Insurance headaches

[Earl Weiss]

At some later date I may write an article for an industry Mag. with more detail as a warning for operators Suffice it to say your insurance may not do what you think they will do. Summary:

Ceiling collapse (32 feet of concrete / precast) 3/27/16. (Sunday) Ins Notified 3/28/16

Takes insurance 2 months to decide they will cover me in the interim hammering me that I need to take measures to prevent further damage to structure.

Find out "Equipment" under this policy is considered part of the building coverage. (Fortunately building limit is high enough to cover but why have I been paying for $250,000 of personal property coverage which I thought was for equipment.)

By October 15 submit all figures for loss of Income claim thru September based on 3 year averages month by month less related expense savings for being out of business. Takes them 6 weeks to get me a check and they chop my Average by 20% saying there was a downward trend from 2014 - 2015 and the trend would have continued. After arguing that 2015 was higher than 2013 so the trend is baloney and only related to weather variations and a planned week shut down for conveyor replacement they finally reconsider and send me a check for the shortfall in Feb. 2017. (I was hoping to have Oct. - Dec. 2016 lost income paid by then.)

Since Jan. 15, 2017 they had all data for the lost income claim thru December 2016. They had it sooner but insisted on a P&L thru December 2016 even though wash income was $0.00. End of Feb. 2017 they tell me job should have been done by 9/30/16 so they are cutting off my lost income claim as of that date. Reason is their consulting contractor said job (Construction could be done in 10 weeks (Plus 2 months for equipment install) except for 3 large open items on report that could not be evaluated until demo was done.)

Insurance company totally ignores open item issue, and while actual construction might possibly take that long there was lots of work to be done before it could begin including engineering, permitting and hiring contractors for demo and then getting Architectural, Engineering, and permitting for Construction as well as obtaining materials and contractors to do the work, as well as delays for City inspections.

I hope to be open in 4 weeks or so, which means the lost income will have expired on the one year anniversary.

Old saying. "Men plan and the fates laugh".

 

[loewem]

Earl, can you share the name of the insurance company? I need to shop for a new policy and would appreciate the info.

 

[Ghetto Wash]

I've had one significant insurance claim. My wash was damaged in a tornado. Took 4 months to repair and reopen. The insurance company paid like clock work (even the business interruption portion). I was very satisfied with my insurance at the time.

My broker was and still is Midlothian Insurance. The underwriting insurance company has since changed and I don't know if I would have the same positive experience today that I had back then.

 

[Earl Weiss]

Earl, can you share the name of the insurance company? I need to shop for a new policy and would appreciate the info.

I will PM you. I will disclose at a later date. At this time I will allow them an opportunity to re think their actions and preserve any reputation.

 

[mjwalsh]

Earl & others,

I suggested to my agent to not include the "lost income ... business interruption" I was told that the main reason for that specific coverage is to make sure the business can maintain their employees' income during reconstruction.

 

[Earl Weiss]

Earl & others,

I suggested to my agent to not include the "lost income ... business interruption" I was told that the main reason for that specific coverage is to make sure the business can maintain their employees' income during reconstruction.

To each their own. With my rent / mtge service / taxes , insurance etc. running over $15,000 / mo It is something that became really important. I would never predict that my tunnel would be out of business for over a year for any reason.

 

[washme1]

I recently filed a claim with IMT and was pleased with the way it was handled. The claim involved property damage and loss of income for 25 days during a busy period this Dec/Jan. The previous Dec was unusually slow so was not a good comparable. I submitted a lot of documentation. The adjuster finally had an accountant contact me on their behalf. The accountant previously had a car wash client and understood the swings due to weather. He dialed my estimate back just slightly and we settled.

 

[Earl Weiss]

My insurance company handed it over to an accountant as well. They got 3 years of P&Ls, as well as tax returns, and i think Sales tax returns as well. Thank heavens everything is on quickbooks, so that only took a few clicks, Tax returns were in electronic format, and the State has the sales tax returns on line as well.

 

[MEP001]

To each their own. With my rent / mtge service / taxes , insurance etc. running over $15,000 / mo It is something that became really important. I would never predict that my tunnel would be out of business for over a year for any reason.

It's probably like carrying comprehensive/collision insurance on an older car. I keep it on my 17 year old truck because it's only an extra $6 a month with a $1000 deductible and I might get $1500 from a total loss, but with no deductible it's close to $100 a month so not worth carrying. It varies immensely by situation.

 

[Earl Weiss]

It's probably like carrying comprehensive/collision insurance on an older car. I keep it on my 17 year old truck because it's only an extra $6 a month with a $1000 deductible and I might get $1500 from a total loss, but with no deductible it's close to $100 a month so not worth carrying. It varies immensely by situation.

Often you can do the same with lost income by choosing a 30-60-90 day exclusion period. If you are out of business for less than the exclusion period they don't pay or if it's longer they don't pay for that period which reduces the premiums since apparently many out of business conditions can be corrected during the ecclusion period. You would still be covered for major problems that lasted longer.

 

[Earl Weiss]

Well, March 27 marked the one year anniversary of the roof Collapse Hope to be open in a couple of weeks.

 

[Earl Weiss]

After being closed 13 months for the roof collapse passed last City inspection Friday. Got open and discovered blown Data trax panel. Had a spare one but it had to be wired in. Then discoverd functions not set up properly, Do a work around, Get open at 1:30 pm After an hour pop a starter for first Power pack. Get it to re set. Blows again. Electrician picks one up Saturday at 7:00 am ad arrives at 8;00 am. Mechanic adjusts speed control torque do reduce amps on unit and controls freeze closed. Have to remove, disassemble and re install 3. Meanwhile electrician straightens out functions, and get open at 12:30 pm - It started raining at Noon. - Gotta luv the car wash business.

 

[JMMUSTANG]

Earl gotta give you credit.
You said all this without one cuss word, lol

 

[mac]

It's easy to get screwed by insurance companies. I bought a used Coleman automatic and had R & L Carriers haul it across the state. When they showed up at my shop, the idiot driver unstrapped the machine, moved the truck, and dumped it off the flat bed. Totaled it. They denied all claims. Called and sent notes to every agency except the CIA.

 

[Earl Weiss]

After having my claim package for 3 months the insurance company sends me a letter saying they are not paying any more on my claim because I did not restore the property but upgraded it and that i s why it cost more and took so long plus many more false contentions. Not surprising they are acting on Bad info because no one has come to see the finished project. So, right now they have paid about $200K out of my $850K Loss.
I will not out them yet on public forums until my counsel green lights that.

 

[Robert2181]

After having my claim package for 3 months the insurance company sends me a letter saying they are not paying any more on my claim because I did not restore the property but upgraded it and that i s why it cost more and took so long plus many more false contentions. Not surprising they are acting on Bad info because no one has come to see the finished project. So, right now they have paid about $200K out of my $850K Loss.
I will not out them yet on public forums until my counsel green lights that.

Earl. I have been following your updates on your claim. Were they following the repairs and approving the cost as it was being down?

 

[Earl Weiss]

They did not follow anything.
Communicating with them was a never ending lack of response. For weeks after the adjuster first came I called for a status report only to be told they were trying to get approval to hire an engineer. After the engineer came i called for weeks again and finally sat down and Googled contact for all the company top executives and e-mailed them all which finally resulted in a coverage letter. The first demo quote I got was way to high. They weighed in on this. Worked on a second and then a third. They had my lost income for weeks and after calling for weeks was told some accountant had it. Took about two months to get the first check. Since I had one year lost income coverage i need to move along without any more delays by them looking at or approving stuff.
At one point during a call they said "Nothing is happening" I asked how they would know that particularly since they were wrong. Engineering was done for shoring and bracing, architectural was done, demo was done, permits obtained, excavation was done, demo was done, footings dug, soil testing done, concrete poured.
That is just a sample of how messed up they were. Although an adjuster was there a few times pre demo, I don't know that one ever returned. Never heard of one coming and they never mentioned that one did.

 

[pgrzes]

It is amazing how insurance companies can do this to people and business's. I had a truck go through my High Velocity and rip everything apart, all on video took over 6 months and several Attorney letters to get paid. Oh and loss of business, hahahaha I got little to nothing. A never ending battle for every penny. Fortunately I was able to pay out of pocket to get back up and running. Otherwise I would be shut down. Flip the coin, if your house has a fire and you say your TV was a 55" rather than a 47" they will throw you in jail for fraud!!!! Its ok for them to commit fraud on a daily basis on the consumer!! They will knowingly lowball EVERY claim trying to get you to settle for less and drag it out forever. Why not find a huge lawfirm to take on the insurance companies and file a classaction lawsuit against them all!!!

 

[Earl Weiss]

It is amazing how insurance companies can do this to people and business's. I had a truck go through my High Velocity and rip everything apart,

It is bad when the other guys insurance treats you like this, but far worse when it's your own insurance and you are still paying them premiums when you are out of business. Suffice it to say I no longer have this company for the 3 places they covered.

 

[GoBuckeyes]

It is bad when the other guys insurance treats you like this, but far worse when it's your own insurance and you are still paying them premiums when you are out of business. Suffice it to say I no longer have this company for the 3 places they covered.

Earl, so sad following this thread. Hopefully they will get whats coming to them. Can you tell us who it is we should be weary of?