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whichwaysup

Learn from my mistakes - Insurance Learnings

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I am not an expert, I thing the insurance company is pretending the crack developed over time rather than from a single accidental occurrence. I think they are playing games. if the boat would have sunk before he made it back to the hill the insurance company would have likely paid up.Bottom line Insurance company wiggling out of taking care of the boat

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Something I don't understand. The Ins company insured the boat with no inspection, so they can only assume the boat was in normal usable condition. Maybe a required inspection on their part would've discovered the issue or verified that its in good shape.  Why do you now have to prove to them how the damage occurred? Bottom line is the boat is damaged, possibly unsafe and they blindly insured it. Im sure there is some legal angle to all that, but Im not an Attorney. 

Here's my take away from this, if I ever need to file a claim. My boat is damaged because of "X", Im an honest person........................................

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Sudden, direct, physical loss. I Was a cat ( property @ auto) adjuster and had to explain the SDPL quite a few times. I have no knowledge on the marine side but it sounds like to me they are considering your claim as long term damage, neglect.  When the policy does not state named peril , its usually up to the policy holder to prove the claim is a covered loss.

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The last few comments make me glad I go through a broker for my boat insurance.  Auto are simple as everyone has one but boats are very limited in perspective.  I feel that with a good broker that they are able to help fight for you with the insurance company.  Hopefully the broker knows both boats and insurance so you stand a better chance.

I had my lower go out and when taking it apart they saw a tooth broke off of a gear that might have been caused by impact.  Spoke to my broker and he told me what to do and walked me through it.  In the end the lower was covered.  Would having a broker helped with your hull, I do not know but it would not have hurt. 

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13 hours ago, hurricane said:

Something I don't understand. The Ins company insured the boat with no inspection, so they can only assume the boat was in normal usable condition. Maybe a required inspection on their part would've discovered the issue or verified that its in good shape.  Why do you now have to prove to them how the damage occurred? Bottom line is the boat is damaged, possibly unsafe and they blindly insured it. Im sure there is some legal angle to all that, but Im not an Attorney. 

Here's my take away from this, if I ever need to file a claim. My boat is damaged because of "X", Im an honest person........................................

Hurricane, I think you nailed it here.   I carry both comprehensive and collision insurance.   It seems like an easy "fix" for the insurance company to ONLY offer comprehensive with a qualified survey from one of their vendors prior to offering the insurance.  Heck, even make it a requirement that a new survey must be done every XX years to determine insurability.  That would go a LONG way to avoid this issue.  Folks unwilling to pay for the survey wouldn't get the survey and wouldn't expect to be covered for an issue like this.  For folks who want this coverage, it will be worth the extra cost.  This won't eliminate all of the inherrent ambiguity, but it would at least eliminate, at least legally, the possiblity that the damage was pre-existing or was "normal wear and tear."   

Without that, it isn't a hard mental leap to suggest that the insurance company, in this case Progressive, knowingly offer insurance for claims that they know that they will deny.  I am not accusing the insurance companies of doing this knowingly, but conflict of interest is both real and perceived.   They knew my boat was 17 years old when they offered insurance.  They did nothing to determine or verify the condition of the boat prior to offering comprehensive coverage.  When an issue is discovered, their default position is that it is "wear and tear" unless I either a) know EXACTLY what caused it   2) Lie about what caused it  or c) am willing to (on my own dime) hire a company who will determine cause (if they can) and, even if they do, the insurance company my not even accept that evidence to honor the claim. 

 One of the key differences between auto and boat incidents is that the damage caused to a boat doesn't necessarily have to leave a mark. 

Take the wake issue we described - would anyone disagree that, if you hit a wake hard enough that it could cause damage to the boat?  Rip off the trolling motor?  Puncture a gas tank?  Break stringers loose?   Over a wide range of the thousands of boat manufacturers out there (who are all treated the same by the insurance company at point of coverage), the probability of this damage obviously varies, but if a wake caused the damage, it should be covered, as the damage was caused by a sudden, direct, physical loss (thanks for that education, Steve!)

 However, unless the insured a) realizes the damage immediately or b) is absolutely positive that it is the cause, or c) willing to be less than honest in his/her statements, the claim will be denied.  Ergo, the boat, by the very nature of its age isn't really eligible for certain benefits that a newer boat would be eligible for, even if the damage is identical and the cause were equally ambigious. 

 

Now, enter the fact that there is no objective third party involved in the decisioning of the claim, and you have the fox fully in control of the henhouse - a company who benefits from claim denial that is fully in charge of the decisioning of a claim that has an ambigious cause, and who, by their own admission, lacks the expertise and facts required to make an accurate determination of cause.  

You could even make the case that the Insurance company has a financial motivation NOT to require a survey up front, as it would reduce the # of policies it offers, many of those would not offer the full benefit to the covered person anyway, and therefore, guaranteed profit with very little risk of cost.

My goal here is not to flame the insurance companies.   It is to help those who are operating used boats and have insured them better understand the way their insurance works from the point of view of someone who thought he was covered and found the hard way that he was not.   Whether I agree with the reality or not is of little consequence - at the end of the day, I need to do things differently next time to ENSURE I'm covered for what I should be covered for.

And heck, it may not even be a broken stringer.  It could be an easier repair than I fear.   I'll keep you all posted once I start getting more info.

Ah, first world problems.  :)

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2 hours ago, mulligan said:

The last few comments make me glad I go through a broker for my boat insurance.  Auto are simple as everyone has one but boats are very limited in perspective.  I feel that with a good broker that they are able to help fight for you with the insurance company.  Hopefully the broker knows both boats and insurance so you stand a better chance.

I had my lower go out and when taking it apart they saw a tooth broke off of a gear that might have been caused by impact.  Spoke to my broker and he told me what to do and walked me through it.  In the end the lower was covered.  Would having a broker helped with your hull, I do not know but it would not have hurt. 

You nailed it, mulligan. Yacht owners that know & understand this logic make up at least 90% of my agency's policyholders.   

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Gus do you think that it being denied may have been your presentation of some doubt (and honesty) of how it may of happened? 

What if you had hit the wake and immediately felt the floor flex and had bilge pump going off soon after? After talking to them, do you feel that would have yielded a different outcome? 

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36 minutes ago, justfish said:

Gus do you think that it being denied may have been your presentation of some doubt (and honesty) of how it may of happened? 

What if you had hit the wake and immediately felt the floor flex and had bilge pump going off soon after? After talking to them, do you feel that would have yielded a different outcome? 

No question.  Had I said, " I hit a wake yesterday and checked my boat and I can see that it caused a crack, now fix it," I suspect it would have been paid.  The problem is that I couldnt say that honestly.   I honestly dont know what the cause was or when exactly it happened, only that when I bought the boat it was not there, it is now, and that there is no way this is normal wear and tear.  Its an 11 inch crack in my hull.  

 

A quick update, I had a boat builder, repairer that the adjuster mentioned (he isnt allowed to recommend) come over and take a look.  He checked the boat out top to bottom, inside and out, more thoroughly than I would have expected.  Spent about an hour here.  Heres what he found:

1)  The boat is in excellent shape, structurally everywhere else besides the rear port area inquestion.  No other spider cracks, stress indicators, or any other issues.  The boat is in excellent shape, except this spot.

2) No repairs have been done to the hull and covered up.  The gelcoat appears to be original from one end to the other, no halos or other indications of repair.  

3)  The damage is caused by a stringer that has broken loose from the hull.  He showed me the cracks from the inside, which are ragged and the fiberglass is broken on top of the stringer, along with the tabbing attaching it to the hull.

4)  The damage, in his opinion was caused by an impact.  The cracks are ragged, it isnt normal wear and tear.  It is also confined, he thinks, to the rear port quadrant, fairly easy to fix if they cut out the livewell.  

5)  He didnt rule out the wake, but because of the location, but suspects an impact while the boat was on the trailer is more likely.  On november 11th, I hit a pothole with that trailer so deep it hit the axle.  I had three guys following me with their boat and they called me to see if I was okay.  So, at least I have witnesses to the event.

He is putting this in writing.  we will see what happens.  Fix is somewhere between 3500 and 5k.

 

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2 hours ago, whichwaysup said:

On november 11th, I hit a pothole with that trailer so deep it hit the axle.  I had three guys following me with their boat and they called me to see if I was okay.  So, at least I have witnesses to the event.

That is key info IMO. You may have something to work with in order for Progressive to consider overturning your coverage denial. Ask the people who saw your trailer hit that pothole to write letters on your behalf attesting to what they saw. The more detail, the better. Go take pics of that pothole yourself. Submit all of that plus the repairers report to your adjuster....ASAP!!

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I actually just realized that I posted the trip report in the mid atlantic section: 

and  checked with the guys.  They remember it.  may not change anything but maybe I am getting closer to understanding the cause.

Screenshot_2017-12-05-21-10-24.png

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Just an update here, for those interested.  Got a call from the adjuster today.  Seems that they are going to send a surveyor out to do a causation analysis and get a third party opinion.  Thats great news.  Either way, now, I will be happy about the outcome.  Either they determine the cause is covered and I get the boat fixed, or they dtermine it isn't covered and I can trust that the decision was a fair one based on facts and expert opinions.  

 

Will keep you all posted once the survey is done.  Weather has been mercifully miserable here.  Hope I can get her fixed soon.  

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Sounds like you are making progress. It is a shame that they took the denial stance to start without  having a qualified adjuster look at the issue. I hope the second expert agrees with the last guy. 

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Wondering if there is a possibility that the vehicle policy would covet the boat damage since it may have been damaged during the pothole event???

My understanding from my agent on all of our towables is that they are covered by the vehicle covrrage while being towed. We’ve gone back and forth over this as I have also been advised that it is only covered when connected to vehicle.  We had a boat and trailer come completely loose once and auto insurance denied claim because it was mot connected to behicle when damage occured. Their position was that even though we were towing it prior to the trailer coming off, the boat coverage should pick up when it was no longer a part if the vehicle. Of course, the boat only had liability coverage because it was an older boat. 

I would explore the vehicle coverage route. 

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Most insurance will cover liability on the boat while towing but no replacement or repair of the boat. Know this from experience.

If the boat hits a car and your fault they will cover the other guy but not your boat.

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My agent has explained to me that the vehicle coverage is the same for the towed. If you comp/coll on vehicle, towed has it as well. We haven’t had to test that statement and hope not to but we’ve hashed on it a lot since we are towing boats, utility trailers, RVs, dump trailers etc with mixes of personal and commercial autos and towables. 

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Gus,

I really hate that you are dealing with this.  You're honesty and ethics alone will payoff when you lay your head down at night.  There are many people on site forum that will most likely be more than helpful when it comes to; How do I get this fixed and what is it going to cost me.  It will work out, and you will be back on the water before you know it.....

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