What is comprehensive claim?

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PostPosted: Thu May 10, 2007 9:02 pm   Post subject: What is comprehensive claim?  

I have a question about automobile insurance coverage. My vehicle was damaged in two places while parked after a snow storm in March: dent in front right fender and chrome strip snapped at the center of the front bumper. It was most likely due to someone shoveling snow and accidentally whacking my car. I brought in the vehicle to get it appraised as scheduled by my insurance, Liberty Mutual. The appraiser says the chrome strip is "a separate incident" and that my comprehensive only pays for "each loss". I told her that it was not true; it was one incident since I found the damages on that same day in March. Also, there was a mound of snow in front of my vehicle so no other car could've backed into it. My only suspicion is that it was someone shoveling and piling the snow in and around the front of my car who did the damage. I also confronted my neighbor whose house I parked my vehicle in front, who said that he had no idea on how it happened, he suggested that it was the difference in temperature from cold winter temperature to hot sunlight that had heated up the front and caused it to snap by itself.



My questions surround the validity of the appraiser's terms "separate incident" and "each loss". I totally diagree. I consider the two impacts to be the same incident and same loss. My automobile insurance policy states under Comprehensive, "We will pay for each loss up to the actual cash value of the auto or any of its parts at the time of the loss. If the repair of a damaged part will impair the operational safety of the auto we will replace the part. In all cases, we will subtract the deductible amount you selected. ..." Can anyone with experience with automobile insurance policies and legal information advise? I cannot believe, after all the years of paying insurance with them that they can't foot over more than $150 for repairs when I have a $300 deductible. Is it a good idea to get a written deposition from my neighbor about what he witnessed? i.e., he doesn't know exactly, but it wasn't a collision and that it happened on the same day as the other damage, and that he believes it was the sunlight?



One last thing, about the repairs for the front right fender that they have gave me an appraisal report. Do I have a right to have new and original OEM parts, i.e. front right fender, primer, paint, etc. to be replaced instead of the currently listed Repair and Refinish(Surface, 2-stage setup, 2-stage), Rustproofing, Primer Car Cover, Anti-Corrosive Primer, Color Sand Buff, Cover Car, Mask Jambs, Test Panel, etc? How do I know if I am indeed getting quality parts? I read that if over 99,000 miles Liberty Mutual has a right to use non-original parts? I have 85,500 miles and would like to have new and original OEM parts if this is true.



post moved to the right forum, thanks

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PostPosted: Fri May 11, 2007 7:51 am   Post subject: Auto Coverage  

As per the clause which states "each loss", I think both your damages should be covered without considering them as "separate incidents". You can always consult a legal adviser to clarify the clause.



If the Insurance Company has given you the report for a repair then you cannot opt for replacing the parts. Replacement occurs only when the insurance provider recognizes the damage as irreparable or the cost of repair exceeds the cost of replacement. Apart from that, for replacement new and original OEM parts are used.



Thanks,

Karmina.

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PostPosted: Fri May 11, 2007 12:54 pm   Post subject:   

It is considered a separate occurrence is it's a broken chain of events. The main thing to consider in your situation is that the damage is in two separate locations... meaning, something caused the initial damage and then, a time later, the second damage occurred. You could argue that someone vandalised your vehicle (or, in other words, knew they were damaging your vehicle and did it, more or less, intentionally) and therefor, this was all one act (of vandalism). The way the insurance company is looking at it now is that someone whacked your vehicle while shovelling snow (1st occurrence) and then continued to shove snow. They then got back to the area of your vehicle and whacked it again (2nd occurrence). You could also argue that this is all one occurrence as it all happen within the same act of the person shovelling snow just the one time. Use the vandalism example above... that is, it's all one _act_ as the "act" of shoveling the snow is the same as someone vandalising a vehicle (the damage from vandalism can be in different areas of the vehicle but the _act_ that caused the damage (vandalising or shoveling snow) is the same occurrence. Now that I've thought about it... that is a very good argument. The adjuster may not accept it and you may need to push it up the chain of command but I really think you'd eventually get this paid as one claim. Just don't mention that temperature change thing. If you give them different examples of how it could have happened, they may accept that and then it's 2 separate claims.



From what you describe, they are paying for the _repairs_ of the damaged areas, not replacement (hence, "Repair and Refinish") but in any case, your insurance contract/policy most likely allows for "repairs" to the vehicle and not something along the lines of returning it to it's pre-accident condition (most carriers changed that wording after they got sued). As such, yes, they can allow for Like, Kind, and Quality parts. Many times these are used OEM parts from vehicles that were damaged in other areas. Sometimes they are aftermarket parts with a warranty. Are you so sure the OEM parts are so good? Pushed on a OEM fender lately? Not too hard I hope Laughing . I've never heard of that 99,000 mile rule and really doubt it. Most carriers will only use OEM parts if LKQ is not available... which is usually only when the part has only been around a year or two (not used on prior models). At 100,000 miles, most vehicles would be 8 years old. LKQ parts are used on vehicles as new as 2 years old (24,000 miles). You can always pay the difference in price.

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PostPosted: Fri May 11, 2007 4:21 pm   Post subject:   

Quote:
It is considered a separate occurrence is it's a broken chain of events. The main thing to consider in your situation is that the damage is in two separate locations... meaning, something caused the initial damage and then, a time later, the second damage occurred. You could argue that someone vandalised your vehicle (or, in other words, knew they were damaging your vehicle and did it, more or less, intentionally) and therefor, this was all one act (of vandalism). The way the insurance company is looking at it now is that someone whacked your vehicle while shovelling snow (1st occurrence) and then continued to shove snow. They then got back to the area of your vehicle and whacked it again (2nd occurrence). You could also argue that this is all one occurrence as it all happen within the same act of the person shovelling snow just the one time. Use the vandalism example above... that is, it's all one _act_ as the "act" of shoveling the snow is the same as someone vandalising a vehicle (the damage from vandalism can be in different areas of the vehicle but the _act_ that caused the damage (vandalising or shoveling snow) is the same occurrence. Now that I've thought about it... that is a very good argument. The adjuster may not accept it and you may need to push it up the chain of command but I really think you'd eventually get this paid as one claim. Just don't mention that temperature change thing. If you give them different examples of how it could have happened, they may accept that and then it's 2 separate claims.








I agree with tcope you should go for one claim instead of two claims make it one incident.
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PostPosted: Fri May 11, 2007 10:12 pm   Post subject: Thanks!  

Wrote them and awaiting response. will let you know the outcome, soon hopefully.


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PostPosted: Thu May 17, 2007 3:36 am   Post subject: Bumper fixed....  

The insurance company got back to me and said that the appraiser noted that the damage seemed to be from collision. I objected and demanded for a 2nd opinion. They said they could send another person out; however I couldn't wait because the damage was annoying me so much so I only got the strip on the bumper replaced and refastened. The repair was an hour of work $58 and the part cost $89, total $147. Now the 2nd appraiser wants to come by tomorrow or soon give a 2nd opinion on the car--but it's fixed now! Any suggestions on how to get the amount $147 to be placed on that claim along with the front fender? I have the receipt of repairs and parts...


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PostPosted: Thu May 17, 2007 3:41 am   Post subject:   

Only advise is to be more patient in the future. You understood the situation and knew that they needed to reinspect, yet you made this impossible. Which was _more_ annoying, loosing the $147 or looking at the damage for a few days?

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PostPosted: Thu Sep 30, 2010 7:14 am   Post subject: letter of demand  

I want a letter of demand for damage caused by

the other party for damaging my vehicles.


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PostPosted: Thu Sep 30, 2010 7:26 am   Post subject:   

Quote:
I want a letter of demand for damage caused by

the other party for damaging my vehicles.
First... read my sig.



Look at www.claimspages.com for some forms.


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PostPosted: Fri Oct 01, 2010 12:47 pm   Post subject:   

Quote:
It is considered a separate occurrence is it's a broken chain of events




Spotted this much earlier in the thread.



I don't have the citation at hand, but I believe it was the US Supreme Court that ultimately ruled the World Trade Center attack a "single event" even though there was a 45 minute separation between the first airplane collision and the second.



The benefit of this decision went to the reinsurance companies who did not have to pay two separate claims, limiting their losses by 50%.


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PostPosted: Wed Jan 05, 2011 4:08 pm   Post subject:   

The claim will count against your rating.



I'd call my allstate agent and ask what effect it would have, he'd advise me & I could make an informed decision about whether to make a claim. Have done this on potential homeowners claims.



Don't know about other agents/companies -- possible they'd put it on your record anyway once you talked to 'em.



Guess I haven't helped much --------

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