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Help! Claim denied

Posted by connieleas 
Help! Claim denied
February 24, 2009 02:33AM
I'm taking Farmers to small claims court next month. They denied my claim for damages caused by a rodent (probably mice). The rodent chewed the wires in the complicated battery unit that powers the electrical part of my Honda Insight (hybrid car). The repair cost was over $5,000. Farmer's basis for denial was that damage caused by rodents chewing wires is not among the 13 covered items listed in my comprehensive policy. (Had I collided with a rat, the damage would be covered.) Wire chewing by rodents is also not EXcluded in my policy. I need a precedent. Has Farmers ever paid your claim for a damage that was not specifically listed as a covered item in your policy? My car repair people tell me that insurance companies routinely pay for repair of chewed wires. I need ammunition.

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Re: Help! Claim denied
February 24, 2009 05:34AM
Depends on what state you are in and what your policy langauge is. Please post your state.

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Re: Help! Claim denied
February 24, 2009 12:40PM
I agree with Middle. Depends but on average, you will lose. The auto policy, unlike most homeowners policies, is not an all covered except where excluded, it is a stated policy. You only have coverage for what the policy says you have, I am now aware of any ISO policy that covers this. You might also be aware of you contract language. You probably will not be able to sue the company as most languages say you have to go to mediation first.

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Re: Help! Claim denied
February 24, 2009 06:52PM
California

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Re: Help! Claim denied
February 24, 2009 07:53PM
What's an ISO policy?

It's true that my policy doesn't list "chewed wires caused by rodents" among the coverages. But some non-Farmers insurance people we have talked to said the damage should be covered. For example, even though not stated in a policy, if the car owner's dog chewed up the upholstery it would be covered, even if the policy didn't say "damage caused by a dog chewing the upholstery." The wording of my policy merely says that the listed items are "covered." It doesn't say "limited to" and it doesn't say "for example" so it strikes me as ambiguous--probably intentionally.

No one has said I was required to go to mediation. I have listed my complaint with the California Insurance Commission.

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Re: Help! Claim denied
February 24, 2009 11:22PM
ISO means Insurance Services Organization. This policy is usually written by the state and in your case,it is. Also, if does not say intentional damage by insured but if you caught the unit on fire or damaged it yourself it would not be covered. It does not say intentional damage by insured, but still not covered. I am not sure what non-farmers people say or who they are or what training they have on such matters, but if the ISO policy written by the state says that this is not covered, it wont be. So many people out there dont realize the states write the auto policies and the insurance companies just sell what they are told that can sell. And regardless, I am not sure any state where this is covered. It is simply not an all risk policy unless prohibited, it is a stated policy and only coverage is broadened by endorsement.

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Re: Help! Claim denied
February 25, 2009 09:53PM
My policy doesn't say that damage to wires by rodents is not covered. That would be listed under exclusions, and it's not listed as an exclusion. I can't believe that a comprehensive auto insurance policy is limited to just 13 items, such as riots, malicious mischief, collision with a bird or animal, and hail. The policy doesn't explicitly say that the coverage is "limited to" only those items. If it did, then the limitations would be clear. It is not clear.

I have communicated with the California Insurance Commision. No one has told me that I don't have a case. I'm having a hard time getting straight answers.

Thanks for your help!

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Re: Help! Claim denied
February 26, 2009 01:02AM
Well,let me state this again, your auto policy is not an all coverage policy except where excluded like your homeowners, it is a stated policy. And yes, if it is not in the policy for coverage, then it does not extend in the auto policy. Also, let me give you fair knowledge on this, the Dept of Insurance is just a regulatory agency, the insurance companies dont HAVE to do what the dept says. Even if the CDI agrees with you, any insurance company can and does tell the state agency to take a hike. That is where lawsuits come into play from the state and the companies, Look at Texas and all that mold stuff a few years back. The CDI will send you complaint to Farmers, they will review it, and send a response. The CDI will send you a letter stating Farmers position and thier position, and that is about all that will happen. You would be better off sending them in writing a demand for apprasial, though since they denied , they will probably deny apprasial also.

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Re: Help! Claim denied
February 26, 2009 06:50PM
Sorry, Redman, for being redundant myself. I realized too late that I stated the same argument twice. Well, I'm going for it anyway--small claims, that is. Here's my final argument: if the covered items are limited to only those 13 damages listed in the policy, what's the point of exclusions? All else would automatically be excluded.

Thanks again for your attention.

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