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    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

    Licata Risk Licata Risk & Insurance Advisors, Inc.
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    Fort Lauderdale, FL 33301
    LicataRisk Advisors is an independent risk management and insurance consulting firm. We are not brokers and we do not sell insurance. We are not connected to any insurance company or product in any way and do not receive commissions. This is an important difference as you will have an expert on your side who is only committed to you.

    Licata Risk is not a law firm and does not practice law. General advice and contract input by the consultants, including those who are attorneys, is to provide insight into the risk and insurance aspects. Your attorney should be the final authority on any legal matter.