by daystar » Tue May 26, 2009 04:31 pm
I would appreciate any thoughts on the following scenario.
Insured gives friend permission to borrow vehicle for a couple of hours. Friend never returns the vehicle. Insured files police report for stolen vehicle the next day and reports claim to his company.
Company denies claim based on physical damage coverage exclusion stating they will not pay for pd coverage if you give someone your vehicle with permission and they do not return it.
Even though it is written in the policy as an exlusion, I still feel there is something not right about the denial. I do not have a copy of the full policy...just the exclusion language.
Any light that could be shed upon this circumstance would be appreciated. I don't want to beat a dead horse but I would like to assist the insured to the best of my ability.
Thank you in advance for your help.
Daystar
Insured gives friend permission to borrow vehicle for a couple of hours. Friend never returns the vehicle. Insured files police report for stolen vehicle the next day and reports claim to his company.
Company denies claim based on physical damage coverage exclusion stating they will not pay for pd coverage if you give someone your vehicle with permission and they do not return it.
Even though it is written in the policy as an exlusion, I still feel there is something not right about the denial. I do not have a copy of the full policy...just the exclusion language.
Any light that could be shed upon this circumstance would be appreciated. I don't want to beat a dead horse but I would like to assist the insured to the best of my ability.
Thank you in advance for your help.
Daystar
Posted: Sat May 30, 2009 06:18 am Post Subject:
Hi Daystar,
Initially, I had a feeling that the friend and his wife might have met with an accident..but now things are getting clearer with your explanation..
He did not go as far as to make an accusation as then he would have to report fraud to the our state AG's office and I do not believe he wanted to take it that far.
Yes, that's probably the reason why he quickly denied when you inquired about his suspecting the insured.
I was searching through my own auto policy and I finally found language that actually sounds very similar to the False Pretenses Exclusion only worded in a more "gentle" context.
Is it just the words that seem harsh or was there a harsh point that was missing in your policy?
Yup, that was a commercial policy I quoted but I could not find anything close to a private auto policy.
Is it really different than a private policy?
Steven
Posted: Sat May 30, 2009 03:50 pm Post Subject:
Hi Steven,
I had the same feeling also. I thought perhaps an accident had occurred. Thankfully that did not happen. There is still much ambiguity surrounding this claim but I am not able to force the company to do much more in the way of investigation due to that darn exclusion!
Yes, the CM was rather quick to backtrack his comment on fraud. He did not want to go there however if one suspects fraud it is their duty to report their suspicions to the proper agency per our state statute regarding fraud.
I don't like the wording of the exclusion but that is my personal opinion and I'm sure the company could less what I think. lol. My supervisor just laughed when I said "I don't like the wording."
The garagekeepers liability policy language pertaining to the False Pretense Exclusion has a much more thorough and lengthy explanation but when it comes down to it, the message is still the same. Claim Denied!
I scanned the policy exclusion to my home email address but I cannot seem to copy and paste it here due to the format of the document not allowing me to do so. I will find another way to post it.
Posted: Sat May 30, 2009 04:06 pm Post Subject:
Daystar, you sure the covered vehicle isn't a tow truck? Best case scenario, the Border Patrol just pulled it over because it had been reported stolen.
Posted: Sat May 30, 2009 05:06 pm Post Subject:
Hi Flint,
I wish it was just a tow truck...would have made things more easier and understandable but it is a 1991 Ford F150 PU. I really feel bad for the insured as they are nice people.
Posted: Sun May 31, 2009 11:28 am Post Subject:
I will find another way to post it.
I've had this trouble too, what I've done in the past, is copy it and paste to an email (from my 'work computer) sending it to my home computer, then I can copy and paste it where ever I want...might work..Posted: Sun May 31, 2009 11:14 pm Post Subject:
Thanks Lori. I will try that tomorrow from work. I had scanned the document and it won't let me copy and paste. :)
Posted: Mon Jun 01, 2009 06:17 am Post Subject:
Thanks Lori. I will try that tomorrow from work. I had scanned the document and it won't let me copy and paste.
You may then add it as an attachment to the mail. You can post the same as image to your posts here. I thin it'd work this way if the doc isn't not allowing you to copy paste the content from it.
I'd love to read more about this 'exclusion'.
~Jeremy
Posted: Tue Jun 02, 2009 04:22 am Post Subject:
Thanks Jeremy. I will try that tomorrow as I had no luck today trying to copy and paste it. Something about the format won't let me copy and paste the darn thing.
Maybe I will request the CM to send me a complete copy of the auto policy booklet via US mail. That may be the easiest way to get this info on the site.
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