Understanding What Your Policy Does and Does Not Require

Most, if not all of us, are aware that policyholders have certain duties and obligations under their insurance policies. Some of the duties focus on pre-loss obligations and others focus on post-loss obligations of the insured. Common post-loss obligations include making the insured property available for the carrier to inspect and submitting to a recorded statement. The purpose of these obligations is to allow the carrier to investigate the policyholder’s claim and make a coverage decision. But it is just as important for policyholders to know what you are not required to do.

Recently, I attended a client’s site inspection for his potential sinkhole claim and the carrier asked to take his recorded statement. Of course, my client agreed. After the field adjuster’s two hour investigation, he prepared my client for the recorded statement. The carrier’s representative then attempted to hook my client up to a lie detection device. Yes, he literally attempted to hook my client’s finger into a lie detection device. I objected and asked the field adjuster to show us the policy language that requires my client to be subjected to such treatment. Not surprisingly, he could not and left without taking a statement.

The field adjuster seemed to have no regard for how this immediate suspicion and intimidation technique made my client feel. He felt belittled and demeaned. He had a relationship with his carrier for several years and never made a prior claim. Why then was he subjected to such an insulting situation? I have not encountered this egregious conduct before, and I assured my client that we would notify his carrier and try and get another adjuster on his claim.

Most carriers and their representatives are good people. They enjoy investigating a claim, writing an estimate, and making a coverage decision. However, like other professions, some carriers and their representatives push the envelope too far and take advantage of their position. After all, the carrier calls the shots. It requests the documents, takes the recorded statement, and, most importantly, decides whether your claim is covered.

While this was a bad experience, imagine if we were all subject to the treatment Moe received in this episode of The Simpsons

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Comments (3) Read through and enter the discussion with the form at the end
SHIRLEY HEFLIN - March 30, 2012 10:26 AM

Hello. I'm surprised an atty would agree to even let their client give a recorded stmt. That's an area where - for 2 decades now - i've noted attys have different views/opinions regarding their clients/insds giving a "recorded" stmt.

I'm not an atty, but to me that's where court reporters and litigation come into play. If a client/ins'd is standing b4 an adjuster w/their atty (OFFICER OF THE COURT) that's about as honest as it gets. That's my opinion anyway.


SHIRLEY HEFLIN

Javier Delgado - March 30, 2012 10:56 AM

What a great start to a future bad faith case!

Mark Phillips - March 30, 2012 12:13 PM

And don't forget the volley-serve approach: "Fine, we will be videoing every measure of your investigation / questioning from this day forward".......regardless of how many different adjusters show up on this file.

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