:48:05
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Can anyone show me the language in the policy that says exactly "we don't owe to match" or a closely worded interpretation thereof - chapter and verse please. Thanks
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Lon |
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Russ
USA
75 Posts |
Posted - 09/10/2002 : 15:01:43
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| Lon, Using the old adage.(If it aint broke dont fix it)!! all policies pay for sudden and accidental DAMAGE by the perils covered under that particular policy. If a slope or an elevation is not damaged there is NO coverage afforded. I have worked for a lot of Carriers who will pay for the fourth side if three sides are damaged and if more than 50% of the roof is damaged they will pay for the whole roof. Not all will do that, but every claim has its own particular merits and us adjusters are given leaway in some cases. Y'all have a great day and PLEASE WORK SAFE!!! |
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Ghostbuster
476 Posts |
Posted - 09/10/2002 : 21:50:34
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Ya know, Jim, when dealing with narcissitic individuals, sometimes we must be extra tolerant and try to appreciate the road of life they trod. Often under the influence of prescibed psychotropic medications, these poor souls can only deal with their problems in the only way they have learned. Many a brain care specialist has sought to aid these cases to lead meaningful and productive lives in this more than confusing American society.
Tolerance. Friendship. Love. These basics of life are what they seek, just as we all strive for them as well. Dealing with the perplexing complications of an insurance policy and the representatives from those organizations places more than the usual stress on these unique individuals. I just know you'll join me in a new understanding of their special needs.
Can we have a group hug? |
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Straw
13 Posts |
Posted - 09/11/2002 : 02:12:59
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| Read your policy it helps a lot. This is not your total answer but it might help: Ho3 (10-96) page 10 of 17 Loss settlement #4. Hey! it's a straw to work from. |
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CCarr
Canada
1200 Posts |
Posted - 09/11/2002 : 15:57:16
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Hey Lon! Come down off the roof for a minute. I was looking for those posts I read about diminished value, but cann't find them, so I thought I would pick this shingle to tell you something I found.
I have no side to lean on in this issue, but while I was looking around for something else I came upon an article you may find interesting.
Go to www.claimsmag.com/Issues/june02/index.asp
There you will find, "For the Record, The Contentious Issue of Diminished Value". The unfortunate story of how DV has penetrated the auto insurance world; where the dark jungle of ACV is much different - at this time - than our property world of replacement cost.
I might suggest, that before I get too old to read, we will likely see some penetration of DV to the property side.
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Lon Sterling
68 Posts |
Posted - 09/11/2002 : 16:39:48
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Thanks, Clayton I read the article. My question, however was the exact location in the policy of the verbiage that contained the phrase most similar to "we don't owe to match."
By the way, check this article out:
http://www.claimsmag.com/Issues/September99/by.asp
See, I don't think all roofers are truthful just as I don't think all carriers are truthful. Very interesting article.
Thanks
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sbeau4014
USA
53 Posts |
Posted - 09/12/2002 : 09:07:11
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| Just to stir up things a little, I've never seen language in the policy itself as "we don't owe to match". But then I've never seen the language "we owe to match" either,and as it is a contract I wonder how it is intrepreted in the 1st place to owe for a total match. Don't have a policy in front of me right now, but I think they reference that "we will pay for damage caused by a covered peril to covered property.....". |
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Lon Sterling
68 Posts |
Posted - 09/12/2002 : 10:45:05
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| An earlier question which was deleted by Admin inquired as to why felt was replaced even though hail had not "directly" damaged it when only the shingles were bruised and suffered the damage. Did anyone read the Claims Mag article I linked from '99? |
Lon |
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genco
USA
18 Posts |
Posted - 09/20/2002 : 12:55:01
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Interesting topic as everyone has a different perspective. This is the question that is "almost" daily before me.
I don't think you will find the exact language anywhere. Some carriers will not cover undamaged portions regardless, while others do.
It is my understanding that if it isn't written specifically in the policy the items in question default to the policy holder.
This appears to be an issue that is "gray"
Another consideration, when the illusive siding you are trying to match is available but only by special order, there is additional freight charges and they won't ship partial boxes so you have to round up to the next box.
Most of the time it ends up costing more than just replacing with something that is locally available. |
Genco Joe |
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KileAnderson
USA
875 Posts |
Posted - 09/21/2002 : 00:25:45
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I liked Sbeau's answer. He brings up a good point. Nowhere in the policy that I have seen does it say that we owe to match. I have had managers tell me we don't owe to match the shingles on the back to the front, and I have had a manager tell me to replace the siding on the dormers on the oposite side of the house that are not visible from the front of the house to match the siding that I am replacing on the dormers on the front of the house. Even though the rest of the house is brick and there is no angle where you can possibly see the front and rear dormers at the same time even after the claim was closed and the insured satisfied. He thought I was joking when I called him back to tell him I was sending him another check and a revised estimate.
If you look at things like I do and half of the public does, insurance owes you to fix what is broken. If you look at it like the other half of the public insurance owes you to fix whatever you want to whatever degree you feel you can milk it. (I'll leave it up to you as to which candidate each group voted for in 2000).
I guess the answer Lon is like most issues of contenction, it isn't in the policy otherwise it wouldn't be an issue of contention. |
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JayEsq
USA
1 Posts |
Posted - 10/17/2002 : 15:06:28
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Hi, I don't know if you are still looking for this information, and I don't know what state you're in, but I can tell you that in California, this issue is governed by the Insurance Regulations promulgated by the state legislature and the Insurance Department. I had to deal with this issue in a bad faith case against an insurer a couple of years ago. Basically there is nothing in the policy that governs this issue (the insured in that case took the creative position that the policy's coverage to replace "pairs or sets" required the insurer to pay to replace all of the carpeting, light fixtures and exterior painting and cleaning of one tower of an undamaged building to "match" those in the fire-damaged tower).
The California regulations state that "When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace all items in the damaged area so as to conform to a reasonably uniform appearance." This took that place of the old regulation that required that “[w]hen a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace all items in the damaged area and that area which encompasses a clear line of vision from the damaged area" (the "line of sight" rule). The line of sight rule was abrogated because it was too unworkable.
Hope this helps.
Jay
quote:
Originally posted by Lon Sterling
Can anyone show me the language in the policy that says exactly "we don't owe to match" or a closely worded interpretation thereof - chapter and verse please. Thanks
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Todd_Summers
USA
69 Posts |
Posted - 11/01/2002 : 09:37:41
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| I would like a discussion on wall-to-wall carpeting and cabinets. Particularly, if there is water damage to carpeting in a closet only, where there is a door. Who has been instructed to pay for carpeting throughout all continuous runs and who has been instructed to pay just for the closet ? What are your opinions and experiences on this? |
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tomgriffin56
USA
88 Posts |
Posted - 11/01/2002 : 13:30:09
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The "usual" direction from my leads has been to only replace in the damaged room if there is a closing door separating the rooms. If, however, there is an open doorway with no door then you continue into that room. Always on a "case by case basis" as our current leads like to say (distancing themselves from a blanket statement?)
Hope this helps. |
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tomgriffin56
USA
88 Posts |
Posted - 11/01/2002 : 13:32:41
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| This also presupposes there is no other visual break between the rooms. Sorry, even I'm getting wishy-washy. |
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Wes
USA
62 Posts |
Posted - 11/01/2002 : 14:44:59
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| I maybe jumping in here where I dont belong being that I have only worked three storms and I still have tons to learn but I would like to share an observation. In every situation like this where an insured mentions matching the remaining covering be it siding, painting, roofing, carpeting or what have you I inform the insured that I can only pay for the actual damaged materials at the time of the inspection (however I scope all materials because I know whats coming). I tell the insured if they have a matching concern they will need to discuss it with their agent. Now here is my observation, I have never or at least 99% ever had a agent turn down the insureds request to match. Two days later you will get the call from the agent telling you to go ahead and write up the remaining siding or the other half of the roof or in this case the bedroom carpet. I dont know if this is just good customer relations on the carriers part or the fact that all my storms have been in rural towns where the agent and insured always know each other personally. For all you very experienced guys is this the norm? Thanks for hearing my 1/2 a cents worth of knowledge. :-) |
Edited by - Wes on 11/01/2002 16:08:02 |
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Todd_Summers
USA
69 Posts |
Posted - 11/01/2002 : 16:54:05
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Wes,
Thanks for your reply. You should realize one thing. You are not the agents subordinate. Agents are salespeople. Agents sell policies. The claims department works claims. Your authority limits are most likely much higher than the agents for a reason. You should communicate with agents and be able to explain what the direction is that you have been given by your claims manager, but you do not have a responsibility to do whatever the agent thinks should be done. And most of the time they are on your side after an explanation has been given. That is, until you get the one that asks you if you are a "real" adjuster or an independent. This actually happened to a friend of mine. He then asked the agent if he was a real agent or an independent. He was, of course an independent. Hope this helps.
Tom,
Thanks for your replies as well. That makes sense. Now using the same "line of sight" rule... what about upper and lower cabinets. Lowers are damaged. Uppers are not. Cabinets can't be matched. Then what? |
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I've often heard "We don't owe to match"
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