Claims

Claims Reporting: Better Late than Never?

A common in the claim process is the late reporting of claims.
There are many reasons for missing a reporting deadline; however, in most cases, they will not matter. We have seen the courts stand behind the strict reporting requirements of the insurance policy. The policy is a binding contract between the two parties, and the provisions are usually very clear. We have yet to see a “sympathy clause” in an insurance policy.

Claim Reporting Requirements

An insurance policy is not tested until there is a claim made against it. Most policies are straightforward regarding the acts or events that are covered. Insurance policies also spell out the proper way to submit a claim to the insurer. Within the reporting requirements, you’ll often see time requirements, as well as a list of the information that must be included, that establish sufficient notice of claim or loss.Read More »Claims Reporting: Better Late than Never?

Addicts Can Sue Pharmacies and Doctors

According to the recent ruling of West Virginia Supreme Court pharmacies and doctors who negligently prescribed pain medication can be sued for enabling people’s addictions. According to court documents, FBI raided and shut down the Mountain Medical Center in Williamson in 2010 and found evidence of improperly prescribed controlled substances involving 29 people who became addicted while were Center’s patients… Read More »Addicts Can Sue Pharmacies and Doctors

Insurance During the Course of Construction

Construction FireThis morning, downtown Los Angeles is on a massive fire.

The apartment tower that was under construction is burnt down to ashes. Other buildings surrounding it are heavily damaged.
When the fire department is finished, who is going to pay for damages?

First, the damage to the building under construction worth at least the cost of all the materials that are now gone. These are tens of thousands of dollars that the building owner has lost, UNLESS he had Builders Risk Policy in place. Builders risk policy, which is sometimes called Course of Construction policy will pay for the cost of materials lost due to the fire.

Second, what about the neighbor buildings that are damaged too? What if there are people injured (hopefully not)? This is the liability of the apartment building owner which could be tens of thousands of dollar too, UNLESS he had Owners and Contractor’s Protective liability Policy. This is a liability policy which pays for property damage (buildings burnt, roads and street lights damaged) and bodily injury (people injured or dead) that results because of owner-builder’s liability during the construction.Read More »Insurance During the Course of Construction

Top 5 Ways for Homeowners to Prepare for Winter

Top 5 recommendations to homeowners to prepare for winterRoof is the largest single surface and the first line of defense in protecting your home. Insurance carriers tend to see a lot of damage to roofs in those instances where they also have structural claims. Obviously certain portions of the country get very different climate and different winter weather. The northern states will have heavier snow and ice, where the south may get more rain.

Here are top 5 recommendations to homeowners to prepare for winter:

    • Do a visual inspection of your roof to look for maintenance issues or things that could make it more susceptible to hail or wind or other damage — like missing or damaged shingles or tiles on sloped roofs. Or if it’s a flat roof, look for surface bubbles in the membrane material or missing gravel.
    • Look at flashing along the roof to make sure it’s in place and in good condition. The flashing is where you transition between vertical places and the horizontal roof — things like around skylights, vents or chimneys. Anywhere where you have a change in roof elevation, you’ve got flashing there and that’s a typical source or place for water to penetrate into the roof covering.

Read More »Top 5 Ways for Homeowners to Prepare for Winter

Someone has to be responsible…

Butterfly EffectOften times our prospective clients tell: – “I wouldn’t worry about this…” or “I wouldn’t worry about that particular issue with my coverage… How likely people are going to sue me for something I should not be responsible for?”

Well, our answer is something most people are not going to like:

– In United States of America everyone with a slightest chance your operations/negligence/products have something to do with the accident or claim that occurred is to be found responsible.

For example,

Read More »Someone has to be responsible…

Report: New Emerging Risks

Report New Emerging RisksSwiss Re has released a report – ”New emerging risk insights,” which is based on the reinsurer’s SONAR process, described as a “unique tool which uses Swiss Re’s internal risk management expertise to observe and evaluate new and emerging risks.”

Some of the other emerging risks examined in the SONAR report includes the following:

  • Cloud computing security
  • Contagious emerging market crisis
  • Eurozone crisis leading to deflation
  • Short-termism of macro-policy measures
  • Air pollution as mortality driver
  • Concussion crisis in sports
  • Democratisation of genetic testing
  • Digital slander
  • E-cigarettes
  • Financial consumer protection regulation
  • From closed to open business models
  • Food and water safety: trade-offs with growthRead More »Report: New Emerging Risks

Insurance for Snowplow Damage

Our West Coast readers can skip this post. All other homeowners in the U.S. are aware that with a snow comes snowplow damage.
Mailboxes often are the first objects damaged because of snowplows, and the city ordinance may note that city shouldn’t be responsible for digging them out if they are covered with snow. Many properties sustain damage after a municipal snowplow driver tear apart the entire length of road at the front of residence, damage parked vehicles, lawns. Residents whose property lie beside public roads are reminded not to place any type of private property, including landscaping shrubbery, fences, light posts or mailboxes, in the right of way.
Here is a short video of snowplow literally cleans Brooklyn’s street.

Read More »Insurance for Snowplow Damage

Top 10 States for Hail Claims

According to State Farm: Texas—47,000 claims Illinois—41,000 claims New York—34,000 claims Ohio—31,000 claims Missouri—25,000 claims Tennessee—24,000 claims Indiana—23,000 claims New Jersey—23,000 claims Kentucky—22,000 claims Colorado—16,000 claims While hail storms most frequently impact the Great Plains and Midwest, every state in the nation is susceptible, according to the insurer. * According to State Farm damage caused by wind and hail cost insurance… Read More »Top 10 States for Hail Claims

Commercial Kitchen Fire Safety

commercial grade kitchen equipmentOperation of a commercial grade kitchen, many safety considerations should be addressed, including food safety, employee and volunteer safety, and fire safety. This blog post addresses the specific issues associated with providing adequate fire safety for your kitchen.

Commercial cooking operations are defined as kitchens that have cooking equipment that produce grease and grease laden vapors. This includes flat grills, char broilers and deep fat fryers. The typical residential range (electric or gas) would not be considered a grease producing appliance. Other equipment, such as ovens, microwaves and steam kettles also fall into the non-grease producing appliance category. The following is information regarding two of the most common types of equipment that produce grease and/or grease laden vapors.

Deep Fat Fryers

Deep fat fryers are a major cause of kitchen fires. Oil can splash and easily come into contact with an open flame from an adjacent piece of cooking equipment, such as a gas-fired range top. A 18-inch clearance must be maintained between the deep fat fryer and the open flame cooking equipment. If a 18-inch clearance is not possible, a vertical steel barrier extending 12 inches above the top of the deep fat fryer or open flame appliance(s) can be used as an alternative means of protection.Read More »Commercial Kitchen Fire Safety

Questionable Insurance Claims on the Rise in TX

Questionable insurance claims rose by 38 percent in TX from 2010 through 2012, the National Insurance Crime Bureau (NICB) reports.

Questionable claims (hereby referred as QC) are those claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud. A single claim may contain up to seven referral reasons.

This report analyzes QCs by loss city, core-based statistical area (CBSA), policy type, loss type, policy and loss type combined and referral reasons.

In 2010, there were 7,520 Texas QCs referred to NICB from its member insurance companies. In 2011, the number increased to 8,016 and rose again in 2012 to 10,368 — a 38 percent increase over 2010′s figure.

The top 5 loss types were:

Read More »Questionable Insurance Claims on the Rise in TX