Search CompleteMarkets

... Garage Cars Brick Frame ...

... or coming unexpectedly' (Merriam-Webster) . In other words, sudden' means unexpected or unforeseen, a surprise — and it appears likely that the insured did get a surprise. Here's another example, involving a Commercial Lines claim. The insured cement contractor was pouring a concrete driveway at a home in a new subdivision. As nightfall approached, he inadvertently caused cement to be splattered on a nearby garage door, necessitating its replacement at a cost of $827.69. The owner of the home made a claim for his negligence. The insured received a letter from his CGL carrier's Senior Claim Representative denying coverage, citing Exclusions 2.j.(5 ) and 2.j.(6 ) . Upon receiving a response from the agent to this letter, the claim rep sent another letter citing Exclusions 2.j. ... exclusion in this way would mean that insurers would never have to pay a negligence claim and policyholders' premiums would plummet by at least two-thirds! Everybody wins! We argued that because the insured foresaw that the door could fall on him, it was an act of self-defense, triggering the exception. We also cited the state's bad faith settlement provision that's triggered when a claim isn't paid even though. liability has become reasonably clear. Although we provided 39 pages of authoritative documentation to support coverage, the carrier still refused to pay this $827.69 claim. At that point, the agent turned our file over to the insurance department. Their investigator telephoned the company on April 11. In a letter dated April 12, the insurer's claims manager stated, In the spirit of compromise we will send our insured ...

...ehicles left in his care. Primary garage keepers was not in place to respond, ...

...ment to be splattered on a nearby garage door, necessitating its replacement a...a claim isn’t paid even though '... liability has become reasonably clear.' Al...

... accounting documents are necessary to determine actual ownership of a law office and trace the flow of funds between individuals engaged in handling fraudulent insurance claims. These records also frequently show that capping has occurred. The homes of attorneys, cappers, and other participants almost always contain evidence that links the suspects to the crime. Sometimes, evidence of insurance fraud and conspiracy has been recovered at suspects' homes or garages. It's common practice for attorneys to work at home as well as at the office, and the attorney may feel that a home is a safer repository of incriminating evidence than a law office. Suspects' motor vehicles are also likely to hold evidence of insurance fraud or conspiracy. Cappers often use their cars to visit and sign up potential clients. One capping journal was recovered in the capper's ... their information to the Highway Patrol. A second type of staged collision is called a paper accident, ' and can be accomplished in different ways. In some cases, two people with their own vehicles conspire to report that they were involved in an accident together. Usually a capper has recruited these individuals and orchestrates the accident. One driver, usually the insured, will be at fault and will claim liability for hitting the other vehicle. The criminals commonly refer to the insured vehicle as the bull car' or the hammer'; the claimant car is the cow car' or the nail. The damage on the claimant car may already exist, or it may be intentionally inflicted to make it appear as if the two cars actually collided. This is accomplished by simply taking the two cars and crashing ...

... would pay first dollar claims to his clients in the event their property was damaged through theft or vandalism. He was willing to pay the higher price since he was in the business of servicing Mercedes, Rolls Royce, Jags, BMWs, and other expensive toys. Vandalism occurred over the weekend, and the insured was forced to spend thousand of dollars repairing 11 vehicles left in his care. Primary garage keepers was not in place to respond, but you can guess what was: the agency E&O policy. Failure to obtain any coverage represents 20% of the claims logged by E&O carriers. The cases just cited demonstrate the need for education among all the agency's personnel. These cases could have been avoided if agency personnel were trained to recognize the sources of claims and had ... for his fur-cleaning firm. Unfortunately, the agent did not pursue the Bailee insurance resource that accompanies the cleaning and storage of valuable fur items. Award for the plaintiff (insured) . If that sounds like a simple mistake, take a look at this error in obtaining the proper coverage: Case No.2: Failure to Obtain Proper Coverage To maintain his business relationships with clients, the insured required general liability and other coverages. A certificate of insurance was issued indicating that the insured had all the proper coverages to meet the standards of contracts required by the client. The client, a general contractor, reported a loss arising from the work of the insured. The loss resulted in discontinuation of underground utility service to a major manufacturing plant. The insured, a swimming pool subcontractor, did not have ...