The grey area when your boat gets stolen !!!

[bliss]

Re: The grey area when your boat gets stolen !!!

One way insurance companies control costs is to do a limited amount of underwriting and investigation at the point of application. That gets new policyholders and premium on the books quickly. If, over time, there are no claims on the vast majority of policies that is money and time wll saved. The problem that is created is called "post claim underwriting". The job that could have been done at the time of application is done after a claim is submitted. This takes time-your time! Depending on the size and nature of the claim the insurance company will determine how far they will go. First they will want to verify all statements and representations made by the applicant(s). In your case they are going to be interested in two separate applicants. If they choose they look at anything that might make you look like a moral hazard. Past history of all kinds-criminal, civil, etc., etc. How is your relationship with your marina(s)? and repair yards? By now Progressive knows more about that then you do. As to state insurance commissioners; in many states they are political pawns beholding to business interests like insurance companies and brokers.
I think you could be in for a long ride. In my experience (I am a retired commercial insurance broker)once you engaged an attorney the authority moved away from the claim adjuster and toward the legal department. These guys are in no hurry. . They can afford to settle your little claim on the court house steps-FOUR YEARS LATER. There is a huge advantage to Progressive moving slooooowly. They can set up a reserve of say $130,000 to cover the ultimate claim dollars AND expenses to handle the claim. The earnings on those reserves until the claim is settled are tax sheltered. So from their viewpoint-what's the hurry? Of course the sales departments need to have an acceptable reputation in the market place. It is an exquisite balance between product, price and service. This is not directed at you--buy cheap, get cheap.
Good luck, I hope it works out fairly and quickly.

 

[bliss]

Re: The grey area when your boat gets stolen !!!

Earlier you mentioned a fiancee and then referred to a wife. Are there two women ? Are you having fun or is the fun part over and you are recently married?
Seriously, take a very hard look at the representations that both of you made on the application and any follow-up statements. I guarantee you they are going to investigate your representations before your meeting. Any statement that is less than dead accurate will be used against you. If there are any inaccuracies it will be your job to prove them irrelevant to contract issuance. If you cannot meet that standard you can expect Progressive to argue that if they had known "the truth" they would never have issued the contract that your statements are now a part of. If they go in that direction brace yourself! They will next say that because the application had material misrepresentations there never was a meeting of minds which means there never was a contract. They will then hand you a check in the amount of all premiums paid and say, "Good Bye." That will be just a small bit of bad news compared with the position the bank will take. Since you did not get the required insurance and the collateral , for all intents and purposes, no longer exists; they will demand the loan principal right now. So when I say be prepared to defend all of the application statements and their relevancy or lack thereof I'm not kidding.
Again, good luck!

 

[H8tank]

Re: The grey area when your boat gets stolen !!!

So let me get this right... you have a $99K boat stolen from your driveway while you are home.

The insurance company says ok, to proceed with writing a check for one hundred grand, we just want to check your financials for any red flags.

You say no, you can't see them.

They say ok, RED FLAG.

You get all lawyer'd up and start sending threatening 'faxes', do I understand you correctly, you sent them a FAX?

If I were them, I'd tell you to **** up a rope too.

I believe you are telling the truth, but they deal with people every day trying to defraud them. To you, this is a once in a lifetime event, to them, you are another number and procedures come into play.

I wish you well, but you should have done what they asked if you have nothing to hide. The same exact thing the Insurance commissioner and your first lawyer told you.

 

[bliss]

Re: The grey area when your boat gets stolen !!!

H8t- you have a PM.

 

[jay_merrill]

Re: The grey area when your boat gets stolen !!!

The problem is that they didn't say, "just give us a few things and if they check out, we'll pay." Progressive refused to provide information from the beginning. The OP still doesn't even know whether or not they are calling the boat a total loss.

 

[Tim Frank]

Re: The grey area when your boat gets stolen !!!

So let me get this right... you have a $99K boat stolen from your driveway while you are home.

The insurance company says ok, to proceed with writing a check for one hundred grand, we just want to check your financials for any red flags.

You say no, you can't see them.

They say ok, RED FLAG.

You get all lawyer'd up and start sending threatening 'faxes', do I understand you correctly, you sent them a FAX?

If I were them, I'd tell you to **** up a rope too.

I believe you are telling the truth, but they deal with people every day trying to defraud them. To you, this is a once in a lifetime event, to them, you are another number and procedures come into play.

I wish you well, but you should have done what they asked if you have nothing to hide. The same exact thing the Insurance commissioner and your first lawyer told you.

You have to follow the thread from "square one".
There has been a solid stream of armchair experts telling this poor guy that the insurance company " can't be trusted...they are going to screw you....don't give them anything...you don't have to....play hardball....they'd never try that with me!!....etc.".
The results are absolutely predictable.
None of these "Pros from Dover" will be out one penny now that this has blown up due to their ill-conceived (though doubtless well-intentioned) advice.

Judge: " So if I understand, you were advised to provide these records to the insurance company by both a lawyer and your state insurance board but opted to do otherwise?"

Plaintiff: " Well Your Honour, several of my friends on i-boats said I didn't have to."

Judge: "Are they insurance professionals?"

Plaintiff: "No Your Honour, but I think one of them stayed at a Holiday Inn Express last night".

The wisdom of trying to sort out a $100K insurance claim in a public forum where many of the participants in the discussion are anonymous, is questionable at best.

These forums are incredibly well organised, have great participants, the overall character, class, and good will of the members is clear....but I truly believe that this particular thread has gotten out of hand and has been potentially very prejudicial to the situation of the victim in all of this....of course, in a very out of the ordinary case.

 

[Nandy]

Re: The grey area when your boat gets stolen !!!

Judge: " So if I understand, you were advised to provide these records to the insurance company by both a lawyer and your state insurance board but opted to do otherwise?"

Plaintiff: " Well Your Honour, several of my friends on i-boats said I didn't have to."

Judge: "Are they insurance professionals?"

Plaintiff: "No Your Honour, but I think one of them stayed at a Holiday Inn Express last night".

Tim, you are killing me here... that was funny!

There has been a solid stream of armchair experts telling this poor guy that the insurance company " can't be trusted...they are going to screw you....don't give them anything...you don't have to....play hardball....they'd never try that with me!!....etc.".
The results are absolutely predictable.
None of these "Pros from Dover" will be out one penny now that this has blown up due to their ill-conceived (though doubtless well-intentioned) advice.

These forums are incredibly well organised, have great participants, the overall character, class, and good will of the members is clear....but I truly believe that this particular thread has gotten out of hand and has been potentially very prejudicial to the situation of the victim in all of this....of course, in a very out of the ordinary case.

Thank you, thank you, thank you... Just what I tried to tell the op before, now just plain English.... Well put!

 

[fishrdan]

Re: The grey area when your boat gets stolen !!!

(EDITED...)

He found a lawyer he is comfortable with and is proceeding as he thinks best. I'm sure his lawyer knows Florida law better than any of us, what is acceptable, what is not and how to represent his client's best interests.

 

[kaferhaus]

Re: The grey area when your boat gets stolen !!!

Here's the skinny on how this works.

The insured has a right to refuse to release any information he wants.

The insurance company then has the right to refuse payment.

The insured's only option at that point is to sue. Once he files suit the insurance company will get ALL his records via court order. All they need to do is tell the judge they need this information to defend themselves in court...

I've never seen a judge refuse such a request, never.

If you apply for any form of insurance, you ALWAYS sign a waiver which allows the insurance company to investige your character and finances. It's why they require your date of birth and SS number.

The insurance company can run a credit check and or a background check (including criminal history) any time they want to. They can do so merely to "update our records". And often run credit checks before your policy is due for renewal.

They don't do this to "screw anybody" they do this to protect themselves and their other policy holders.

And to all these experts who claim that the insurance company "has to pay" if you file a claim have no idea what they're talking about. Remember hurricane Katrina??? thousands of lawsuits filed against insurance companies. The companies were granted summary judgement in their favor in over 95% of those cases. Of the 5% that ever went to trial they only lost .3% of those cases. All of those cases save 3 were overturned on appeal. So thousands of lawsuits and they ended up losing 3... the three they lost cost them under $700,000 combined...

EVERY insurance policy requires that to successfully file a claim you must cooperate with any investigation. A few have chimed in saying that the cooperation must be "reasonable". Is it not reasonable to request your financial documents if a claim is considered "suspect" for any reason?

Getting dodgey with the adjuster is a real quick way to open your claim to scrutiny. On large claims involving theft or fire it is common practice to perform a cursory investigation of the claimant. Often neighbors are talked to, your credit is checked and a background check is performed. If information comes to light that places your claim in a enhanced "risk" catagory then the investigation goes a bit further.

What usually happens is something you told the adjuster doesn't jive with the circumstances or what other parties may have told the adjuster. Or may not jive with what the adjuster already knows by reviewing your history.. If you have "issues" with your finances and then you've misled the adjuster your claim automatically goes into the "enhanced risk" catagory.

I'll give you an example. You're behind on you car payments, you're way upside down in your car. You file a claim saying your car has been stolen. During your interview with the adjuster you're asked about your finances and you tell the adjuster that you pay all your bills on time... not good.

You state in your report that the car was stolen on Friday. your neighbors say they haven't seen that car for at least a week before you reported it stolen... not good.

Upon checking your criminal history they find that you've had some trouble with the law in the past few years... not good.

Unless the insurance company can prove the claim is false they will pay it. However so long as they have cause to continue an investiagtion they can and do refuse to pay until they're satisfied that they cannot prove fraud on your part.

So the original poster isn't telling everything. That's his right but I can guarantee you there is a reason his claim is being further investigated.

His attorney is an idiot if what he told us is true. The company will get that information one way or the other. I also guarantee you his attorney will NOT take this case on contingency if it excludes the amount claimed... if the OP lets an attorney take this under those circumstances then he's going be out roughly half of the money he had coming to him anyway.

If the claim is legit then all he has to do is comply with their requests for information. Once they see they cannot prove fraud they will pay promptly.

 

[jay_merrill]

Re: The grey area when your boat gets stolen !!!

Sorry, but I don't buy the Katrina comparison. The lawsuits that were filed in regard to Katrina were pretty much all in regard to property damage caused by wind v. storm surge. The reason why that was a big deal is because homeowners policies exclude water damage from flooding. The position of the insurance companies was that flood damage was covered only under other insurance, namely the national flood insurance program. There just isn't a close connection between that circumstance and an insurance company claiming that an insured commited a theft and "strip down" of his own boat.

Its also worth mentioning that State Farm Insurance settled with 600 home owners in Mississippi to the tune of 80 million dollars. While there was a later court decision that struck down another settlement by State Farm that would have had them paying an additional 50 million to 500 million, I have found nothing to suggest that the original amount was disallowed. Add to this that Louisiana Citizens Insurance settled for 35 million and the Port of New Orleans settled with FM Global for 100 million dollars.

I'm sure that there are many more examples, but I think the point is made. If anyone thinks that insurance companies walked away from disagreements concerning Katrina claims after paying a pittance, they are very much mistaken.

I too have a friend who deals with these sorts of issues. He is an attorney who pretty much does nothing but sue insurance companies. He is a millionaire many times over, and would probably get a big kick out of people thinking that an insurer can just walk away from something without consequences, when they can't substantiate a breach on the part of the insured.

 

[catfishcharlie]

Re: The grey area when your boat gets stolen !!!

Ikes, I just insured my boat thru Progressive! I hope I dont have claim. Persoannaly, I think most insurance compaies are a bunch of crooks.

 

[kaferhaus]

Re: The grey area when your boat gets stolen !!!

If anyone thinks that insurance companies walked away from disagreements concerning Katrina claims after paying a pittance, they are very much mistaken.

From valid claims they paid through the nose. From the lawuits they paid next to nothing. Odd the following year they had record profits... know why? because most of what they paid out was covered by "reinsurance" where the companies had bought insurance against catastrophic losses themselves.

And you totally failed to comprehend my point. Just as in Katrina when people with "homeowners" policies wanted paid for water damage which is specifically excluded in every one of those policies, these policies (all of them) state that you must "cooperate" with the investigation of your claim.

The insurance company hasn't accused the OP of anything... they're refusing to settle his claim because he is refusing to comply with a provision of his policy concerning claims.

Any way you slice it it's his fault the claim hasn't been settled yet. The only reason he could reasonably refuse to provide the information requested is he is fearfull that something in those records is going to implicate him.

If that's the case then he'd be stupid to release them and even more stupid to then file suit.... as that would guarantee their access to the records.

Again when you apply for ANY insurance you have to give the insurer all the information they need to check your credit history and background. They can "re-check" that information as often as they like so long as you're still their customer.

 

[reelfishin]

Re: The grey area when your boat gets stolen !!!

I think the point that everyone here keeps missing or overlooking is that there is no reason why an insurance company should have access to someone's personal records or information without due cause. If the claimant has no record of insurance fraud or prior exorbitant insurance claims, they have no reason to see that information. I would consider that a serious invasion of privacy. It's not a matter of hiding or not hiding anything, personal finances are non of their business unless they have reason to believe otherwise.

I'm not advising him either way here, just stating the way I feel and the way I see it from my point of veiw. There's no way I'd open my finances to an insurance company. I've had claims paid, by other companies and never a question. One was in the ball park dollar wise of the case in question. It was a stolen/wrecked vehicle and I was paid in less than a week after the incident. They did drop me when time came for renewal but it ended up to be in my benefit insurance cost wise anyhow.

The bottom line is unless his original contract states that he is required to relinquish all of this personal info in detail, I'd have to see it as an attempt at getting out of paying the claim.

What bothers me is that unless they truly feel they are being defrauded, it would be my guess that they would have paid the claim at face value, then if fraud was found, file any charges later.

I definitely feel that they are dragging this out and forcing more payments to be made simply to reduce the amount of the payoff to the finance company. What bothers me about that is that this is supposed to be an agreed amount policy, in which case their settlement won't change by the fact that more payments have been made. They may be hoping to see the loan default as a tool to argue financial state or intent of fraud.

I no doubt think he did the right thing getting an attorney, whether he got the right attorney is yet to be seen. It is common practice here to either get an attorney or an insurance representative on your side in the event of a big claim. A professional will simply know the ins and outs of the business and be able to insure that you get whats due to you.

I can see where the wrong attorney, maybe one who's got a history of suspect cases or excessive litigation would provoke an undue fight as well but I can't judge that from where I sit.

With the latest economic downturn, there's no doubt been a huge amount of insurance fraud and companies are on the lookout for fraud but that still doesn't give them the right to personal information, regardless what the amount is. The bottom line is that the boat was stolen, there are no charges against the insured, and there was an agreed policy. If the boat is indeed totaled, and I'd venture to guess it is, they should have already paid the claim. End of story. I doubt they would have jeopardized themselves in a future lawsuit if they didn't feel they had something to look at or reason to do so.

I've dealt with insurance companies in the automotive business for years, I've not yet seen a case where they demand personal info, the normal routine is to see a police report of the incident, estimate of repairs, and their adjuster's report and a check is normally issued within a few days of the estimate if the vehicle is totaled, or within days of the repairs being completed if the vehicle is to be repaired. Generally if the repair reach 50% of the vehicles value, with the potential of additional hidden costs, the vehicle is totaled, if the estimate reaches 70% of the value, assuming that there may be added repairs, then the vehicle is totaled. They don't usually gamble with a vehicle since more than not the repairs go over the initial estimate.
This becomes less prevalent as vehicle value goes up but still holds true to some extent. (Do $75k worth of damage to a $100k car and its headed to the scrap yard unless the owner assumes some financial responsibility if it runs over estimate or if they can get a guaranty that the estimate will hold fixed).
One thing they do look for is any indication of abuse or neglect, own a $100k car and leave the keys in it or loan it to a stranger who don't bring it back and you may have a problem, but get it ripped off from your locked garage, only to be found later wrecked or stripped, and they didn't catch a thief that said you paid him to do it, and there's no real problem in getting paid.
I have seen two cases where a vehicle was intentionally stolen and burned, the other stripped and sold for parts. The insurance companies had paid the claims, but after a police investigation revealed a thief in one case and the owner in the other who had committed insurance fraud, the insured was sued and forced to repay the settlement with interest after the police filed and proved insurance fraud. But in both cases, their respective insurance companies paid the claims in the beginning, even though an investigation followed.

I've also been on the fact finding end of similar insurance and liability investigations, mostly in burned automobiles. It's pretty easy to find proof of intentional fire in a car or presence of an accelerant for instance or a false mileage or condition claim. In most cases the claim had been paid but the insurance company was paying to have the car investigated for arson or possible insurance fraud, after the claim was paid. The paying of the claim perpetuated the fact that insurance fraud had been committed vs. only the intent to commit fraud.

From what I've seen in my experiences with insurance companies, they won't usually delay or refrain from paying a claim due to fraud, but they will refrain from paying if they feel that they have a way out of the claim all together. It may just be that for it to be prosecuted as fraud, the claim might have to have been paid were as the filing of the claim may only be intent to commit fraud or 'filing a false insurance claim' at best.
If they feel there may be a loop hole in which they can get out of paying a claim, rest assured they are exploring that in every way possible.
That loop hole may include the claimants unwillingness to comply with their demands, this is where it gets legal and a bit sticky, and may depend on local laws.

Again, I'm not an insurance expert and not an attorney, I'm just stating what I see and what my impression is from both my past experiences and from what I've read so far here.

 

[jay_merrill]

Re: The grey area when your boat gets stolen !!!

Kaferhaus, once again I have to disagree. I didn't miss your point at all. You are trying to compare claims issues that are not at all alike. In the Katrina disputes, the disagreement was over wind v. water, not who did or did not refuse to provide information, or cooperate with the insurance company. Its an invalid comparison.

You also tried to paint a picture of insurance companies nearly always winning and they don't. In the three examples (only) that I gave, insurance companies paid out 215 million dollars on claims that they tried to either minimize or get out of. These cases were not those of magnanimous insurance companies just cheerfully paying out on claims. They fought them and then found themselves in a losing position, so they settled out of court.

Your argument reminds me of a traffic court prosecutor that I once went up against while defending myself on a ticket that was just nonsense. He tried to bluff me by telling me that he had never lost a traffic court case. To that I replied, "of course you haven't because your never try one that your aren't absolutely sure you can win."

As to the case at hand, of course Progressive has not come right out and accused him of stealing. They may be annoying, but they aren't stupid. That said, its obvious that they believe that he did, or are trying to create such an appearance in order to delay or deny payment, and if you think a jury would not get that, I think you are kidding yourself.

In the beginning of this thread, I was of a mind that the OP should give them nothing. As the situation was better described, I changed my mind and felt that he should give them the financials but not other information that is personally instrusive and unecessary. My point was simply "be reasonably cooperative & don't look like the bad guy." If you read all of the posts, however, he has given them everything they want. That said, there shouldn't be any problem. If there is, and Progressive can't substantiate a breach on his part, they are going to have a problem, and its likely to cost them more than the value of the boat.

In the end, what the OP needs to do is to listen to his attorney and ask questions when he doesn't understand something, or is uncomfortable with the plan of action being taken. Hopefully, sensibilities will prevail, and he will be paid in a timely manner.

 

[jay_merrill]

Re: The grey area when your boat gets stolen !!!

Reelfishin, I agree with you. Unless the OP is lying to us, which I doubt he is, there's nothing that would give Progressive reason to believe there is fraud. There is no police report suggesting anything that was suspicious, the neighbors would not have reported inconsistencies (nor has Progressive apparently even asked anyone), there's nothing in the OP's credit report (he has stated that he is current on all of his bills) that would suggest financial stress - there's "no-nothing."

I would also add that "reasonable cooperation" is very much an issue. If it weren't, there wouldn't be language in the OP's agreement with Progressive that talks about "as may be reasonably required." The simple fact of the matter is that the concept of a "reasonable person," is a basic tenant of both contract law and torts law.

This isn't a minor amount of money - its roughly one hundred thousand dollars. That fact alone, makes paying an attorney a few bucks to protect your interests a very smart thing to do.

 

[kaferhaus]

Re: The grey area when your boat gets stolen !!!

Jay, intellignet people can agree to disagree, that's what we'll have to do. I"ve been in this business far too long not to know something smells with this fellow's claim.

I'm not a fan of progressive for other reasons, mainly because their ads are very misleading.

I can assure you that if they had no reason to doubt the validity of this claim they'd have paid it.

The OP has not been back on here for awhile now... he said he was going to comply with their request.... but said his attorney told him not too... which on the financial records issue I find hard to believe as any attorney who has experience with insurance companies knows that his client is going to have to give up that information one way or the other.

And as I stated earlier EVEN if the guy's credit is crap it's not going to preclude the claim being paid. However if they find that he's recently paid off a bunch of debt, made large deposits that he cannot account for where the money came from etc. then they have the right to further investigate the claim.

Just because the OP has mentioned that his neighbors or family or co-workers haven't been talked too doesn't mean it hasn't happened or that he even knows about it.

I guess the moral here is that if you want headaches when trying to settle a claim then fail to cooperate with the adjuster. He doesn't want to deny claims as it makes his own job much more complicated and stressfull. But unless he can cross all the T's and dot all the I's he has no choice.

Theft of big ticket items and the type of fires that I mentioned in an earlier post automatically trigger scrutiny. There's just too much fraud going on and with the economy as it is and getting worse so will the fraud.

Also the vast majority of boats are stolen in broad daylight from monday through friday. Outboard motors and automobiles are a different story those are usually stolen at night.

 

[bliss]

Re: The grey area when your boat gets stolen !!!

Without rereading I think the next item on his agenda was a meeting with Progressive. The holidays and other obligations on both sides of the table may push the meeting over 'til next week or the week after.
I can't wait to hear how it goes-if we hear.

 

[lkbum]

Re: The grey area when your boat gets stolen !!!

I'm not a fan of progressive for other reasons, mainly because their ads are very misleading.

I can assure you that if they had no reason to doubt the validity of this claim they'd have paid it.

.

Maybe, maybe not....... You need to go back and re-read the posts from me, Lkbum, on this thread. I have personal first hand experience with progressive on claims... Once where I was the insured " a stolen wave runner" and twice where I was involved in auto accidents in which the other drivers were insured with progressive, were cited in the accidents and clearly at fault. In the first wave runner theft, I was accused of having it stolen, was asked for all financial records, give a taped recorded statement and asked if I would take a polygraph. I complied completely, still took 2 months to pay the claim. In the first wreck (my wife as rear ended), Prog wanted to pay $1800 for repairs. I paid my dealer $3800 to fix the car, it took the threat of lawsuit to settle. In the next, the accident was bad, one of my daughters spent the night in the hospital. Prog did not return my initial call for three weeks. They interviewed all witnesses on the accident report, the state patrol, and finally repsonded to my threat of a law suit....... You may have been in the businesss for years, but have yoiu ever settled a claim with Progressive? My adivice has always been to give what they ask, but be prepared to deal with the worst inurance ompnay on earth (IMO of course, but based on personal experience).

 

[Bob_VT]

Re: The grey area when your boat gets stolen !!!

WARNING..... Gentleman do NOT turn this into a bashing thread or a battle .... everyone just be patient and wait for the outcome. If it continues we will be left with no choice but to shut it down.

Thanks!
Bob

 

[tashasdaddy]

Re: The grey area when your boat gets stolen !!!

i think this sums up this thread,

Judge: "Are they insurance professionals?"

Plaintiff: "No Your Honour, but I think one of them stayed at a Holiday Inn Express last night"

please when you have settled this, tell us the outcome.

other wise this is going no where.