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HELP! Insurance Problem.

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Old 08-19-2010, 10:24 PM   #1

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Exclamation HELP! Insurance Problem.

Last week while vacationing on Lake Vernon in Huntsville Ont, we had an unfortunate accident with our Mariah. With 4 people in the boat, and a water skier in tow at about 20 MPH, we hit something in the water below the surface. We heard and felt a big thud under the boat. The engine kept running so we went slowly back to the dock.

I pulled the boat of the water with the trailer, and found a bent prop shaft, scraped paint on the lower unit, and a broken gimbal ring. Our boating was obviously done just two days into our vacation.

I took it to a local Marina, and the repair estimate was just over 4K with tax. The engine has to come out to change the gimbal ring, and the drive has to be torn apart to replace the bent prop shaft.

Because of the value, my insurance company [will not say which one at this point] wanted to send an adjuster to look at the damage before they agreed to repair it. Next thing I hear is the adjuster does not believe that the damage was caused by any kind of impact, and they are disputing the claim!! I asked him what did cause the damage then and he had no answer...

I asked to have the claim escalated to a supervisor, and he is supposed to contact me tomorrow.

Any advise as to what to say or do to get them to pay up? I don't have an extra $4K lying around to fix it!

Thanks,
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  • Old 08-19-2010, 11:13 PM   #2

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    Default Re: HELP! Insurance Problem.

    Look at the fine print in your policy.If anything works in your advantage then call them out on it. You like me will have to do research in order to avoid lawyer fees.
    Its were i would start.Hope it helps.

    Sorry to hear and good luck.
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    Old 08-20-2010, 12:44 AM   #3

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    Default Re: HELP! Insurance Problem.

    hi Mike

    Stick with your story and be adamant about it. Talk to the mechanic at the shop and ask him what he thinks happened. Ask him what the damage appraiser said. Before you go off the deep end on the appraiser or his/her supervisor, find out what reason they have for disputing what occurred.

    At this point i wont ask which insurer since i work for one here in Ontario & they do boat insurance.....
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    Old 08-20-2010, 01:07 AM   #4

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    Default Re: HELP! Insurance Problem.

    The ironic thing is I have been with this same insurance company for many years. I have two boats with them, two automobiles, and my house. I have never had a claim with them, and they have the nerve to do this?!?!... They are basically calling me a liar without actually coming out and saying it...

    There is no damage to the skeg, which I too was surprised at. The hull was not touched. Whatever the drive hit, it glanced off of the side of the drive, which broke the gimbal ring, and bent the prop shaft. The SS prop was not damaged as far as I can tell.

    At this point I could care less what the appraiser thinks... I was there, along with 5 others who heard and saw it happen.
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    Old 08-20-2010, 01:56 AM   #5

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    Default Re: HELP! Insurance Problem.

    Quote:
    Originally Posted by 300sflyer View Post
    The ironic thing is I have been with this same insurance company for many years. I have two boats with them, two automobiles, and my house. I have never had a claim with them, and they have the nerve to do this?!?!... They are basically calling me a liar without actually coming out and saying it...

    There is no damage to the skeg, which I too was surprised at. The hull was not touched. Whatever the drive hit, it glanced off of the side of the drive, which broke the gimbal ring, and bent the prop shaft. The SS prop was not damaged as far as I can tell.

    At this point I could care less what the appraiser thinks... I was there, along with 5 others who heard and saw it happen.
    Again, talk to the mechanic and ask him what he thinks happened and also ask him what the appraiser said to him. Ask the mechanic if he will put his opinion in writing. If necessary, have a 2nd mechanic examine it. It sounds like the appraiser has seen something that is making him think there may have been some sort of a mechanical failure (rather than an impact) and you may have felt that as your 'bump'. He will very likely have discussed the findings with the mechanic. If the mechanic is backing up your version and believes some form of impact caused the problem, the insurer will soon realize it will be a tough go of it to deny the claim and will usually give the benefit of doubt.
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    Old 08-20-2010, 01:23 PM   #6
     
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    Default Re: HELP! Insurance Problem.

    I agree with MikeyT. Definitely get the mechanic to give his opinion. Insurance adjustors typically are not experts in mechanics and repair unfortunately. Maybe get the marina to draft a written suggestion as to what may have caused the damage (??). Keep on them about it and take it to the highest level you possibly can.

    Also, try to be as nice as you possibly can, even though you're rightfully upset. You catch more flies with honey than with vinegar, so really try to sweet talk them
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    Old 08-20-2010, 08:18 PM   #7

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    Default Re: HELP! Insurance Problem.

    I spoke with the insurance company supervisor, and they are denying the claim.

    I am so pissed right now, I dare not type anything further... Except to say it looks like it is time to speak with a lawyer...
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    Old 08-20-2010, 08:38 PM   #8
     
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    Default Re: HELP! Insurance Problem.

    Oh man.. so sorry to hear that. I don't see why they denied it since that is a fairly common occurrence after an impact. My boat shop has done 7 of these jobs in the past 2 months. Might as well tell us the insurance company, imo.
    Best of luck to you.
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    Old 08-20-2010, 08:51 PM   #9
     
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    Default Re: HELP! Insurance Problem.

    Have you tried what the others suggested: Talk to the mechanic to see if he has any clue as to why this might be?

    I've no wish to make you angrier, and I'm certainly not doubting your word, but, from the outside looking in, so to say, I think the rest of us can see why the adjuster might be skeptical. All that internal damage and no external evidence of a strike? You said you found that surprising, yourself. So put yourself in your insurance company's position. They weren't there. All they have is your word (so far as we know) and, tho you may be Mr. Integrity, himself, they have plenty of customers who aren't.

    Jim
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    Old 08-20-2010, 09:16 PM   #10

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    Default Re: HELP! Insurance Problem.

    Quote:
    Originally Posted by 300sflyer View Post
    I spoke with the insurance company supervisor, and they are denying the claim.

    I am so pissed right now, I dare not type anything further... Except to say it looks like it is time to speak with a lawyer...
    I hear you Mike but Jim's comments are spot on. You have to make sure of the cause first before you go speaking to a lawyer etc. or you will waste your time & money. Do what i suggested and find out what it is they found that makes them suspect it was not an 'impact' that caused the problem. This means speaking with the mechanic involved! It's not unheard of for an internal mechanical failure to have caused the problem and the failure could well have caused a "bang / bump" and resultant similar feeling of an impact and i suspect that is what the insurer is basing their opinion on. The insurers are not afraid of the threat of a lawyer and will only change their position when there is evidence that an impact or some other external force was the cause. If you have that evidence & the insurer will not change their position, then its time to speak to the insurer's ombudsman or a lawyer. The ombudsman will review the evidence with the claims manager. The lawyer (if used) will make use of that evidence along with things like witness statements to resolve the matter with the insurer. In that situation, the insurer usually ends up covering the insured's reasonable legal costs too if you are successful. If not, its your dime.
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