I had a claim assigned to me for a break-in to an insured’s house. I got a copy of the police report the insured filed, and it looked like the house was unoccupied at the time of the break-in, and the only claim was for damage to the house itself; no contents were stolen.
It took some time, surprisingly, but I finally tracked down our insured, who our documents showed as the owner of the house, and got him to meet me at the property. It was there at the meeting that he told me that he didn’t actually own the house anymore, and that the man he sold the house to made it one of the conditions of the sale that our insured keep paying for insurance on the house. While that struck me as odd, and possibly illegal, he thought nothing of it and still expected he’d be getting a check for the damaged property.
He somewhat got it when I explained what insurable interest was, and how he didn’t actually have any in the house once he sold it, and the guy he sold it to shouldn’t have made him keep insurance on a house that he no longer owned. Okay, problem solved, I thought.
But then he asked me if, despite him not actually owning the house, or suffering a loss, if there was any possibility that I could somehow find a way of paying him for the damages.
I had to then explain the concept of insurance fraud and file auditing and tell him how I really wasn’t in much of a position to lose my adjusting license or go to jail for helping him out by “finding a way” of paying him for damage to a house he didn’t own.
I think he sort of understood. Maybe.
Municipalities will typically have an employee change their name to "Nature" so that they may carry out "Acts of Nature."
After being affected by a tropical storm, calls flooded the city’s risk management department and people expected to get paid for lost food after power went out. This is a typical conversation that occurred several times a day:
Adjuster: “Risk Management Division, how may I help you?”
Citizen: “Um, um…I was told to call you, that you could pay for my food.”
Adjuster: “Who advised you to contact the City?”
Citizen: “The news.”
Adjuster: “Did you have food spoilage because of a power outage from the storm?”
Adjuster: “Why is the City at fault for your food spoilage?”
Citizen: “Because I lost my electricity.” Continue reading
"It's good, but I can make it better. Let me just get rid of this one thing."
This was submitted by a former adjuster who used to work for a Florida city’s risk management department. At least the claimant is thinking globally:
A young woman, new mother, contacts her local municipality asking for reimbursement for a taxi ride to work. She stated the previous Friday the sewer drains had flooded onto her street. Once the water receded, there were large pieces of debris and glass in the road. She told the adjuster she was afraid to back her car out of the driveway for fear the glass and debris would burst her tires. The best course of action, the citizen felt, was to call a taxi cab to get to work. The woman had no family in the area or co-workers that could pick her up and drop her off. Continue reading