Pre-Existing Damage

    Posted by MAIA on May 15, 2020 12:00:00 AM

    This question was answered based upon current rules, regulations & statutes in effect on May 12, 2020
     
    QUESTION

    First and foremost, hope you are all safe... if not sane!

    Irene, as I texted you this morning, thanks for calling me back and leaving a voicemail yesterday, so sorry I missed you.  Given you are in a seminar today, I figured I would send both of you this email and if either of you could respond, I would appreciate it.  Or if you feel there is someone else at MAIA who might have some input/advice, you can forward it along to them as well.

    I have attached the following:

    • MEMO I wrote up with insured's help of the situation
    • 27 page Adjuster report of the claim damage and their observations/estimate (I reference certain sections of this report in my MEMO so hopefully no need for you dive into the entire 27 pages)
    • Experian AUTO CHECK report given to insured upon purchase of vehicle from dealer in late Nov / early Dec 2019
    • CARFAX report given to insured last couple of days by body shop 

    What advice am I seeking?:

    • I am just an agent trying to decipher all this as the middle man, trying to keep insured happy and informed, trying to not have him mad at us (isn't that always the case), trying to justify to insured why he uses us as an agent without biting off more than I can chew here
    • I am assuming, for now, the following (I may or may not be correct in assuming all this):  insured telling truth about incident, adjuster using his experience to rightfully detect prior damage, Mapfre correctly/legally/properly? not paying for prior damage, etc
    • It seems insured is a victim of circumstance here, bought a vehicle with prior damage that was not fully disclosed for whatever reason, and now this single vehicle incident on the highway has revealed that he bought a damaged vehicle and might be left "holding the bag"... again, assuming all the above.

    So, 

    1. Does insured have any gripe or beef with Carrier not paying for the serious bulk of the damage that appears to be pre-existing?  (Although the 27 page appraisal appears to indicate there is only about $2976 of total damage, insured and body shop think an entire new frame might possibly be needed!!!!)
    2. Does insured have a any gripe or beef or recourse with dealer who sold him the car using the Experian Auto Check report that showed the vehicle as clean with no accident or damage history?
    3. Does insured have a gripe or beef with Experian Auto Check service itself?

    If any of the above apply, who do we as an insurance agent proceed?

    Do you have any other thoughts?

    Thanks to you all,

    ANSWER

    Irene Morrill:  Was there an attachment that I didn’t receive? – I see that you sent the email to me and kathy …but I only received her response to you

    I don’t know what an “experian auto check” is …but doesn’t sound worth it. If they were supposed to have done a “thorough” check and didn’t … I think they could be responsible …but I don’t know. 

    Though if whatever damage that vehicle had previously suffered was NEVER reported to an insurance company …then I don’t doubt that CARFAX didn’t know.  Kind of the “don’t ask don’t tell syndrome”

    Claims adjusting IS a forensic science … I read the IFB.org newsletters.   It’s like CSI and NCIS …they can tell whether one is the “hittor” or “hittee” … They can tell the relative age of a loss

    If the damage happened before the insured owned it … current company is NOT responsible.  But …if the carrier discussion of why they won’t pay is thorough enough, perhaps that can be used against this Experian thing.    The prior owner knew they did something … but this could be an “I need a lawyer” thing.  

    This document is not a legal opinion and should not be relied upon as such. The intent of this document is to provide a general background regarding the topic or topics discussed, not to provide legal advice. Producers and agencies should consult an attorney regarding specific situations and specific questions with respect to the topic or topics covered in this document. Neither the Massachusetts Association of Insurance Agents, Number One Insurance Agency nor any of its employees shall be responsible for any errors or omissions regarding any statements made in this document, nor any errors or omissions regarding any statutes, regulations, court rules, and/or any other government documents cited in this document.

    Topics: Registry, 2020

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