by gertes » Wed Oct 20, 2010 11:16 am
What are the step by step tasks a loss adjuster undertakes to come to an amount of money that the insurance company hiring his service must pay to the claimant?
Isn't it inevitable that two or more adjusters working on the same loss claim will come to different amounts of money that the insurance company has to pay the policyholder?
Yrger
Isn't it inevitable that two or more adjusters working on the same loss claim will come to different amounts of money that the insurance company has to pay the policyholder?
Yrger
Posted: Sun Oct 31, 2010 09:48 pm Post Subject:
First off, the insurance agent selling me the policy of home insurance never took any listing of my contents before he delivered to me every year the policy on my two homes, for 3 million pesos on the house each and .5 million on the contents of the house each.
Yup... not their job. The _sell_ insurance... they don't walk through everyone's home and determine the value on every item. This is your responsibility.Now that both homes had been devastated by typhoon-flooding, they are insisting that I should make a listing of all my properties in each house.
Here is the thing.... _you_ have the _duty_ to show what your loss was. In many cases insurance companies can/will asses certain damages but in the case of smaller personal property there is simply no easy way for them to do this. So they fall back to their right to have the insured tell them what was damaged and the value. You may not like it, it might be difficult for you... but that is the way it is. You can not like it all you want, you can complain all you want... it won't change this simple fact.Can you make a listing of all the possessions in your home when you have always been living in a home your own, from since you got married and raised two kids, and furnished that home continuously from even before your wedding day to the present, when the typhoon-flood devastated your home
Simple answer... yes. It will be time consuming but it can be done and it's not complicated. As you remove these items make a list. It does not need to be uber detailed... group items together. But also make good notes on high dollar items. This items need to be removed anyway... so just keep track of them as they are removed.Take the World Trade Towers brought to the ground by terrorists crushing commercial airplanes into them, do the owners of these towers have to make a complete listing of all the possessions they have in them, before the insurer will come to an estimate of how much he has to compensate for their insurance covering contents possessions in those towers?
I'm sure in many cases they did need to asses what their person items were. Keep in mind it was not one insurance company that insured everything... it was thousands. The difference in that case is that those items could not be accounted for. In you case they can. You have wet and dirty items but they are still there.I'm also betting that many of your personal items were _not_ damaged. Yet you want to be paid on those items as well.
How come that the insurer is being irrational when the situation is clear that all the losses of possessions can command more than .5 million, so just pay .5 million, the limit of his liability, and the matter is finished as regards compensation for the losses of the contents in the house.
So all of your spoons were damaged beyond use by water? So everything you own was 4' or lower in your home? This is simply not the case.Your formula that 4/5ths of your home is below 4' so they should pay 4/5ths of your policy limits it comical at best. You can not like it... you can bitch and moan, you can consider it unfair... but at the end of the day your insurance company is 100% correct.
Posted: Mon Nov 01, 2010 01:24 am Post Subject:
Take the World Trade Towers brought to the ground by terrorists crushing commercial airplanes into them, do the owners of these towers have to make a complete listing of all the possessions they have in them, before the insurer will come to an estimate of how much he has to compensate for their insurance covering contents possessions in those towers?
Actually, here you completely confuse two issues: ownership of the structure and occupancy. In the World Trade Center event, the owner of the buildings collected on a claim for the loss of the buildings. The owner of the buildings had no responsibility for the contents of the building. Each occupant was responsible for their own contents, and you can be sure that in order to obtain payment on their claims for the loss of their "stuff" when the buildings collapsed, they had to provide a listing of all of the items.
You continue to refuse to cooperate in this (relatively) simple act -- as (most likely) required by your contract.
How come that the insurer is being irrational when the situation is clear
Well, who's being IRRATIONAL here? And what exactly is CLEAR? You have your opinion as to what is rational, and what is clear. Your insurance company is telling you . . . like tcope is trying to . . . that your attitude/opinion is IRRATIONAL, and that the true extent of your loss is NOT CLEAR to them.
How do you make things clear to the insurance company? You make a very rational list of all of the property that you allege was damaged or destroyed in the covered event.
The longer you persist in acting irrationally as you are, the longer it will take to obtain a satisfactory resolution of your claim.
Posted: Fri Nov 05, 2010 12:11 am Post Subject:
I really did not know as much as I know now about home insurance and also car insurance.
For example in the Philippines when you get a comprehensive car insurance, it does not cover damage from flooding, but in the US now that I read about insurance in the US it also covers damage from flooding.
When you get a comprehensive car insurance policy in the Philippines, you must also have it clearly written out in the policy document, that the car is also covered against acts of God, an example of which is flooding.
Now, my agent who serves me all the years of my insurance years never ever mentioned to me the need for coverage against acts of God.
I asked him why after the terrible typhoon and flooding of Ondoy on Sept. 26, 2009, he lamely told me that no one is interested in coverage against acts of God, and to think that every year I told him to give me the best protection and not to worry about higher premiums I have to pay -- in fact I never questioned him about anything in the policies he sold me, how much the limits of coverage and how much the premiums, I assumed all the time that he would give me the best protection, because he was a good man after my best interests.
There is a lot that insurance companies and their sales agents don't tell their prospective policy buyers.
They are full of smiles and assurances, but what they don't tell you is what will bring you to hate them when disasters strike, and you try to get an equitable compensation from them, all within the limits of the insurer's liability.
Who knows about actual cash value and replacement cost value in home insurance?
Who knows about having to itemize all the possessions of your devastated home, when you claim your compensation from the insurance company?
Who knows about independent adjusters and public adjusters, the first serving insurance companies, that is where they get their bread and butter and honey, and the second help the policyholders to get the most equitable compensation from the insurance companies, all within the limits of their contracted liability?
Now, in this regard, the insurance commission in my country, the Philippines, the highest authority in matters of insurance, never ever has the imagination to require candidates applying for license to act as independent adjusters to go into public adjusting; so there are no public adjusters in the Philippines except two which are into marine insurance adjustment, not home insurance adjustment.
Why the insurance commission in my country never ever even had the imagination to require by turns independent adjusters to serve policyholders even pro bono, otherwise they the policyholders are at the mercy of predator insurance companies and their henchmen, socalled independent adjusters hired by them to act as their front cover...
That is a mystery to me, but not a mystery to the people in the insurance commission, if they have any intelligence and insight into their heart and mind.
That is why I can see nothing in the insurance commission in my country except practically in effect a huge "independent adjuster" with official muscle for the insurance establishment -- against the policyholders.
Now, about the US who among home insurance policyholders there know about socalled independent adjusters serving the insurance companies only, and public adjusters? who can and do serve policyholders for pay of course -- as also independent adjusters work to be paid or paid off by the insurance companies.
I will say in hindsight that it is the very serious duty of sales agents of insurance companies to inform the policyholders the truth, the whole truth, and nothing but the truth, in home insurance, specially in regard to the crucial knicks and knacks of getting a loss claim settled equitably, when it is time for the home policyholder to get satisfaction from the insurer company.
Gertes aka Yrger
[This post edited for typos.]
Posted: Fri Nov 05, 2010 05:53 pm Post Subject:
There is a lot that insurance companies and their sales agents don't tell their prospective policy buyers.
They are full of smiles and assurances, but what they don't tell you is what will bring you to hate them when disasters strike, and you try to get an equitable compensation from them, all within the limits of the insurer's liability.
Who knows about actual cash value and replacement cost value in home insurance?
Who knows about having to itemize all the possessions of your devastated home, when you claim your compensation from the insurance company?
I will say in hindsight that it is the very serious duty of sales agents of insurance companies to inform the policyholders the truth, the whole truth, and nothing but the truth
Your tirade would have some traction except for the FACT that the insurance company provides you with a CONTRACT YOU ARE EXPECTED TO READ. If you don't understand something in it, then you ask the agent or the insurance company to explain it to you. You shouldn't just sit around waiting to eperience a loss and file a claim to discover something is not covered.
As far as providing a list of damaged/lost personal property . . . just go ahead and put anything and everything you wished you'd owned and lost as a result of the typhoon. I'm sure they serve three meals a day in the prisons in the Philippines like they do in the US.
Or do the right thing and list what you actually lost, let them determine the value, and accept their offer if it makes sense.
Posted: Sat Nov 06, 2010 03:35 am Post Subject:
The cards are stacked up in favor of the insurance company and against the insured policyholder, why?
Because they are the big big big guys who have topshot lawyers who will go to any length to prove their employer correct and sweet-smelling, and use massive volumes of words to establish beyond any reasonable doubts as to convince themselves that they are worth the luxurious fees and bonuses from their employing insurance company, that their employer is all correct and sweet smelling against the non-knowledgeable in all the nooks and crannies of the minutiae of insurance laws and theories and policies and actual practice.
I insure my cars and my homes on the generality of knowledge about insurance, namely, that for a yearly amount that is well within the yearly budget of a homeowner paid to the insurance company, this latter will bring you up to your feet again, when if ever rarely disaster should strike as to make you homeless overnight or in a few hours time.
In all my insurance years I never cost the insurance companies any money, but they have profited fabulously from me and people like myself from the faithful premiums we pay them year in and year out.
Yes, we are happy that we don't have to lay any claim against the insurance companies, because we have been spared from disasters.
In all my insurance years only twice did I have to collect from the insurance companies, both owing to damages from other motorists who banged on my cars because of reckless driving on their part -- and I have always been a very careful and safe and all traffic rules observant driver.
What did I get on those two occasions?
Not bad at all, except for the lousy ways people in the Philippine government get things done in the name of service to its long-suffering people.
First, in this country, when you have an accident, you and your counter partner in the accident must get down from your cars and go each one in his own chosen directions to look for a policeman, who is going to go over to the location of the accident and make a sketch of the event, with diagrams of the cars involved, and also write down the details of your cars' registration and your drivers' license.
While you and your counter partner in the accident are going all over town to look for a cop to record the accident, making a report of it, the traffic congestion can pile up to ten blocks long, and everyone suffers in the stretch of the street where the accident occurred.
Why the Philippine government does not work out a better way, that is another mystery which you will appreciate if ever you come and visit this country.
Next, you and your counter parter in the accident will be accompanied by the cop to one of only four police headquarters in the whole city of more than 20 millions people, to perform further processing with which documentation then you can present your claim for compensation from your insurance company.
That is the very very bad part.
Now, here is the good part, the insurance company will require you to bring your car to one of their repair shops, i.e, their contracted shops, which will make an assessment of the cost of repair, and you bring that assessment to the insurer which will routinely approve it (because guys in the insurer's offices could be part owners or receiving kickbacks from the shop).
Or you can ask the insurer that you would rather that you get the money and have the car repair by yourself in any shop you go to regularly.
They will accommodate but then the cost of repair will be much lesser than the assessment of their contracted shops, so you see the gimmick there?
Anyway, on both occasions I opted to get the money because my already regular shop always does a good job for a thrifty billing, and I on both occasions ending up with some few hundreds left over, and I am sure that my regular shop from past experiences has done an honest long-lasting repair work. (One US dollar is equivalent to roughly today 43 plus or minus Philippine pesos).
So that is the basis also of my knowledge on how home insurance should work in regard to claim.
Okay, let us go to why the cards are stacked up already against the home-insurance policy buyer in favor of the insuring companies.
I call it the stratagem of selling you the big picture but when you stake your claim, they bring up all the small pictures by which they fool you, telling you that you don't deserve the promised returns in the big picture, only a miserable pittance.
But you do deserve the substantial returns in the big picture, because how can a big picture be good if the small pictures in the big picture are bad?
Here is how they the insurance company and their lackeys socalled independent adjusters go about their trickery.
Your 'faithful" and all smiling and most righteous looking insurance agent, he can even pray with you and for you if you are the type that goes to church on Sundays and prays at meals, all full of concern for your best protection and safety, presents to you a home insurance policy with 3 million pesos on the house structure and .5 million pesos on the contents thereof; those are the limits of the exposure of the insurer he represents.
You never ever see him making any kind of inspection for an appraisal of the worth of your house and its contents.
And he charges you accordingly for the exposure of the insurance company, which billing or premiums are no trifle, considering that your house is insured by the company up to 3 million pesos on the house and .5 millions on the contents.
You pay up without ever questioning the honesty and sincerity of the insurance agent and the company he is representing.
Now, if you have any intelligence even though you are not a mathematical whiz kid, you know that on the one hand you will not get all of 3 millions on the house and all of .5 million for the contents when your house -- unless your house and contents are incinerated by an atomic bomb explosion, like those homes in Nagasaki and Hiroshima in Japan toward the end of WW2, which finally brought the Japanese to use their practical reason otherwise they had all the time been proclaiming to the whole world that they would fight to the last man, for the glory of their kingdom of the Sun goddess.
You normally don't get up to the limit of the exposure of the insurance company for the house, but you will get a reasonable or equitable portion of 3 millions for the house, and more likely the whole .5 million for the contents. I will tell you why, from my own reckoning on my two homes.
So everytime there is a typhoon with flooding, you hope it does not wreak any disaster except for the resulting mess in the garden, anyway you assure yourself if the worst happens you will get compensation from your insurer to put you back on our feet, to as much as all of 3 millions on the house and .5 million on the contents
That is the big picture.
So unpredictably it happens that this one typhoon and flooding turned out to be exceptionally fierce, and in my case my two homes got flooded up to two feet in one house on the second floor and four feet in the other on the second floor.
Even though I am not a whiz math kid, I already right away know that I should get a good portion of the 3 millions each for my two houses and all of .5 million of the contents of each.
The minimum therefore I should get from the insurer must be not less than 4 million pesos for both homes and the contents thereof.
Here is my calculation which I can see to be very reasonable even though I am not a cost analyst.
The two houses are still standing but they are damaged very badly, so I can say that their function as homes are reduced by 1/2, meaning 1.5 millions is what the insurer must compensate me for each house, therefore for the two houses the total is 3 millions.
Now as regards the contents, since the water got to the second floor up to two feet in one house and four feet in the other, then the contents damages do certainly come to any conservatively reckoned amount of together 1 million pesos.
Hence, total payable compensation from the insurer is 4 million pesos.
That is the big picture, and if you have any intelligence you will come to that big picture also.
What the loss adjusters employed by the insurance company do is to dwell interminably on small pictures and long long calculations and computations and voilà, the insurance company is obligated to pay you only 610,333.80 pesos for both houses as regards structure and contents, that is all. and it is not even 1/7 of the total exposure assumed by the insurance company, from having insured my two homes at 3 million each on the house and .5 million each on the contents.
That is what I call their trick of not seeing now the big picture when pay-back time arrives, but when they sell you the policy it is the big picture they present to you which is a genuinely very reliable picture.
When pay-back time comes they the hireling independent socalled adjusters work on very small and very many of these small pictures to come up with a measly amount for all the losses and damages on both homes and contents totally only a meager 610,333.80 pesos.
Now I expect everyone with a bit of intelligence to be able to see what insurance companies and their hirelings the independent socalled adjusters make monkeys of the whole noble institution of insurance.
Gertes aka Yrger
Posted: Sat Nov 06, 2010 04:18 am Post Subject:
this latter will bring you up to your feet again, when if ever rarely disaster should strike as to make you homeless overnight or in a few hours time.
Have they denied your claim? Your point is incorrect. The problem is not that the insurance company has _ever_ told you that they would not pay... the problem is that you don't feel like telling the insurance company what your loss was.In all my insurance years I never cost the insurance companies any money, but they have profited fabulously from me and people like myself from the faithful premiums we pay them year in and year out.
This is a misconception that many people have and it's not how insurance has ever worked. If it was, they would never pay out more then a person has paid in. If you insured your home for $1 million and only made one payment, would you like it if they only paid out $10? As long as you've be paying on the policy the insurance company has been assuming all of your _risk_. It's this assumption of risk that you are paying for... not a dollar for dollar payment. Show me just _1_ company that pays out more then they take in and I'll show you a company that is no longer in business.In all my insurance years I never cost the insurance companies any money
In all my insurance years only twice did I have to collect from the insurance companies
Obviously one of these statements is not true.Why the Philippine government does not work out a better way, that is another mystery which you will appreciate if ever you come and visit this country.
I won't even begin to guess... but what does this have to do with your insurance?They will accommodate but then the cost of repair will be much lesser than the assessment of their contracted shops, so you see the gimmick there
No... only because I don't think your statement is completely correct. i think you are complaining because one estimate was lower then the other and the insurance company paid the lesser of the two. No "gimmick". They paid the cost to repair the vehicle just as the contract states.You pay up without ever questioning the honesty and sincerity of the insurance agent and the company he is representing.
When you buy fruit in the store do you check it first to make sure it's what you want? When you buy a car do you "kick the tires" before you buy it? Why should an insurance policy be any different? I also don't think the agent lied to you in any way... I just think you did not read the policy or care to understand how the policy/insurance worked. That is fine... many people don't. But they simply can't blame the insurance company for that.The minimum therefore I should get from the insurer must be not less than 4 million pesos for both homes and the contents thereof
Do you also get rabbits out that that hat? We've already discussed this part... you think 10 feet to the ceiling divided by 4 feet of water tells someone how much you should be paid.:roll:
Here is my calculation which I can see to be very reasonable even though I am not a cost analyst.
You did not need to mention that... I think it's understood.Now as regards the contents, since the water got to the second floor up to two feet in one house and four feet in the other, then the contents damages do certainly come to any conservatively reckoned amount of together 1 million pesos.
I'm not sure if this is more sad or funny. I'm laughing and crying at the same time. You can think this all you want but at some point you are going to need to come back to reality. If you want to take your insurance company to court... feel free. I'm sure a judge would _love_ to hear how you arrived at your loss amount.That is the big picture, and if you have any intelligence you will come to that big picture also.
Well, I've never been very bright.That is what I call their trick of not seeing now the big picture when pay-back time arrives, but when they sell you the policy it is the big picture they present to you which is a genuinely very reliable picture.
Yes, I see. This "trickery" in paying for _actual_ damages... it's all just tom foolery! The nerve!Now I expect everyone with a bit of intelligence to be able to see what insurance companies and their hirelings the independent socalled adjusters make monkeys of the whole noble institution of insurance.
Yes... I think we all understand the situation.:roll:
Posted: Sat Nov 06, 2010 11:12 pm Post Subject:
I'm almost sorry we had begun to answer this OPs post. Each successive post of his offers a greater insight into his steadfast reluctance to cooperate in the resolution of his claim.
As tcope points out, the insurance company has already acknowledged its liability to pay a claim (or two claims). So there is nothing here to indicate that the insurance company is engaging in any trickery. There is a dispute over the value of the loss.
The insurance company is offering X and the insured thinks he's entitled to Y because that's how much coverage he has. But in his attempt to recover Y, he refuses to justify his losses, simply stating, there was flooding up to the second floor. The assumption being that everything on the first floor was lost.
I don't suppose, knowing that a typhoon was coming (they just don't happen suddenly like an earthquake), that a clever person could move most of his valuables and personal property up to the 2nd (or 3rd) floor to prevent its damage or destruction . . . and a criminal would then tell the insurance company, "It was all damaged by the flood water and I threw it away."
As tcope has also said, insurance is a form of gambling: you bet you're going to suffer a loss, the insurance company looks at your likelihood of suffering the loss, and determines how much of your money they need to cover the bet, understanding that you or they could "win".
But when insureds "win", they have actually lost. So it's not quite the same as betting red or black on the roolette wheel (spelled incorrectly to avoid the censor). Life is far better when you pay your premiums for years and years and never have a claim. You've not lost anything, and you've given up a relatively small amount each year for the significantly greater "promises" of the insurance company. It's what allows us to sleep at night, or take a vacation, or simply live life to the fullest -- we call it "peace of mind."
In this OP's case, having paid his premiums, his insurance company is ready and willing to honor its promise, according to the contract it gave the OP. But the OP is defiantly failing to provide the insurance company with the information it needs to reevaluate its original and subsequent offers. As long as he does so, there will be no resolution to the situation.
He goes around bad-mouthing the insurance company, and some poor claims examiner is tearing his hair out trying to explain to his supervisor why the claim file is still open after all these months.
The lesson to learn here is that a little cooperation goes a long way. It might even result in a substantially greater loss paid by the OP's insurance company. But . . . we'll probably never know, or hear about it, if it happens. Far easier to trash the insurance company than compliment it on its swift handling of a claim.
As I said earlier, insurance companies are in business to make money. They stay in business by paying claims. They stay in business longer, as tcope has indicated, by paying less in claims than they collect in premiums.
Personally, I prefer to do business with insurance companies that, on average, pay less in claims than they collect in premiums. Because I know that if I am one of the unfortunate ones to suffer a loss, they will have the money to pay for my loss.
Now I expect everyone with a bit of intelligence to be able to see
A fitting conclusion to this response. Most people understand that when they have $500,000 of protection that it represents the MOST the insurance company will pay, not HOW MUCH the insurance company will pay for each loss.
Posted: Sun Nov 07, 2010 08:32 am Post Subject:
As tcope has also said, insurance is a form of gambling: you bet you're going to suffer a loss, the insurance company looks at your likelihood of suffering the loss, and determines how much of your money they need to cover the bet, understanding that you or they could "win".
Well, I did not say that... it's one way to look at it... but I'd not really agree with that statement.I don't like that statement as it implies that you get nothing if the insurance company does no pay out. Nothing could be further from being correct! All of that unknown risk out there.... all of that possibility that you could loose everything... all of that burden to spend money to defend yourself... GONE! The insured no longer needs to be concerned about all of that and they can get on with their daily lives.
Imagine hitting someone in your vehicle and not having insurance. In some states that person can file suit and attach their judgement to your wages. Here in UT they can lower your wage to just above minimum wage until it's paid. How sweet is that! In other states your drivers license will automatically be suspended until you can show that you've paid the other person back. Setting all of that aside, how about if you don't feel you were at fault... who's going to pay for an attorney?
How about having all that nice stuff in your home. Somethings can't be replaced but what about that kitchen fire that causes $20,000 in damages.... what about a guest slipping on your property... what about that strange who knocks on your door and tells you he fell on your defective property. You may not worry too much about some of these things but they _do_ happen. You no longer need to be concerned about them.
Is all of this worth a few hundred a year? Is paying that few hundred a year now only worth it if you are paid back all of that money?
If I gamble and lose I walk away with nothing. If I have paid for insurance I got something each and every day I had it.
Life is far better when you pay your premiums for years and years and never have a claim. You've not lost anything, and you've given up a relatively small amount each year for the significantly greater "promises" of the insurance company. It's what allows us to sleep at night, or take a vacation, or simply live life to the fullest -- we call it "peace of mind."
I agree with this part much more!Posted: Sun Nov 07, 2010 09:33 am Post Subject:
Sorry to have put words in your mouth -- it was not my intent in the least. I think we're both on the same page with regard to the OPs stance. It was perhaps a mischaracterization of your statement:
If you insured your home for $1 million and only made one payment, would you like it if they only paid out $10?
(Meaning, "bet" $10 to "win" $1,000,000 -- obviously, it's not the only way to describe the process of insurance, but it IS one way.)That's what makes insurance a form of "gambling". The insured is exposed to a risk of loss. Evaluating their financial capacity to withstand the loss, they realize (as you have pointed out in the rebuttal above) that the cost to defend against their own negligence (as opposed to simply collecting a claim for property loss) and the resulting financial harm that could attach to driving around town without auto insurance (or having someone trip over the hose in the front yard of one's home and breaking a leg or arm or worse), is well worth the trade of several hundred (or a couple of thousand) dollars -- for the PEACE OF MIND knowing that, in the worst case scenario . . . a major loss occurs . . . the insurance company money will cover some or all of that loss.
But others look at their past experience, say things like, "It won't happen to me," and bet the other way. Remaining 100% exposed to their risk of loss. Some people say things like, "I've been driving for 30 years . . . never had an accident. Wasted all that money on insurance!"
If they can sleep at night, I guess that's OK for them, but it's not OK for those of us who would be harmed if we were the "victims" of this person's negligence.
Most of us have a very different attitude. Do we risk everything we have worked for, have accumulated, enjoy the benefits of on the off chance that "nothing's going to happen"? We sleep better at night knowing that our savings are secure, and our home and wages will not be under attack (in most cases) because we smashed into someone's car and injured the driver and/or occupants. Or the neighbor kid gets his hand caught in our fence and the dog chews off a finger or two (there are far less gruesome losses that come to mind!).
That's precisely the point -- we trade a small "known loss" (our premium $$) for the coverage of hundreds of thousands of $$ in the hands of the insurance company. We do not consider it a waste of money. We don't get "nothing" in return for our bet. Unlike pure gambling, where the "house" prefers for us to lose, but is benevolent enough to allow some us the occasional win so we don't feel like we're only there to be ripped off (and most people are very happy to report they "broke even" for the weekend, despite having hundreds or thousands of dollars pass through their hands), we get a contract that covers our actual losses. That's our break-even!
If I gamble and lose I walk away with nothing. If I have paid for insurance I got something each and every day I had it.
That's what makes "gambling" on an insurable risk not the same as gambling on red or black. We do get something of value. We just don't necessarily "collect" anything tangible. The "entertainment" some of us enjoy at the tables or in front of the machines, as we're losing "everything" is intangible, too.
Fortunately, most of us will never suffer a major loss to be covered by our insurance. And a few will never experience ANY loss.
But the one time some of us do, we expect our insurance company to come through and handle the claim promptly and efficiently, and the vast majority of the time, they do. That's not to say there aren't problems that arise, such as the OP's difference of opinion as to the value of his claim. And disputes such as this are usually resolved with some measure of satisfaction to all concerned.
And that's what allows me to say, "Life is better when we have no claims against our insurance." Because to receive that tangible benefit, we have lost something of greater value or importance.
When I remodeled my home a couple of years ago, I had all of the lumber treated with the "No-Burn" fire and mold inhibitor product. Cost me $5600 to treat the lumber of a slightly less than 2000 sq ft dwelling and 450 sq ft. attached garage. The product demos are all very impressive. Will it prevent my home from burning to the ground? I sincerely hope so.
But I'd much prefer to die many years from now, never finding out whether it works as advertised -- or not.
Posted: Wed Nov 10, 2010 04:07 am Post Subject:
First, I want to ask the experts on claims is it reasonable for the insurance company to see the big picture, like this:
First, we are dealing with homes, not warehouses.
They insure your home for 3 million pesos maximum exposure from their part (one US$ = roughly today 43 Philippine pesos) on the house and .5 million on the contents; there are two homes insured by the company on the same amounts and with the same premiums paid by you.
They are the ones who come to how much they will expose themselves, you do not bargain on how much they should expose themselves.
They then accordingly fix how much you pay in premiums.
You therefore pay the premiums they charge you.
Now your two homes are devastated by typhoon and flooding up to the second floor to 2 feet high in one and to 4 feet high in the other, so that everything reached by the dirty water and the mud is rendered useless for the purposes they were made for.
So, you go to them and tell them:
Since you as insurer expose yourself to pay me as much as 3 millions each for all kinds of losses on the house in both homes and as much as .5 million for the contents, suppose to make it quick and simple and equitable for both you the insurer and specially for me the claimant, you just pay me 1/2 of 3 millions on each house and all of .5 million for the contents of each house, therefore the total is 4 million pesos, as against the total exposure of the company at 7 millions.
And we can dispense with the drama or play-acting of you consigning to socalled independent adjusters to come to the amount you are bound to pay me.
That 1/2 of three millions ( = 1.5 millions ) on each house and .5 million on the contents of each have already factored in all kinds of depreciations and also the deduction that I should as the claimant absorb.
Is there a law that prohibits the insurance company to proceed in that quick, simple, and equitable manner, dispensing with the play-acting from the part of the insurer employing his socalled independent adjusters?
Have courts in the US ruled in favor of claimants on the basis of what I describe above to be reasonable?
Remember a home is not a warehouse.
Gertes aka Yrger
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