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All Claim Stories

April 2009
Cause of this Loss: Failure to Provide Proper Coverage
Line of Business: Commercial Property -- Building
Prevention Method: Follow-Up More Frequently.

Seems renovation is never easy.

A PAR client’s building was being renovated when burst pipes caused water damage. The underlying insurer on the property cited a number of arguments as to why coverage should not apply:

  • The location involved was not listed on the policy. (The carrier first stated it had received no request from the PAR firm to endorse the location.)
  • The property would have been underinsured at the amount desired, and, therefore, the claim was subject to a substantial coinsurance penalty.
  • According to the policy’s terms, the building was vacant (voiding the coverage).
  • The pipes burst due to wear and tear. They also had rust and corrosion. (Thus, the damage was excluded).
Faced with obtaining no reimbursement for its loss, the client sued the building’s insurance company -- but not the PAR-insured agency. The underlying carrier did attempt to draw the agency into the claim from the beginning, using the allegation the firm failed to ask that coverage for the location be endorsed.

However, the PAR-insured firm had documentation in its client file of three separate requests, over a six-month period, to add the building to the policy. Although more frequent follow-ups (at least once a month) would have been wise, the underlying insurance company eventually admitted it was negligent in not endorsing the policy.

As for the building insurer’s other arguments against making payment:

  • The client had a history of underinsuring its property (to save premium dollars) and had been told there would be a coinsurance penalty in the event of a partial loss.
  • Actually, the location was not considered vacant.
  • The wear and tear plus rust/ corrosion bases for denial wouldn’t hold water (pun intended).
So, if the insured agency had followed-up more frequently for the endorsement, this claim could have been a true no-liability situation. We contributed nothing for damage to the building; the nearly $40K in legal expenses which were shelled-out were all within the firm’s deductible. Therefore, the agency reimbursed these dollars to PAR.

Q3 2009

Q3 2009

 
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