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R&R Insurance Blog

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

Wrestling Injury Leads to Heightened Regulations

Posted by Paul Lessila

Wrestling MatA tragic accident at a North Carolina high school wrestling meet in 2014 led to heightened regulations on mat thickness and placement. When no-1 ranked wrestler, Luke Hampton, attempted to drive his opponent backward he wound up headfirst in a padded wall - leaving him completely paralyzed from the neck down.

 

In the weeks following the accident, tournament officials, school superintendents, and coaches refused to complete until mats were positioned correctly. According to the 2011–12 edition of the federation’s handbook, Rule 2-1(5) states: “The mat area includes the wrestling mat and a space of at least 10 feet surrounding the mat, as well as the team benches and scorer’s table where facilities permit.”

 

Today, 12 inches of padding is recommended with it extending at least 8 feet beyond the area of activity. In order to ensure you’re meeting regulations, visit the ASTM Standards 1292 – an excellent guide for mats and protective surfacing. Suppliers are also a reliable source for recommended protection.

 

What is ASTM International?

Established in 1898 originally as the American Society for Testing and Materials, ASTM International is one of the largest voluntary standards developing organizations in the world. ASTM is a not-for-profit organization that provides a forum for the development and publication of international voluntary consensus standards for materials, products, systems and services. ASTM’s members, including producers, users, and consumers from more than 150 countries, develop technical documents that are a basis for manufacturing, management, procurement, codes and regulations.

 

Contact our Knowledge Brokers for additional information.

Topics: Safety, Schools, Real Life Examples

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

Think Before You Click: Review of the State of WI Homeland Security Cyber Conference

Posted by the knowledge brokers

Homeland Security_State of WI_LogoI attended the recent 2013 State of WI Homeland Security Cyber Conference. The overall message from the day: it is not IF you will suffer a breach but WHEN you will suffer a breach. I'm to passing along a few notes:

  • Back in 2012 the State of South Carolina suffered a breach that exposed 3.8 million taxpayers, 1.9 million dependents, 700,000 businesses and 3.3 million bank accounts. The Breach occurred because an employee inadvertently opened a pfishing email. This error cost the state over $20 million—all because of an email. The State didn’t realize that they had been attacked until notified by law enforcement.
  • Lockhead Martin had discovered an attack of their network that came in the form of emails sent to employees that had attended a conference by sending emails that appeared to send follow up slides and information to the conference attendees.

The FBI reported that the landscape for cyber crimes is changing to state sponsored attacks, i.e. countries trying to steal US companies R&D trade secrets from the private sector. Attacks are advanced and aggressive.

  • As individuals we should be aware that our greatest vulnerability is using credit/debit cards at places such as gas pumps, bus rides, remote vendors, etc. Companies that accept credit cards and are PCI compliant need to realize that this compliance is a baseline minimum.
  • The biggest threat to networks are the employees: "Think before you click" / "Beware before you share" should be the mantra. Businesses need to promote a culture of security awareness.
  • Private companies are urged to join InfraGuard which is a way to communicate with the FBI regarding threats and for the FBI to communicate back to businesses. www.infragard.org

No matter what precautions a company takes, you will never get ahead of a hacker.

The speakers included representatives from Utility Companies, Banking, Security Consulting, FBI, SC Dept of Revenue, and The State of Wisconsin National Guard/Homeland Security.

See the conversation on Twitter by searching #WICyber.

R&R Insurance Cyber Liability eBook

Topics: Cyber Liability, Real Life Examples

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Posted by the knowledge brokers

“Wellness” is more than just a buzzword. Wellness means having the energy and vitality to be productive, and feel and perform your best. It’s our greatest opportunity to restore Americans and American businesses to better health. Your company’s healthy journey begins now. Step by step, employee by employee, to a new culture of health and a healthier bottom line.

Take a look around. What can you do to make your worksite a healthier environment?

  • Have you checked your vending machines lately?
  • Got stairs? Anyone using them?
  • Are you sending out reminders about how to get healthier and avoid injuries.

Helping your employees improve their health is one of the best long-term strategies for reducing your health care costs. Most people spend 53% of their waking hours at work; you have an incredible opportunity to change the lives of the people you see and work with everyday.

The single issue driving the cost of medical, pharmacy, disability, behavioral health, worker’s compensation, absenteeism and presenteeism (coming to work when you’re sick) is the lifestyle choices people make.

  • Chronic conditions such as diabetes and heart disease account for 75% of our nation’s health care costs.
  • Obesity costs employers $45 billion annually in medical costs and lost productivity.
  • The excess cost to employers of employees who use tobacco, factoring in increased medical cost and loss of productivity increases to approximately $3,400 per year per smoking employee.

When your employees are healthy, there’s a healthy chance that:

  • Productivity increases
  • Premiums or total medical spending may be reduced

When your employees experience fewer health complications, the result is a healthier, more productive workforce and potentially lower overall health care costs. It’s estimated that over 10 years, cumulative medical cost savings through reduced obesity rates could reach $282.6 billion.

Your Worksite Wellness team will assist you in choosing health screenings, health seminars and other wellness events that will work best for your employees. Help employees identify possible health risks and how they can lower them and start enjoying a healthier life or understand their benefits and treatment options so they’ll be able to make more informed decisions. Once you get a good idea, you can better choose which wellness programs will go over well, so employees will be more likely to participate. Your leaders can be your best wellness champions by sending emails directly to employees encouraging them to participate. Other ideas can include:

  • Decide what the focus of your program will be: awareness, education, behavior change, culture enhancement, etc.
  • How often will you have an onsite program and how long will it run?
  • Who’s the targeted audience: staff only, spouses, dependents, retirees?
  • Consider interventions that would impact both the low-risk and high-risk staff.
  • Identify incentives that will increase participation such as low cost giveaways for participation or raffle/door prizes like fitness equipment, lunches, gift certificates or even paid time off.

Your wellness team should be a winning combination of management, front line staff and employees from every health status. Lay out a specific plan for your wellness campaign.

Topics: Workers Compensation, Employee Benefits, Wellness, Health Reform, Healthcare, Real Life Examples, WellCompForLife

Real Life: Avoiding Roof Scams

Posted by the knowledge brokers

roof repairsAfter turbulent winter weather and heavy rainstorms in spring, roofs take a beating from the elements. And wherever you find damage, unfortunately you also find scams.

In the Milwaukee area, storm chasers have been known to blanket an area hit by hail or wind damage and look for unsuspecting homeowners. They’ll pass out leaflets, show up unannounced, and offer a free inspection. The scammers know the claims process with insurance companies, and based on the square footage of the roof, they can figure out how much it will cost to put on a cheap new roof. The catch is that the storm chaser does the bare minimum to replace the roof and usually pushes the homeowner to move forward with the repairs before the insurance company has a chance to inspect the damage.

The homeowner is then left with a poorly constructed roof and a claim that potentially could be denied by the insurance company because the roofers often cause the damage.

Lessons to learn:

  • Insurance companies should inspect damage BEFORE work begins
  • Research the roofing company
  • Ask for qualifications - they should be an accredited company
  • Shop around for at least 3 quotes to ensure you are getting the best price and service
  • Do NOT provide money upfront - they may say it is needed to purchase supplies but it is all part of the scam

Wisconsin residents looking for help contacting your insurance company, please contact a knowledgebroker before beginning any repairs.

Topics: Personal Insurance, Real Life Examples

A Dishwasher on Fire? Believe It!

Posted by the knowledge brokers

burnt wooden spoonA reminder from our friends at Kelman Restoration - certain things should never be put in the dishwasher. As the photo shows us, never put a wooden spoon in your dishwasher. In the case of this insured, the spoon fell between the cracks and landed on top of the heat coil, resulting in a fire.

Other items to avoid putting in your dishwasher:

  • Acrylic
  • Adhesive-joined pieces all aluminum
  • Antiques
  • Blown glass
  • Bronze
  • Cast iron
  • China with metallic decoration
  • Crystal
  • Disposable plastics NOT labeled "dishwasher-safe"
  • Flatware with bone, plastic, or wood inlays or handles
  • Gold-plated flatware
  • Iron
  • Knives
  • Many nonstick pots and pans
  • Milk glass
  • Pewter
  • Rubber tools
  • Tin

Remember, dishwashers can catch on fire. Wisconsin residents, contact a R&R knowledgebroker to ensure all aspects of your home are properly covered.

Topics: Personal Insurance, Real Life Examples

Real Life: Client Would Have Had a Brand New Car, But ...

Posted by Dan Wolfgram

Car_AccidentOne of our clients was driving home from work when another driver hit her 2009 Acura TSX 4-door sedan. Our insured and her older daughter were injured. Her newborn baby daughter was unharmed (thank goodness for the child safety seat). After a visit to the hospital, I am happy to report that the family will be fine. I wish I could say more for her car - her 2009 Acura was totaled. You can see from the picture that the front end sustained enough damage that it could not be repaired. The accident was so severe that several of the airbags went off.

So, when does $60 = $13,000? Recently, some insurance companies started offering 'Car Damage Replacement Coverage' on new cars. The cost for the endorsement is around $20-$35 a year. Our insured owned this car for 3 years and her cost to have this on her policy would have been $60 over 3 years. Our insured declined this coverage when she bought the car. She probably thought, "I’m a good driver”. Problem is, we don’t know about the drivers around us.

When the dust settled, our client will receive what the value of her car was worth (fancy insurance term is 'Actual Cash Value') right before the accident. This is how typical claims are settled. Had she added the Car Damage Replacement Cost endorsement, she would be driving in a brand new Acura TSX. The difference between the value of her car and a new Acura is around $13,000. This is when $60 = $13,000! Not all insurance companies offer this endorsement so please check with us when you add a new car to your policy.

Wisconsin residents, now is a great time to contact us about any questions you might have on your auto, home, or life insurance!

 

Topics: Personal Insurance, Real Life Examples

Elkhorn Home Went Up In Flames - But All Is Good

Posted by Dan Wolfgram

Frank Staab and Faith Harrington-Staab, residents of Elkhorn, WI and an R&R customer since 2006, talk about the trauma involved with watching your home go up in flames. The concerns for their family, their belongings and what to do next were top of mind for R&R Insurance and their insuring carrier. Watch their quick story...

Wisconsin residents can have the same peace-of-mind that the Staab's experienced. Contact knowledgebroker Dan Wolfgram for more information about personal insurance options through R&R Insurance Services.

Topics: Personal Insurance, Dan Wolfgram, Testimonials, Real Life Examples, faith harrington stabb, home up in flames, frank stabb

Whitefish Bay Resident Has Painless Experiences After Teenage Driving Accidents

Posted by Resource Center

Jay Mueller, Whitefish Bay, Wisconsin resident and long-time personal lines customer of R&R Insurance Services, explains that even with 5 kids behind the wheel and a few minor accidents along the way, dealing with his insurance agent has been "painless".

Have a teenage driver? Here are some short articles we've put together that can help keep your children safer:

Teen Drivers
Travelers' Tips For Teen Drivers
West Bend Mutual Insurance's Beginning Teenage Drivers

Wisconsin residents, for more information about insuring your family with R&R Insurance Services, contact knowledgebroker Dan Wolfgram.

Topics: Personal Insurance, Testimonials, Real Life Examples