Insurance Policy Terms a Mystery … to the Insurance Company Who Wrote Them !!!

In a recent claim, the adjuster sent an e-mail saying “I wanted to make you aware that there are issues of coverage and some of the costs incurred to date may not be covered under the policy. We should discuss.”

The adjuster explained patiently:

“Your policy does not have ‘sue and labor’ coverage.  This is the coverage which would pay for the cost to protect the property from imminent damage; and that’s what you did. The engineer told you to shovel the roof because it was about to collapse, you did so.  If you had that coverage, it would be part of the claim, but since this coverage isn’t in the policy, there are no funds available for that expense.”

We knew the appropriate coverage was on the policy, it’s one we negotiate for.  So we explained to the adjuster “you’re right, there is no coverage called ‘sue and labor’ in the policy.  But, there is ‘Preservation of Property’, it’s coverage N on page 27 of the policy, if you look, you will see it discusses expenses to protect the property from imminent damage.”

After helping him find the right page in the policy, it was almost like this moment from Saturday Night Live:

You have to know what’s in your policies, because your insurer won’t know.  Whether it is honest mistake, as in this case, or an attempt to avoid their duties to you, you need to know your facts. Or, you need us on your side.

May 19, 2015