|
Any independent agents here that are licensed in NJ? Looking to send a referral your way... Also insurance question I wanted to bounce off ya'll. One of my insureds was driving on the highway and the car in front of her kicked up a piece of metal that was on the road. It damaged the undercarriage of her car. Is coverage afforded under comprehensive or collision?
|
#
?
Jun 19, 2015 14:26
|
|
|
|
| # ? May 13, 2024 17:50 |
|
|
DOMDOM posted:Any independent agents here that are licensed in NJ? Looking to send a referral your way... Hitting something in the roadway that is stationary should be collision. Hitting something that was kicked up off the roadway should be comprehensive. Unless the rules in your state are different than mine. The problem with the scenario you have presented is it will all boil down to how it is articulated to the claim rep and how the adjuster interprets the coverage.
|
|
#
?
Jun 19, 2015 15:02
|
|
|
It sound like it was a "missile" or flying object which would fall under comprehensive. If it fell off the other vehicle and was run over, that would be a collision.
|
|
#
?
Jun 20, 2015 03:59
|
|
|
I think you'd be hard pressed to say something that was, in essence, run over would qualify as a missile. Usually it it isn't high enough on the car to actually be airborne I would say collision.
|
|
#
?
Jun 20, 2015 14:55
|
|
|
Well, the scenario is one of those grey areas and I would be getting a very clear recorded statement from the driver on the specifics. I think if they hit it while it was flying and it happened to go under the vehicle immediately after, it was still a flying object on impact.
|
|
#
?
Jun 21, 2015 03:59
|
|
|
Bovril Delight posted:I think you'd be hard pressed to say something that was, in essence, run over would qualify as a missile. Usually it it isn't high enough on the car to actually be airborne I would say collision. In my state anything that is STATIONARY in the street is Collision (which includes already hit and dead animals). Anything that is falling off of, kicked up from, or moving on the roadway is comprehensive. But as I said before...it is all going to come down to the phrasing used to describe the loss and the adjuster handling the claim.
|
|
#
?
Jun 22, 2015 14:05
|
|
|
OssiansFolly posted:In my state anything that is STATIONARY in the street is Collision (which includes already hit and dead animals). Anything that is falling off of, kicked up from, or moving on the roadway is comprehensive. You'll see the specifics in the Definitions part of your policy jacket. Generally speaking though that's how it works. Let's say there's a chunk of broken muffler in the road, and one car runs it over shredding a tie rod end or something. That car files a collision claim for hitting stationary debris in the roadway. Now, if after doing that it kicked it up in the air where it hit a second vehicle damaging the windshield, that second vehicle files a comprehensive claim. The missile wasn't a byproduct of negligence on the part of the first operator, so it's not any sort of liability payout, just a first party comprehensive claim.
|
|
#
?
Jun 22, 2015 16:31
|
|
|
NeurosisHead posted:You'll see the specifics in the Definitions part of your policy jacket. Generally speaking though that's how it works. Let's say there's a chunk of broken muffler in the road, and one car runs it over shredding a tie rod end or something. That car files a collision claim for hitting stationary debris in the roadway. Now, if after doing that it kicked it up in the air where it hit a second vehicle damaging the windshield, that second vehicle files a comprehensive claim. The missile wasn't a byproduct of negligence on the part of the first operator, so it's not any sort of liability payout, just a first party comprehensive claim. I'm well aware, but that claim adjuster is going to ask all kinds of questions to see how closely you were following that other vehicle, did you see the debris before he hit it, did it bounce before it hit the windshield, could it have been avoided, etc. etc. I did claims for a few years and there's more to it than just hitting or being hit.
|
|
#
?
Jun 22, 2015 18:17
|
|
|
Hello all, Fun-time health insurance questions! I'm turning 26 this year, and thus lose coverage from my parent's plan (a Humana PPO). I'm male, work in the film industry which means no long-term jobs that offer any kind of benefits so I'll be handling all of this personally, and for the past 3-4 years have been working overseas 90% of the year. This is my first year where I'll be spending the majority of it in the US (CA) and it looks like that will continue through 2016. The most frequent recommendation I've seen in scrubbing through most of the thread is for the Silver level packages offered by the exchange in my state. There are some Gold-level offers, however, that are quite similar in price (<50$/mo difference) to their Silver counter parts, and have the benefit of not having a deductible at all. I want to ask if one of these options might be a better fit for me as while I am normally quite healthy, I do have a few underlying long-term health conditions that if/when they do cause problems require quite extensive care. The last time that happened was nearly 6 years ago, but required a hospital stay of several weeks. If spending the additional money on the premiums would make this a significantly less risky prospect I have no problem doing so, and would contain the additional benefits of making my regular medical upkeep easier since there is no deductible to hit. Regardless, while I'm obviously happy to get the best deal possible financially, I'm more concerned about getting a plan that is smart and will cover what I might need covered than about saving x$ per month. So if I'm thinking about this in entirely the wrong way, feel free to straighten me out! Beluga Snail fucked around with this message at 19:32 on Jun 22, 2015 |
|
#
?
Jun 22, 2015 19:17
|
|
|
FelixReynolds posted:Hello all, Sounds like you should go for the most affordable Gold PPO offered in your state. I'd be worried going with another plan if you could end up in the hospital soon for an extended period of time. The problem is that it sounds like there is a crap shoot, so for us to recommend one or the other will come with risk...you either pay more monthly to avoid the out of pocket costs for a hospital stay, OR you pay less monthly and run the risk of paying more our of pocket for a lengthy hospital stay. I personally would rather have a good plan and pay a slightly higher monthly premium rather than get hit with a potentially higher hospital stay that could really hurt me financially and hurt my credit. Make sure you do all of this NOW, because you do qualify for an emergency policy, but to avoid a gap you want something quoted, accepted and paid for prior to your birthday!
|
|
#
?
Jun 22, 2015 20:34
|
|
|
OssiansFolly posted:In my state anything that is STATIONARY in the street is Collision (which includes already hit and dead animals). Anything that is falling off of, kicked up from, or moving on the roadway is comprehensive. I think you'll find it isn't a state regulation but a policy interpretation.
|
|
#
?
Jun 23, 2015 03:47
|
|
|
The insurance company has come back with an offer for me for Grandma's damages...the total replacement cost is $12700, and they're offering $9350 with depreciated replacement parts. I'm certain that they have lowballed the offer as much as possible..as an example, all of the listed parts have been described only in age and condition, and every single part is listed as average condition, which seems suspicious. They've also listed some things with questionable ages- my fence and gate as only having an lifetime of 10 years. So it's time to negotiate the offer. I'm not certain how aggressive to be, but I'll be taking my cues from their position, I guess. What a pain. Edit: The main issue is that you can't buy used/refurbished pool heating/pumping equipment, as far as I can tell. It's unfortunate for the insurance company, but it was all working before Grandma went haywire, it should be replaced with working equipment afterwards. Glass of Milk fucked around with this message at 23:13 on Jun 23, 2015 |
|
#
?
Jun 23, 2015 23:00
|
|
|
Glass of Milk posted:The insurance company has come back with an offer for me for Grandma's damages...the total replacement cost is $12700, and they're offering $9350 with depreciated replacement parts. Or call a lawyer. Do you have their written explanation for why they won't replace your equipment?
|
|
#
?
Jun 23, 2015 23:32
|
|
|
Glass of Milk posted:The insurance company has come back with an offer for me for Grandma's damages...the total replacement cost is $12700, and they're offering $9350 with depreciated replacement parts. Is the replacement cost number from 21st or from your pool contractor's estimate? If not the estimate, what was that number?
|
|
#
?
Jun 23, 2015 23:45
|
|
|
Both are from 21st century. They initially provided an offer of $4983 where they determined the replacement cost was $6990. This offer didn't include any of the pool equipment other than the heater, but included the fence/gate/other misc damaged stuff. I submitted the repair estimate from my pool guy for $5790 for replacement of the additional pool equipment and asked them to include it in the offer to review. The new offer is $9350 where they determined a total replacement cost of $12700 (assuming that's the $6990+$5790). SiGmA_X posted:Do you have their written explanation for why they won't replace your equipment? I haven't received their written justification for the depreciation, but I'm going to request it when I speak with them tomorrow. Glass of Milk fucked around with this message at 00:27 on Jun 24, 2015 |
|
#
?
Jun 23, 2015 23:59
|
|
|
Glass of Milk posted:Both are from 21st century. Mention you're expecting to be made whole, a few times. And mention you'll seek legal action. And know your rights in your state. In Oregon, if you lawyer up and win, the insurance company gets to pay lawyer fees. Progressive loved that with a dispute over vehicle value. (Removing and spending 5k on rebuilding an engine from a highly modified car doesn't make it a rolling shell or reduce value - Progressive and I disagreed over that, Progressive lost.)
|
|
#
?
Jun 24, 2015 01:52
|
|
|
Glass of Milk posted:Both are from 21st century. Have you asked them if they plan to pay the rest once you replace everything? If they say yes ask for that in writing. Don't cash checks until you are getting what you need to actually replace everything.
|
|
#
?
Jun 24, 2015 03:29
|
|
|
OssiansFolly posted:Have you asked them if they plan to pay the rest once you replace everything? If they say yes ask for that in writing. Don't cash checks until you are getting what you need to actually replace everything. I suppose this could vary by state.
|
|
#
?
Jun 24, 2015 03:54
|
|
|
OssiansFolly posted:Have you asked them if they plan to pay the rest once you replace everything? If they say yes ask for that in writing. Don't cash checks until you are getting what you need to actually replace everything. I haven't. The claims person left me a voicemail as she was leaving for the day, so I'm calling tomorrow. I don't think they intend to pay me beyond what they've stated for any of the items they include in the offer. As an example, they estimated the pool heater to have a replacement cost of $3307.44. They stated it was in average condition, and 10 years old with an expected life of 10 years. Because of that, they put depreciation at 75%, which calculates through some voodoo math as $1723.67 in depreciation, leaving $1583.77 as the amount they intend to pay out. Because of that, I'm not accepting any offer they provide until I've reviewed it with them to determine their criteria. Before the accident, the heater was operating perfectly, with some paint fading due to sun. I'm not sure if their expectation is for me to somehow go buy a 10 year old heater, but there's no way for me to replace it with a like item at that depreciation level. It's like they're trying to make it analogous to getting a 10 year old car, but it doesn't work the same with appliances.
|
|
#
?
Jun 24, 2015 04:11
|
|
|
It kinda does though. They owe you the equivalent of a 10 year old pool heater. They don't owe you a brand new pool heater. Liability insurance is required to replace the value of whatever was damaged or destroyed, not replace a 10 year old part with a brand new one. It may be worthwhile, if you have replacement cost coverage on your homeowners insurance, to pursue through them and let them subrogate for the damages.
|
|
#
?
Jun 24, 2015 04:19
|
|
|
sheri posted:It kinda does though. They owe you the equivalent of a 10 year old pool heater. They don't owe you a brand new pool heater. Liability insurance is required to replace the value of whatever was damaged or destroyed, not replace a 10 year old part with a brand new one. I'd be happy to replace the destroyed unit with the same one- it worked perfectly. But I don't know of a way to do that- it would be like trying to buy a 10-year-old refrigerator. I'm fine with depreciation, even, but I think their criteria for measuring it is not accurate, or at least they haven't accurately represented the worth of the items.
|
|
#
?
Jun 24, 2015 05:44
|
|
|
SiGmA_X posted:Cashing checks shouldn't make a difference, acceptance of consideration doesn't conclude the agreement. Many people don't understand this, because contract execution does require exchange of consideration. Many insurance companies have a clause in the claims paperwork that says by cashing the check you are accepting their settlement unless otherwise noted. So, until he brings up his qualms with the pay out he should hold the check. Also, the longer you hold that check and complain the longer that claim remains open and that claim adjuster can't close the file. Claims adjusters get paid to finalize and close claims, so by not cashing that check you are wrecking his claim closing numbers (which the majority of insurance companies use to offer bonuses and promotions). Keeping an uncashed check is a good idea until you get satisfactory responses from the insurance company.
|
|
#
?
Jun 24, 2015 13:51
|
|
|
OssiansFolly posted:Many insurance companies have a clause in the claims paperwork that says by cashing the check you are accepting their settlement unless otherwise noted. So, until he brings up his qualms with the pay out he should hold the check. Also, the longer you hold that check and complain the longer that claim remains open and that claim adjuster can't close the file. Claims adjusters get paid to finalize and close claims, so by not cashing that check you are wrecking his claim closing numbers (which the majority of insurance companies use to offer bonuses and promotions). Good to hear that part about the claim closing rate though.
|
|
#
?
Jun 24, 2015 17:56
|
|
|
OssiansFolly posted:Many insurance companies have a clause in the claims paperwork that says by cashing the check you are accepting their settlement unless otherwise noted. So, until he brings up his qualms with the pay out he should hold the check. Also, the longer you hold that check and complain the longer that claim remains open and that claim adjuster can't close the file. Claims adjusters get paid to finalize and close claims, so by not cashing that check you are wrecking his claim closing numbers (which the majority of insurance companies use to offer bonuses and promotions). If you're not singing a release then there isn't any paperwork. Most PD payments don't have a release either. Also lol at adjusters getting paid by the claim closure rate. Maybe at some poo poo tastic podunk company, but that doesn't happen at any big carriers.
|
|
#
?
Jun 24, 2015 20:01
|
|
|
OssiansFolly posted:Sounds like you should go for the most affordable Gold PPO offered in your state. Thanks for the advice, and it gels pretty well with what I've been leaning towards so far. Follow-up question, is there a reason you'd say go with a PPO as opposed to an HMO? I ask as I have the option between an HMO with Anthem (which has, from what I have seen, huge in-network coverage here in CA as well as in NYC where I frequently spend a few months total out of the year in) or a more expensive PPO from a smaller network company that still has decent coverage out of state but with a smaller network overall. Outside of having to get a referral through my designated "general practitioner" guy, is there a reason I want to opt for the PPO over the HMO?
|
|
#
?
Jun 24, 2015 22:05
|
|
|
SiGmA_X posted:I wonder if you could call your insurance commission and ask if this is legal. Or call a 21st agent and ask for input. I'm a little unclear on the terminology "made whole". From what I've determined, it's only related to bodily injury. Is that correct? Glass of Milk fucked around with this message at 22:18 on Jun 24, 2015 |
|
#
?
Jun 24, 2015 22:08
|
|
|
FelixReynolds posted:Thanks for the advice, and it gels pretty well with what I've been leaning towards so far. Generally the PPO option actually has the larger network, which is why most people choose it. You might want to look at the actual providers associated with each network in the areas where you live/travel too; a larger overall network might not be a good fit for you if the only providers in that network are hospitals/doctors you don't want to use. Depending on the price difference, it may also be worth it to you to get a plan that has some out-of-network benefits (common to PPO plans) versus NO OON benefits, which is how most HMO plans work.
|
|
#
?
Jun 24, 2015 22:32
|
|
|
Bovril Delight posted:If you're not singing a release then there isn't any paperwork. Most PD payments don't have a release either. I worked in claims at State Farm...the largest and most successful insurance company in the US. Guess what...this is how it works. Adjusters get paid, receive bonuses and are considered for promotions based on satisfactory closing rate. The faster you close claims the better, because people come to and leave companies based on how claims are handled. I now represent 9 different companies and of the 4 I have visited they all handle claims the same way. Keeping claims open requires more hours and the company is losing money as someone works that claim...not to mention the aspect of keeping or losing a customer gets better or worse depending on how quickly that claim is handled. Trust me...this is how claims works. Glass of Milk posted:I'm a little unclear on the terminology "made whole". From what I've determined, it's only related to bodily injury. Is that correct? No. Made Whole in the sense of insurance is to return you to the point that you were in prior to the loss, but not better (when possible). So, if you have hail damage on your home the insurance company is obligated to repair that damage. BUT, lets say the damage is only on 1 side of the house (not uncommon). In this case the insurance company is ONLY obligated to pay for that ONE side of the house. What if the siding doesn't match or can't be matched? This is where a good company may step up and pay for some or all of the siding to make it match. MOST companies will NOT pay for the rest of the siding because your home is functionally repaired and whole with that ONE side being repaired. It may not be pretty, but it is functionally repaired. Bodily injury actually gets harder depending on the injuries sustained. If you could run prior to, and need a knee replacement after then you are not made whole. You are made functional and then they compensate you for your life changes as they see fit (or your lawyer sees fit).
|
|
#
?
Jun 25, 2015 14:41
|
|
|
I'm 31 and was recently diagnosed with Crohn's Disease - how hard will it be for me to get Long-Term Care Insurance either now or later in life?
|
|
#
?
Jun 25, 2015 19:34
|
|
|
OssiansFolly posted:I worked in claims at State Farm...the largest and most successful insurance company in the US. Guess what...this is how it works. Adjusters get paid, receive bonuses and are considered for promotions based on satisfactory closing rate. The faster you close claims the better, because people come to and leave companies based on how claims are handled. I now represent 9 different companies and of the 4 I have visited they all handle claims the same way. Keeping claims open requires more hours and the company is losing money as someone works that claim...not to mention the aspect of keeping or losing a customer gets better or worse depending on how quickly that claim is handled. Eh, success is relative. SF is huge because they've been around forever, and as a mutual insurance company, aren't obliged to make money for shareholders. I've worked in claims at several major insurance corporations. High level. Sure, claims inventory is something to review, but that because claims rarely age well, and customer satisfaction is directly correlated to it. Attorney represented, commercial claims, and litigation claims can take years to resolve, and this has no impact on that person's job performance. If you handled claims in SF's centralized claims environment you may see something like that, because it's a volume operation. Low complexity, high throughput centralized claims handling is very common nowadays. Because the work is segmented into low complexity claims, the volume is increased to distribute it evenly. If you didn't ever close a claim you'd be in trouble, but nobody is losing out on promotions or a profiting sharing/bonus system because someone decided to not cash a check. Once you issue the check and it reflects a loss payment on the claim, it's considered closed at any rate.
|
|
#
?
Jun 25, 2015 23:51
|
|
|
From my experience, closure rates of claims is factored into the adjusters overall performance level. So is time on a call, payouts, how quick everyone is contacted, how long you take a dump, and every other metric that companies track these days. But I've never heard of an adjuster taking that into account on a claim by claim basis. I know I try to close claims quickly but that's just because morons can't stop crashing into each other, and I can't keep up, not because I might get five more cents on a raise someday. I close claims every day as soon as a check is issued. If they never cash it, I could care less. They can call me in six months and complain when their check is no longer valid.
|
|
#
?
Jun 26, 2015 05:28
|
|
|
Here's the specific wording from the offer I received: "I'm pleased to provide you a $9,346.98 offer. This offer is the undisputed repair cost for your damages from this loss. Accepting this offer does not represent an acknowledgement or agreement that the claim is settled and is not a release of future liabilities. If additional amounts are determined and agreed to be owed, we’ll address and pay them accordingly. By writing this letter, we do not waive any of our rights or any of the terms, conditions, or provisions of the insurance policy, all of which are expressly retained and reserved. Further, any activity on our part by way of investigation, determination of damage, or emergency advance payments to you, does not constitute a waiver of our rights. We understand you're retaining your rights as well." So it sounds to me like they're open to further items made against the claim after they consider whether they're applicable. However, I'm still trying to include everything up front so I don't have to go through the process more than once.
|
|
#
?
Jun 26, 2015 05:29
|
|
|
Glass of Milk posted:Here's the specific wording from the offer I received: I'd be hesitant to cash a check even with that language. I'd hold out for your valuation that you had that actually pays for the replacement of your damaged equipment. As another poster said, its about indemnity and getting you a non-functional piece of equipment doesn't quite do that, especially if you have a reasonable (if more expensive) replacement from a professional. EugeneJ posted:I'm 31 and was recently diagnosed with Crohn's Disease - how hard will it be for me to get Long-Term Care Insurance either now or later in life? That one actually comes up on a lot of applications. It'll be tough, but not impossible. I'd go get yourself quoted up NOW as it'll likely only get more expensive from here on out. I'm sorry man, that runs in my family too and I know how bad it can be.
|
|
#
?
Jun 27, 2015 23:01
|
|
|
We are looking at switching from State Farm to Liberty Mutual for two autos and our home. The switch looks like it is going to save us $500 annually which is pretty great. Liberty Mutual is asking us to install their RightTrack car monitoring system (same as Progressives Snapshot) for additional discounts. Does anyone have any experience with these types of devices?
|
|
#
?
Jun 28, 2015 16:42
|
|
|
Jastiger posted:I'd be hesitant to cash a check even with that language. I'd hold out for your valuation that you had that actually pays for the replacement of your damaged equipment. As another poster said, its about indemnity and getting you a non-functional piece of equipment doesn't quite do that, especially if you have a reasonable (if more expensive) replacement from a professional. I am. Tonight I'm going to whip up a big formal mail with documentation to state my case and try and negotiate for an amount that will put me in a "made whole" state. My coworker made a good point, I think. They've said to track my hours working on stuff, which I have. As someone with a low 6-figure salary, I hope the reminder that spending more of my time on this will be costly and that it's worth it for them to come in closer to my desired offer in short order. Doc_Uzuki posted:We are looking at switching from State Farm to Liberty Mutual for two autos and our home. The switch looks like it is going to save us $500 annually which is pretty great. I've never heard anything good about this. If you speed at all, they can use it as rationale for increasing your premium. Plus, do you really want Liberty Mutual tracking everywhere you go in your car?
|
|
#
?
Jun 28, 2015 22:50
|
|
|
Doc_Uzuki posted:We are looking at switching from State Farm to Liberty Mutual for two autos and our home. The switch looks like it is going to save us $500 annually which is pretty great. Glass of Milk posted:I've never heard anything good about this. If you speed at all, they can use it as rationale for increasing your premium. Plus, do you really want Liberty Mutual tracking everywhere you go in your car? It doesn't track speed violations. None of the systems track speed violations...they don't have the metrics to know what the limit is where you are driving. The system tracks if you go over 80 mph, fast braking, fast accelerations, times you drive, and how long you drive. With Liberty Mutual they are erasing a ticket or accident from your record.
|
|
#
?
Jun 29, 2015 03:12
|
|
|
OssiansFolly posted:It doesn't track speed violations. None of the systems track speed violations...they don't have the metrics to know what the limit is where you are driving. I would skip it, personally. I dislike that the government can see this from our phone profiles as it is, I don't want another party tracking me. #TinfoilHats
|
|
#
?
Jun 29, 2015 17:29
|
|
|
Glass of Milk posted:I am. Tonight I'm going to whip up a big formal mail with documentation to state my case and try and negotiate for an amount that will put me in a "made whole" state... Update- I got a call today and they conceded the points I made in my email and are increasing their offer to $11300 from $9300. Very good news- now I just need to review the offer itself and all will be well. Thanks to everyone who helped me figure this crap out.
|
|
#
?
Jun 29, 2015 21:14
|
|
|
Glass of Milk posted:Update- I got a call today and they conceded the points I made in my email and are increasing their offer to $11300 from $9300. Very good news- now I just need to review the offer itself and all will be well. Thanks to everyone who helped me figure this crap out.
|
|
#
?
Jun 29, 2015 21:36
|
|
|
|
| # ? May 13, 2024 17:50 |
|
|
Glass of Milk posted:Update- I got a call today and they conceded the points I made in my email and are increasing their offer to $11300 from $9300. Very good news- now I just need to review the offer itself and all will be well. Thanks to everyone who helped me figure this crap out. Awesome. Being persistent and reasonable will get you far with insurance companies vs "I'll sue you, you're all evil, etc etc etc". SiGmA_X posted:They don't have GPS? For my company they track 3 things: Total Miles Driven Time of day How often you brake hard/accelerate quickly, which is usually keyed to the engine computer on when it has to kick in the ABS or downshift excessively. Thats it, nothing else. For most people its a net positive. I find in my completely anecdotal experience that the people that are most worried about it are the people that ought not have it.
|
|
#
?
Jun 30, 2015 01:44
|
|