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R&R Insurance Blog

Brian Bean

Recent Posts

5 Tips for Working with Multiple Lines of Coverage on a Claim

Posted by Brian Bean

An accident happens with company vehicles on the road.  Step 1 is to call the insurance company.  Out on the road there are various exposures, each being covered under their own line of coverage.  With multiple coverages comes multiple claims adjusters.  With everyone working on their own timelines, offers are often slow to come in, and quite frankly, creates communication hurdles. 

In one particular case, damage was done to:

  1. Auto physical damage to truck chassis and trailer
  2. Inland Marine items - on- and in- the truck

Noticing the lack of central communication point,  R&R stepped in.  Meeting with each of the adjusters, three approaches were discussed how to evaluate the ACV (Actual Cash Value) of the damaged items:

  1. Market approach
  2. Straight-line depreciation
  3. Broad evidence rule

Each situation will dictate the best evaluation method. In analyzing the various offers from the insurance company's adjusters, and looking at the client's equipment value, R&R was able to recover an additional $78,000+ for our client compared to the original offer from the carrier!

Lessons learned?

  1. Determine best method for equipment valuation
  2. Identify all equipment, including smaller items, with name & serial number
  3. Document where equipment is bought
  4. Utilize equipment appraisals that may already be on file for bonding & line of credit purposes
  5. Have an independent agent facilitate negotiations

Having a KnowledgeBroker working on your behalf will guide you through complicated claims and ensure you're receiving every dollar you deserve.  Want a second look at a claim?  Shoot us an email: safety@rrins.com.

 

Topics: Claim Management, accidents and claims, Inland Marine

Leasing a Personal Vehicle Back to a Business - Are You Covered?

Posted by Brian Bean

Bob is the owner of Giovin, Inc. He owns a car that is titled in his name only.  He also uses the car primarily for the business of Giovin, Inc.  Because of that, Bob had his insurance agent add the car to Giovin Inc.’s commercial automobile policy.  Bob even has a lease with Giovin that pays iStock_000010641551_Large.jpgBob for the use of that car.  This seems like a great deal for Bob, and in the real world, this scenario happens fairly often.

However, there is a serious coverage problem with this arrangement.  Bob may not be covered personally if there is an accident.  Here is an example of what might happen:   

Let’s say Bob is driving the car on business for Giovin Inc., when he rear ends another car, injuring the occupants.  The occupants file a lawsuit against both Bob, personally, and Giovin, Inc.

This is when Bob gets a nasty surprise.  A standard commercial automobile policy does not cover and defend Bob in this situation.  He will have to pay for his own defense in this lawsuit.  If there is a judgment or settlement, he will likely have to pay that personally as well.

This outcome could have been avoided if Bob had told Giovin’s insurance agent that he was the owner of the vehicle, not Giovin, Inc.    

This situation can be handled to make sure that Bob is covered under the policy.  There are different ways of doing that, and the first step is making your agent aware of who actually owns what vehicle.  To be sure, the insurance carrier’s underwriters will have some questions that will need to be answered.  

A good rule of thumb when it comes to commercial automobile policies:  If a vehicle is titled to someone other than the business named in the policy, you need to check with your agent to make sure that the actual owner is covered in case of an accident.      

Contact a Knowledge Broker at R&R Insurance for additional information.

Topics: Auto Accidents, Auto Insurance, auto policy

Terrorism: Am I Covered?

Posted by Brian Bean

Terrorism.jpgOrlando. 

San Bernardino.

The Boston Marathon Bombing.

Fort Hood.   

9/11.

 

Terrorism is again at the forefront of nearly everyone’s minds.  It is no longer something happening "over there."

After 9/11/01, terrorist attacks and fatalities in the United States dropped to nearly zero from 2002 until 2009.  However, since 2009, the number of incidents and the number of fatalities has been rising, including the most recent and horrendous attacks in Orlando and San Bernardino.  It is clear that terrorism can occur anywhere and is not going away. 

 

What Is My Business’ Risk from a Terrorist Act?

Statistically speaking, the average American is far more likely to die from other causes than from terrorism.  For example, the Centers for Disease Control reports the following:

  • You are 271 times more likely to die in a workplace accident than a terrorist act. 
  • You are 1,904 times more likely to die in a traffic accident than a terrorist act. 
  • You are 35,079 times more likely to die from heart disease than a terrorist act. 

However, these statistics do not make the threat of terrorism any less frightening. Clearly, some parts of the country have a greater exposure than other parts.  For sure, the recent events lead typical business owners to ask:

 

Does my insurance cover my business if something happens to me like what happened to Pulse in Orlando?

Unfortunately, that is not a simple “yes” or “no” answer.  It all depends on what line of coverage you’re talking about.  For example, Worker's Compensation does not exclude terrorism.  For all other lines of commercial coverage, the answer is a little trickier.  It involves something called TRIA.   

 

What is TRIA?

The 9/11 attacks resulted in insured losses of $23 billion.  As a result, the Terrorism Risk Insurance Act (TRIA) was enacted by the U.S. Government.  It acts as a re-insurance to the insurance industry to cover insured losses from terrorism.  In exchange for this backing, the law requires insurers to allow businesses the option of buying terrorism coverage.

TRIA defines an act of terrorism as an act committed in the United States by individual(s) to coerce the civilian population of the U.S. or influence the policy or conduct of the U.S. by coercion.  There is currently no distinction between foreign or domestic terrorism. 

The act also specifies that an incident must reach $5 million before it can be certified as an act of terrorism.  The U.S. Secretary of the Treasury, in concurrence with the U.S. Attorney General, makes that determination.  Then there is a complicated set of conditions and thresholds that must be met before the U.S. Government re-insures a particular incident.  Since TRIA was signed into law by George W. Bush in 2002, no incident has been designated as an “act of terrorism”. 

 

What happens if I Accept or Reject Terrorism Coverage?   

If you reject the offer to add terrorism coverage for your standard policy, and an event is certified as “an act of terrorism”, then you will NOT have a covered loss.

If you buy the add terrorism coverage, and there is a certified “act of terrorism”, then you will have a covered loss.

 

What happens if an incident occurs that is not certified as “an act of terrorism”?

As previously mentioned, there has not been one certified “act of terrorism”.  So what happens to businesses’ affected by what seems to be an “act of terrorism”, but has not been certified by the U.S. Department of Treasury as one. 

The Boston Marathon Bombing was not certified, but several businesses were obviously affected.  In this situation, a typical property casualty policy should cover acts of malicious mischief, vandalism, fire, and explosion. 

Business interruption and extra expense coverages would also apply if purchased.  One coverage to consider is for business income or extra expense for “dependent properties”.  These are other business that your business relies on for your continued operations.  What if they are the victims of an attack and are shut down? 

If your employees travel frequently, do you have travel policies that cover terrorist acts?           

Some insurance carriers are offering stand-alone terrorism policies.  These are typically property policies that respond only to acts of terrorism, no matter if they have been certified by TRIA.   

Every situation will raise insurance coverage questions, and all the facts must be investigated to determine how coverage applies. 

The most important task you can do is to consult with your agent and review all of your exposures and policies to determine what makes sense for your business. 

Topics: Terrorism

Real Life Example: Sump Pump Denial Reversed

Posted by Brian Bean

As ouSump-Pumpr Executive Claims Consultant, I frequently assist clients and insurance company partners with difficult and complex claims situations.

 

Recently, we encountered a situation on a homeowner's claim involving a sump pump back-up. To set the stage, this particular client had purchased a separate endorsement on their policy for back-ups of sewers and drains. The endorsement covers water damage associated with sewer and drain back-ups. (Click here to learn more about the importance of this endorsement.)

 

Due to the unique plumbing used for this particular sump pump, the back-up not only caused water damage in the basement around the sump, but on the exterior of the home as well. A pipe from the sump pump leading out of the house began to leak. That water landed on the ground, and then ran directly in through a basement window causing more damage to drywall.

 

The carrier paid for the damages from the water that backed up through the sump, but they denied the other damage as being caused by surface water. Surface water coming into your home is not covered by this endorsement. They said that once any water hit the ground, no matter it’s source, it was considered surface water and damage caused by it was excluded.

 

Through a thorough investigation, I was able to determine that the exterior water damage was in fact due to the sump pump back-up. Due to our closer examination and review with the carrier, we were able to get that denial reversed and have the additional water damage covered.

 

Reviewing complex claims with our Business and Personal Insurance clients is a value added service that R&R is able to provide. With 20 years of claims experience, as well as a legal degree, I understand the importance of walking through difficult situations step-by-step to provide our clients the proper coverage.

 

Disclaimer:

Please note that R&R Insurance Services, Inc. is not a law firm. Brian Bean does not provide legal representation to clients of R&R Insurance Services, Inc., or to R&R Insurance Services, Inc.

Topics: Personal Insurance, Real Life Examples, Resource Center

Claims-Made-and-Reported Policy: No Late Notice Allowed

Posted by Brian Bean

TimerThe Wisconsin Supreme Court recently issued a decision in Anderson v. Aul, 2015 WI 19, which clarified whether Wisconsin Statutes, §631.81 (1) and §632.26 (2), protect an insured when they fail to report a claim during the policy period of a claims-made-and-reported policy.

 

Aul was an attorney being sued by his former clients for legal malpractice. Aul received a letter from the Andersons on December 23, 2009 which stated that they “were dissatisfied with the legal representation Aul had provided.” This letter constituted a “claim made against the insured (Aul)”. As a result, Aul’s duty to report the claim to his professional liability insurance carrier was triggered.

 

Aul had purchased a claims-made-and-reported policy from the Wisconsin Lawyers Mutual Insurance Company (WILMIC) with a policy period of April 1, 2009 through April 1, 2010. However, Aul did not report this claim to WILMIC until March 2011. This was nearly one year after the policy period expired. The policy provided coverage for those “claims that are first made against the insured and reported to the insurance company during the policy period.” This language is typical of claims-made policies, although some policies do allow for an extended reporting period to report claims after the policy period ends. This is usually limited to 30, 60, or 90 days.

 

In this case, WILMIC argued that they did not owe a duty to defend Aul, or pay any damages, because Aul had failed to report the claim during the policy period as required. Aul responded by citing two Wisconsin Statutes, §631.81 (1) and §632.26 (2). These statutes say that an insurance company cannot deny a claim because of late notice, unless the insurance company was prejudiced by that late notice. In other words, if the insurance company could still investigate a claim, and was not harmed by the late notice in any way, the insurance company cannot deny coverage to their insured.

 

Therefore, the question the Wisconsin Supreme Court had to answer was whether these two notice-prejudice statutes supersede the reporting requirements specific to claims-made-and-reported policies. The Court stated that “Requiring an insurance company to provide coverage for a claim reported after the end of a claims-made-and-reported policy period is PER SE prejudicial to the insurance company.”

 

In other words, if you fail to tell your insurance carrier of a claim made against you during the policy period, you cannot rely on Wisconsin Statutes, §631.81 (1) and §632.26 (2) to protect you. So what does this mean to policyholders in Wisconsin?

 

First, this decision only applies to claims-made-AND-REPORTED policies. It does not apply to occurrence-based policies. Also, this decision does not apply to pure claims-made policies.

 

Examples of policies that typically have claims-made-and-reported wording are:

  1. Professional Liability Policies for lawyers, engineers, architects, doctors, etc.
  2. Employment Practices Liability
  3. Manufacturing Errors and Omissions
  4. Product Recall
  5. Directors & Officers
  6. Fiduciary
  7. Contractors Professional Liability
  8. Pollution Liability
  9. Cyberliability
  10. Technology Errors & Omissions

 

If you are not sure if your policy is a claims-made-and-reported policy, make sure you review the terms of that policy with your agent.

 

Second, businesses need to be aware of this decision at all levels of management. For example, a human resources person may be aware of an employment practices claim from a disgruntled employee, but the person responsible for reporting insurance claims may not. As a result, a claim may be late reported and denied under a claims-made-and-reported policy.

 

Finally, policyholders should always err on the side of caution and report any potential claim no matter if the policy is occurrence-based, pure claims-made, or claims-made-and-reported based. It is far better to send notice of a potential claim to your insurance company and rule out any potential denial due to late notice.

 

If you have any questions, please contact a knowledge broker.

Topics: Business Insurance

Menards drops a Board on a Lady’s Foot. The Lady Sues Menards. Menards gets defended by the Lady's Personal Auto Insurance.

Posted by Brian Bean

Has this ever happened to you?

You purchase some lumber at Menards. You drive your vehicle to the lumber area and park it. Then, an employee of Menards helps you load your truck. Actually, this scenario could happen at any store where you purchase larger items or appliances and then get help loading your vehicle.

But I’ll guess that what happened next to Vicki Blasing, did not happen to you.

Blasing stood near the rear passenger side of her pickup truck as a Menards employee attempted to load the lumber. Unfortunately, some of the lumber fell off and landed on Blasing’s foot.

She filed a personal injury lawsuit against Menard, Inc. and its insurance carrier, Zurich American. She alleged two causes of action against Menards. The first was common-law negligence, and the second was based on Menards’ alleged violations of Wisconsin’s Safe Place Statute.

Menards then tendered the defense and indemnification of the lawsuit back to Blasing’s own personal automobile insurance carrier, American Family Insurance. Menards argued that while their employee was loading Blasing’s truck he was, by definition in the policy, “using” her truck with permission. Both he and Menards would then be considered insureds under Blasing’s personal auto insurance, and therefore, American Family owes Menards a defense.

A majority of the Wisconsin Supreme Court agreed with Menards in an opinion where the words “absurd” and “anomaly” appear frequently. However, this decision is actually consistent with prior cases that addressed what constitutes “use” in an automobile liability policy. This case was sent back to the lower court to proceed on the merits. The issue of whether American Family or Zurich Insurance will provide primary coverage to Menards will have to be worked out at a later date.

Three justices dissented from the Majority’s opinion. They argued that Blasing’s Safe Place Statute allegations involving Menards internal procedures, policies and facilities do not constitute “use” of an automobile.

So how can you avoid a legal mess like this? As it stands right now in Wisconsin, if a store’s employee is loading your vehicle, you should just stand back…way back…at a safe distance and let them load it.

Topics: Personal Insurance, Business Insurance

The “Inception” of a Loss Starts the Clock Ticking

Posted by Brian Bean

hourglass

The One Year Statute of Limitations for 1st Party Property Claims

This statute sets the time limit for an insured to file a lawsuit against their property insurer when there is a dispute between them.

The cases below reinforce the importance of reporting all property claims in a timely manner and that if a dispute arises between the insured and insurer, the insured needs to move quickly to preserve their rights.

Even though the statute refers to “Fire Insurance”, Courts have interpreted this to mean all 1st Party Property Policies, such as:

  • Homeowners
  • Dwelling Owners
  • Farm-owners
  • Commercial Property
  • Inland Marine

Wisconsin Statute §631.83 states that:

An action on a fire insurance policy must be commenced within 12 months after the inception of the loss. This rule applies to riders or endorsements attached to a fire insurance policy covering loss or damage to property or to the use of or income from property from any cause, and to separate windstorm or hail insurance policies.

What does “after the inception of the loss” mean?
There have been published cases which have addressed this issue. These cases show just how tough this standard can be.

In Borgen vs. Economy Preferred Ins. Co., the Borgen’s home sustained hail damage in August 1989. They did not discover the damage until October 1990, approximately 14 months later. The Court dismissed their lawsuit and ruled that the inception of the loss was when the hail storm occurred, not when Borgen first discovered the damage. So, unlike other areas of the law, they refused to apply a discovery rule which would extend the 12-month statute of limitations.

In Bronsteatter vs. American Growers Insurance, a farmer’s 12-row corn planter was vandalized on May 17, 2002. As a result of the vandalism, 2 of the 12 rows would over-fertilize and killed the seeds. Unaware of this vandalism, Bornsteatter planted over 1,000 acres of corn. On June 3, 2002, he realized there was a problem, and discovered the vandalism. He reported the vandalism to the Sheriff and his insurance carrier that day. He filed suit against his property insurer twelve months later on June 4, 2003.

However, the court dismissed his lawsuit by concluding that the “inception” of the loss was when the corn was planted in May 2002. The court rejected Bronsteatter’s arguments that the inception of the loss was either when the problem was discovered in June 2002, or when the loss was actually sustained at harvest time in December 2002.

Note that the statute does allow for the 12-month time limit to be tolled, or temporarily stopped, by formal agreement of the parties, or when the parties conduct an appraisal or arbitration procedure outlined in the policy.

As agents we need to make sure that there are no unnecessary delays on our part in reporting a claim to an insurer. R&R's claims tools are available 24 hours a day, 7 days a week. From our emergency claims service center to CSR24, we are here to help when you need it most.

 

This material is for informational purposes only and not for the purpose of providing legal advice. R&R Insurance Services, Inc. is not a law firm. You should contact your attorney to obtain advice with respect to any issue or problem specific to your business. The information contained in this document is intentionally condensed and a summary of statutes and court findings.

Topics: Business Insurance

Dog Coughs Up Lost Wedding Ring: What Happens to Recovered Property?

Posted by Brian Bean

dog ate wedding ringYou may have seen the news story on June 30, 2014 about a Stevens Point woman who lost her wedding ring five or six years ago. She searched everywhere, but could not find it.

 

Last week the woman’s granddaughter was eating a popsicle when the dog stole and ate it. The dog coughed up the popsicle stick shortly afterwards. Two days later the dog started coughing up again and threw up the wedding ring that had been missing for the last 6 years. The veterinarian believes that the stick dislodged the ring from the dog’s stomach.

 

Other than being an interesting story that captured some national headlines, the whole incident brings up some insurance issues:

  • First, the woman comments that six years ago she had just upgraded the ring and had failed to insure it. This highlights the importance of obtaining a personal articles floater to cover valuable items.
  • Secondly, let’s assume that she had insured the ring and the insurance company paid her for the loss six years ago. Now that the ring has been recovered, what should the woman do?

 

Most policies are very clear: she must report the ring’s recovery to the insurance company that paid for the loss. The insurance company owns the salvage value of the recovered ring.

 

Nearly every property insurance policy, whether it is Homeowners, Business Property, Inland Marine, commercial or personal automobile policy, has a Recovered Property Condition in some form.

 

The Recovered Property Condition states that if either you, or your insurance company, recover the property after a loss settlement, then you must promptly notify the other party.

 

You have the option of retaining the recovered property. However, you must return payment to your insurance carrier. The insurance company will pay for recovery expenses and the expenses to repair the property subject to the Limit of Insurance.

 

If you decide that you do not want the recovered property, then your insurance company will sell the property to recoup some of the loss.

 

Over my years of handling claims, I have seen this process play out with recovered jewelry, stolen bikes, cars, and construction equipment.

 

Luckily, this story had a happy ending even though the woman had an extensive cleaning job to do.

Related articles:

 

 

Topics: Wisconsin, Personal Insurance, protecting your jewelry, Real Life Examples, Dog swallows wedding ring, is my jewelry covered?, schedule your jewelry, Lost jewelry, homeowners, homeowners insurance, Recovered Property Condition

What Can They Sue Me For In Wisconsin? Damages Allowed in Bodily Injury and Wrongful Death Claims

Posted by Brian Bean

crutchesOne of the most stressful events you can face as a driver, a homeowner, or a business owner occurs when someone claims they were injured due to your negligent actions. This most often arises from traffic accidents, but it can also arise from slip and fall accidents, dog bites, construction accidents, or allegedly defective products.

 

The first question that has to be answered is whether you are legally responsible for the injury. If you rear-end someone or run a red light, then your negligence is probably fairly clear. However, in other situations, your negligence may not be clear. For purposes of this article, let’s assume you injured the person due to your negligent actions.

 

Question:

So what does Wisconsin Law allow an injured person to recover from you?

Answer:

An injured person may be able to recover:

  1. Past Medical Bills incurred for injuries related to the accident.
  2. Future Medical Bills if those injuries are permanent.
  3. Past Wage Loss due to the accident.
  4. Future Income Loss, if that person is unable to return to their former profession.
  5. Past Pain & Suffering which resulted from their injuries.
  6. Future Pain & Suffering if the injuries are expected to cause pain in the future.
  7. Loss of Consortium for the spouse of an injured person resulting from their loss of services.
  8. Property Damage they may have suffered in the accident.

Luckily, the majority of legally-compensable injuries are not severe or permanent. In fact, most claims are usually resolved by the insurance carrier before a lawsuit is filed, or before the case goes to trial. However, some cases go to a jury trial, and the decision about who is at fault and how much to award the injured person is left in the jury’s hands.

 

Sadly, fatalities can sometimes result from accidents. In those cases, Wisconsin law allows “Wrongful Death Actions” by the deceased person’s personal representative, surviving spouse, domestic partner, child, parent or guardian.

 

In fatality accidents, the following damages are potentially compensable:

  1. Medical Bills incurred before death
  2. Conscious Pain & Suffering, if any, before the person died.
  3. Loss of Future Income to the person’s survivors, which can be very large if the person was young or a high wage earner.
  4. Loss of Society & Companionship. These are damages that the survivors suffer from the loss of that person’s emotional support. Wisconsin has set the following caps on this element of damages: $350,000 for an adult and $500,000 for a child.
  5. Pre-Death Loss of Society & Companionship. If the person survives the accident, but dies at a later date due to the accident, the survivors may be entitled to pre-death loss of society and companionship which is NOT subject to the caps listed above.

Keep in mind that you would be responsible for compensating an injured person, or their survivors, for their damages regardless of how much insurance you decided to purchase.

 

When our agents recommend liability limits in excess of $500,000, and offer to quote additional limits in the form of an umbrella policy, they are looking to adequately protect you in the event of an unfortunate accident for which you may be found liable.

Please talk to your Knowledge Broker about any concerns you have about liability limits. He or she will explain all options available to you and the costs involved.

 

This material is for informational purposes only and not for the purpose of providing legal advice. R&R Insurance Services, Inc. is not a law firm. You should contact your attorney to obtain advice with respect to any issue or problem specific to you or your business. The information contained in this document is intentionally condensed and a summary of statutes and court findings.

Topics: Wisconsin, Safety, Claims, Personal Insurance, wrongful dealth, Business Insurance, injury responsibility, negligent actions, bodily injury, injury, what can i be sued for?

Does Directing Traffic Constitute "Use" for Purposes of Under-Insured Motorist Coverage?

Posted by Brian Bean

Jackson vs Wisconsin County Mutual, Decided 6/10/14 by the Wisconsin Supreme Court

On the day of the accident, Rachelle Jackson was on duty as a Milwaukee County Sheriff Deputy directing traffic at the Milwaukee airport. She was about to direct the driver of a car when she walked in front of that car to check for oncoming traffic. The driver of that car pulled forward and struck Ms. Jackson.

She presented an under-insured motorist claim to the County’s commercial automobile policy. Wisconsin County Mutual disputed coverage and this lawsuit began.

The policy pays sums owed by an under-insured motorist to an insured person who is injured “using an automobile within the scope of his or her employment or authority.

The policy defines “using” by the meaning set forth in Wisconsin Statute § 632.32(c) (2), which defines “using” to “include driving, operating, manipulating, riding in and any other use.”

Jackson argued that she was directing the driver of the car into traffic, and that this constituted “manipulating” or was making some “other use” of the car.

Prior cases have granted coverage to persons directing a car. In those cases, the actual driver is really acting under the direction and control of the person directing them. In those cases, the person directing the car is “manipulating” the car, which constitutes “use”, and coverage was granted.

In Ms. Jackson’s case, she had not yet started directing the car into traffic. Therefore, she was not yet “manipulating” or “using” it by definition. The Court found that she was not entitled to under-insured motorist coverage under this set of facts.

Comments:
Had Ms. Jackson started to motion for the car to pull forward, it seems she would have met the definition of “use” and been granted coverage.

 

This material is for informational purposes only and not for the purpose of providing legal advice. R&R Insurance Services, Inc. is not a law firm. You should contact your attorney to obtain advice with respect to any issue or problem specific to you or your business. The information contained in this document is intentionally condensed and a summary of statutes and court findings.

Topics: Safety, Personal Insurance, Business Insurance