Tree Fell on Car is This Comprehensive

    Posted by MAIA on Aug 12, 2019 12:01:00 AM

    QUESTION

    This question was answered based upon current rules, regulations & statutes in effect on July 25, 2019

    I have an insured who had a tree fall on their car with the recent tornado on Cape Cod. The existing auto policy does include comprehensive coverage. I filed the claim with the auto carrier and included a copy of the invoice from the tree removal company to take the tree off the car. The adjuster emailed me to say the removal of the tree is not covered and that would need to go through the Homeowner policy. (Unfortunately there is no active Homeowner policy in place.) Doesn't comprehensive cover falling objects (in this case, a tree)? And why wouldn't the removal be covered as well? I appreciate your information. Thank you

    ANSWER

    Irene Morrill:  Well,

    First …that adjuster knows NOTHING about the HO policy as a tree felled by windstorm is ONLY removed if it Damages a covered STRUCTURE  (only reason with HO-91) – and a car is NOT a structure

    Or

    Blocks a driveway or handicapped ramp (ISO HO-2000/2011)

    If the auto is NOT damaged and is just “covered by the tree” … I agree …not an auto claim – and hopefully they had the ISO HO-2000 or 2011

    If the tree damaged the auto …TELL ME …HOW THE HECK does the car get fixed with the tree on top of it?

    I can only speak to an auto carrier who uses the AIB …2008 MAP or the 2016 MAP …if they write their own – send it to me.

    Both the 2008 and 2016 state:

    First,
    Help Any
    Injured Person.

    Call an ambulance or the police and, of course, cooperate with
    them.  Do whatever is reasonable to protect the auto from further damage 
    or loss.  Where there is coverage provided by this policy we will pay for
    any reasonable expenses incurred in doing this.

    DO WHATEVER IS REASONABLE TO PROTECT THE AUTO FROM FURTHER DAMAGE OR LOSS … .duh …get the tree off of it …especially if windows are cracked …

    Where there is coverage in the policy means …collision …comprehensive …this is a comprehensive loss

    The 2016 MAP added a sentence (that ALL REASONABLY PRUDENT AND KNOWLEDGABLE adjusters followed anyways)

    Part 9.
    Comprehensive

    Under this Part, we will pay for direct and accidental damage to or loss of your auto other than damage caused by collision.  We will also pay for such damage or loss to other private passenger autos while being used by you or a household member with the consent of the owner.

    We will pay the cost to repair the auto or any of its parts up to the actual cash value of the auto or any of its parts at the time of loss.  We will not pay for any decrease in value claimed to result from the loss.  The most we will pay will be either the actual cash value of the auto or the cost to repair the auto, whichever is less.  The cost to repair the auto is limited to the prevailing competitive price, which is the price we can secure from a licensed repair facility conveniently located to you.  Unless you have purchased agreed amount coverage, actual cash value of the auto will be determined at the time of the loss.  Actual cash value may include an adjustment for depreciation and betterment and for the physical condition of the auto.  We will, at our option, repair the auto, repair or replace any of its parts, or declare the auto a total loss.  If the repair of a damaged part will impair the operational safety of the auto we will replace the part.  We will reimburse your for substitute transportation expenses if your auto is stolen.

    We will also pay reasonable and necessary expenses for towing, recovery and storage of your auto.

    Reasonable recovery expenses have ALWAYS been part of the ACV payment … at least years ago when I was an agent handling claims and claims adjusters knew what they were doing.

    Remind them of these two portions of the policy (if 2016 MAP) or just 1 if 2008 MAP

    Perhaps you should talk to the claims manager and bypass this claims adjuster

    If they don’t pay … I’d suggest the client file a consumer complaint with the MA DOI which will go over REAL WELL after the Governor declared a disaster …

    I’d also suggest that the client video himself explaining his “tale of woe” and post it on YouTube.  I suggest he contact the local news – paper, radio and TV as this will make GREAT PRESS for the company.  I’d also post it on Facebook and let my post and video go viral.

    I am ashamed to be in insurance.

     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: Claims, 2019

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