Comments on: Denied Insurance Claims

By: Tonya

Tonya — Tue, 07 Feb 2012 09:08:34 +0000

I live in Florida.. I was in an car accident and I was not the driverbut I file an claim and was granted compension. Than I was in an shopping plaza and got hit by a car and was granted compension. I was drivin my truck and had no insurance and a girl came out of an shoppin plaza and hit my truck and was granted compension. Dmv had sent me an paper to get insurance r my driver license would be suspended so now my license are suspended now and I’m went out to try and get insurance now don’t no insurance copmany want me because of the 3 claims that I was not at fault of. Please help I need insurance and also my driver license.

By: Jason

Jason — Tue, 07 Feb 2012 04:58:08 +0000

Terra,
Technically, your damage is covered. I don’t know why they are telling you that. If water escapes from a plumbing line or appliance, the claim is covered. This is where you need get a manager involved or someone knows a little bit about the insurance policy. They are relying on it not being sudden and that is why it appears they won’t provide coverage but that is just my guess.

By: Jason

Jason — Tue, 07 Feb 2012 01:57:36 +0000

John,
Thank you for your well written reply. Of course an insurance company can’t just change things unless all parties agree upon existing contract that allows that, or the other party by some element of action or inaction accepts that change the way its presented or done. Sure contracts apply and laws guide those contracts but they, just like many things fall through the cracks. If things fall through the cracks and it happens incorrectly anyway will it all of a suddenly become right or correct?

Actually, since this is an admiralty subject it belongs in federal jurisdiction. It will be dismissed from any other one it falls into.

Now you ask if you paid for a contract, is the insurance company allowed to change the terms without telling you? Again, it’s likely how the contract is set up and if it’s like current insurance contracts, no, they don’t have that right. However, they do it all the time and you are an example of attempting not to let them get away with it when there are hundreds and thousands that don’t make the effort your are taking.

So, in summary because you stand up and hundreds and thousands don’t, the insurance company’s are allowed to change the terms of their contracts. (and you are the one contrary to what actually happens on a constant basis.)

By: Terra

Terra — Tue, 07 Feb 2012 01:40:36 +0000

Hi there, I recently notice a little bubble on my floor in my kitchen next to my refrigerator. My husband pull the refrigerate out and noticed that the wall and floor were wet. The wall had got so wet you could push it in with you hand with easy. We call and filed a claim with our insurance company and they declined our claim because they are stating that the problem had been there for a while and it is not covered under our policy unless it was an accidental incident i.e. letting the bath tub water run over the top. How in the world am I supposed to known that something is happening BEHIND the walls and under the floor! I don’t pull my refrigerator out every evening to check and make sure everything is okay! Help please I need to know what action and step I can take to get them to cover my water damage. Why do I pay them if they aren’t good for anything! Please help!

By: John

John — Mon, 06 Feb 2012 23:40:02 +0000

Jason: Thank you for your reply. My attorney is my best friend. As a matter of fact he owes me more money than I owe him. If he doesn’t produce I’m not paying. Now that that is clear …our (his) point is that an insurance carrier (or agency) has to notify its policyholder of a change in terms or conditions. They can’t just arbitrarily change things and not send out a notification. Correct? Whether it’s a boat, car, airplane or bicycle the contract terms and law still apply. Markel’s suit in federal court is purely for the purpose of dismissal. There is not a lot of drama. I just want what what agreed to. If I signed and payed for a contract (agreement) does the insurance carrier have the right to change the terms with out telling me? and again …….your thoughts thank you

By: Jason

Jason — Mon, 06 Feb 2012 01:46:51 +0000

John,
All this drama and you’re paying your attorney obviously by the hour and he’s convincing you it’s not an admiralty case when it clearly is a federal case. To figure that out takes almost no research to determine it is. There are some people in this world that should not be trusted without first being verified and your attorney fits that requirement.

That would be like your attorney telling you that a bankruptcy case is not a federal jurisdictional case without you questioning him about that. You need to do a little thinking before believing everything people tell you. The existing court will eventually assert that they have no jurisdiction in their court and you will need to start all over. If you need to start all over again, why don’t you make that move right now in federal court?

Find out if your odds of winning or if you will just be throwing away more money that your efforts won’t be worth it.

By: John

John — Sun, 05 Feb 2012 17:27:36 +0000

Oh I forgot to say: Since our “yacht” was tied up for repairs for 3 weeks I still had to get it to its storage site by then it was almost November. I called Markel to change my lay-up to Nov 1 and they said “OK thank you”. No premium charge for this. Don’t you think that If I knew this I would have made that phone call on Oct 1?

By: John

John — Sun, 05 Feb 2012 17:19:51 +0000

Hello:
In 2008 we moved up in boat size from one that was 24 ft to one that is 35 ft. For years we had a boat policy w/ Markel American and had no issues or claims. When we purchased the larger boat I called my agent and asked him to “add” the larger boat to my policy much like you would add a second car to your auto policy. The smaller boat was for sale but that hadn’t happened yet. He called me a few days later and said he had to insure the boat on a separate “yacht” policy because any boat over 34 ft is defined as a yacht. Markel’s “boat” and “yacht” policies are virtually the same with only one exception. The yacht policy calls for a defined “lay-up” period. Usually during winter months like Oct 1 to Apr 1. I was not aware of this difference and was not informed of it. That day in my agent’s office I signed a 4 page application for yacht insurance fully filled out on Markel’s letterhead and included a check as payment of premium. The box that indicates the lay-up period clearly says “NONE”. I have a copy of this. On Oct 5, 2011 while bringing the boat to its winter storage site we had a grounding and resulted in $14,000. worth of damage. We reported the accident that day and 2 days later Markel denied coverage stating that our declaration page indicates an Oct 1 lay-up and we were not supposed to be on the water. What the declaration page says and what I signed are two different documents. Markel or my agent cannot provide us with any documentation to prove that they notified me of a change in my policy terms and conditions. To make matters worse I stopped in to one of my agents offices and asked the secretary to get me a copy of my initial application. She did and in the box indicating lay-up the word “none” was crossed out and the word “Oct” was penned in. No specific day in Oct. We are now in litigation. Markel has counter sued us in federal court seeking dismissal (since they claim this falls under admiralty law hence federal jurisdiction). I paid for the boat repairs out of my pocket. I, as well as my attorney, think this falls under basic contractual law where an agreement was made and it was breached. What are your thoughts?

By: Jason

Jason — Fri, 03 Feb 2012 04:20:41 +0000

Patricia,
Use my address in orange at the top of the page to provide detailed advice about your claim.. Prove the name of the policy,and exclusions. What fire what-so-ever in your vehicle that may have occurred? More questions to follow later. Thanks, Jason

By: patricia

patricia — Thu, 02 Feb 2012 18:18:39 +0000

we are military. could not sell our home forced to rent. tenant forgot to unhook hose and our landlord insurance says we have no water coverage? only fire perils only policy. This is the first we have heard of this? We thought we had homeowner’s with tenant occupancy, apparently, that doesn’t exist. The tenants have USAA renter’s insurance and I am trying to file a claim, since the tenant didn’t unhook the hose, which causes the pipe to break. I have about 8k with of damage? Is it worth getting an attorney? Can I hold the tenants responsible? How can I find a hole in the landlord policy to get them to accept the claim? spontaneous accident?I thought the word “insurance” meant to insure help when an accident happens. The agent who wrote the policy is playing dumb and acting like I knew it was a overpriced sub-standard policy. Hubbie is deployed could use some advice????