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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  10:55:50  Show Profile
I just got a claim on a Mobilehome where the insured states that the plug was in the tub and the cat pushed down the faucet. The insured was gone all day and came home to the tub over flowing. I would like to see what you guys think. The company already told me their opion. I will share at the end.

sbeau4014

USA
53 Posts

Posted - 02/02/2004 :  11:32:28  Show Profile
Don't know the policy involved, but if it is all risk, almost all of them exclude loss caused by "domestic animals". The proximate cause of the water damages may be considered caused by domestic animals. Food for thought. If the insd just said they forgot about starting the tub and left (which may be the case but afraid to admit to it) it would probably be a covered loss, unless intentional act can be shown.
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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  11:36:33  Show Profile
sbeau4014,

It is an all risk policy.
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Catmandale

USA
67 Posts

Posted - 02/02/2004 :  11:49:00  Show Profile
I just hope the cat remembers to turn of the oven when he's finished baking his brownies...
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Manmut

USA
26 Posts

Posted - 02/02/2004 :  12:04:49  Show Profile
Could it possibly have been excluded under the "Animals" exclusion?

Patrick W. Laws
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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  12:20:25  Show Profile
I was going to wait but, here it is still let me know what you think. The company is going to pay for the loss because the water damaged the floor not the cat even though the cat caused the water to overflow. I would deny the claim due to the fact the insured stated the cat turned on the water. The water damage would not have occurred if the cat would not have turned on the water.

Edited by - Dakota Kid on 02/02/2004 12:21:28
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JimF

USA
1014 Posts

Posted - 02/02/2004 :  12:27:43  Show Profile
quote:
I would deny the claim due to the fact the insured stated the cat turned on the water.

Originally posted by Dakota Kid - 02/02/2004 :  17:20:25



Dakota Kid,

Let's not forget that (generally) we as adjusters do not deny claims but only recommend denial or coverge. I think you understand that, and don't mean to be picky nor petty, but as adjusters it is better if we learn to use the proper verbage (which can help to keep us out of E & O infractions) in discussing denials.

I do have a question though. If this loss had been caused by a 5 year old minor child of the insured turning on the faucet, would you still recommend denial of the claim? Why or why not?

Edited by - JimF on 02/02/2004 12:30:15
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Linda

USA
127 Posts

Posted - 02/02/2004 :  12:46:37  Show Profile
I had a very similar claim where a 5 year old child turned the water hose on the house and the window was open. The water damage was extensive. The carrier paid based on the accountability of a child deeming it an accident since the child had no intention of causing damage.
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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  12:47:50  Show Profile
I would not deny the claim if a 5 year old child left the water on. I would not deny if the insured had left the water on. This is an domestic animal.
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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  12:56:21  Show Profile
I read a ISO ho-3 policy and in this policy Section 1 E-8 the resulting water damage from the cat would be covered.

Edited by - Dakota Kid on 02/02/2004 13:28:47
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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  13:02:50  Show Profile
JimF,

You have not told us if you would suggest payment or denial on this claim.

Edited by - Dakota Kid on 02/02/2004 13:29:41
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sbeau4014

USA
53 Posts

Posted - 02/02/2004 :  13:21:17  Show Profile
Don't believe a child of the age of 5 would be held accountable for his/her actions in any jurisdictions in the country and the claim would be covered even if it were shown there was intent on the part of the child to cause damages. When they reach a certain age (varys from location to location) is when intentional act on the part of an insured comes into play. Although based on some criminal courts decisions in Florida, the folks down there may hold someone of this age responsible.
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Wes

USA
62 Posts

Posted - 02/02/2004 :  13:21:40  Show Profile
I had a loss were a rat chewed into polybutylene plumbing causing water damage.

Damage caused by Vermin to Plumbing = Not Covered

Water Damage Caused by Sudden, Accidental and Unexpected Escape of Water from a Plumbing System = Covered

Is this a good example of ensuing damage?
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JimF

USA
1014 Posts

Posted - 02/02/2004 :  13:44:32  Show Profile
Ok, as always, let's take a look at the applicable policy language from the HO-3 (04/91) and see if we can learn something new (Note: emphasis mine):

SECTION 1 - PERILS INSURED AGAINST

Coverage A - Dwelling and Coverage B - Other Structures

We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. We do not insure, however, for loss:

(2) Caused by:

e. Any of the following:

(7) Birds, vermin, rodents, or insects; or

(8) Animals owned or kept by an "insured."

IF any of these CAUSE WATER DAMAGE not otherwise excluded, from a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance, we cover loss caused by water including the cost of tearing out and replacing any part of a building necessary to repair the system or appliance. We do not cover loss to the system or appliance from which this water escaped.


What I suggest is that the water loss caused by the cat is covered.

I further suggest that water damage caused by the rat eating into the plastic water pipe would be covered as well (except for the damage to the water pipe).

What is confusing so many of you, is that you are confused about this policy section of coverage because you are not reading the entire language of that section, wherein some coverage previously excluded is now given back by policy language had you read the entire section.

I hope this helps in your understanding.

Just remember that the policy giveth and the policy taketh away. And sometimes, the policy giveth back that which was previously taketh away!

Did this help anyone in better understanding why there are some coverages under this policy section regarding owned/kept animals, rodents, and vermin, etc.?

Edited by - JimF on 02/02/2004 14:10:23
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Dakota Kid

USA
30 Posts

Posted - 02/02/2004 :  13:49:59  Show Profile
JimF,

I don't have a copy of the mobilehome policy would be about the same on this case with the cat?
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Brooks Todd

USA
43 Posts

Posted - 02/04/2004 :  13:29:10  Show Profile
There's a new adjuster in town.
They call him "The claim turning down Kid"
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