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JimF
USA
1014 Posts |
 Posted - 02/06/2003 : 10:23:03
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| Here is a thread which will allow adjusters to share their most unusual claim ever handled. There surely are some interesting stories among adjusters which others might find of interest. |
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ckleisch
USA
46 Posts |
Posted - 02/06/2003 : 14:36:17
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Most unusual and funniest claim came in on a accord form as follows basically:
"Accident on Rt 13 North near Salisbury, Maryland. Vehicle total loss due to being struck by a 175lb Tuna. Injuries involved determine subrogation possibilities."
investigation determined a fisherman with open pickup bed and tuna on ice had one frozen fall out back of truck and land on hood of the insured vehicle. Always, thought initial report sounded fishy. Oh by way drivers name was Charlie |
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ChuckDeaton
USA
373 Posts |
Posted - 02/06/2003 : 21:30:56
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Several of us, adjusters, worked a Shell Oil explosion in the Houston area, near Deer Park, TX. As they are want to do citizens were making sensible claims and totally insane claims. One afternoon I went out into the county to inspect a loss. The claimant was claiming that particulate matter fell from smoke from the explosion and had contaminated the water in her swimming pool. As I pull up to a loss site I always take a moment to smell the air and to observe the yard and fences. One thing I am looking for is animals that might attack. On this day I smelled what I thought was strong cat urine and noticed a wide trail inside the low chain link fence. I waited to see what was inside the fence and finally went to the door. After knocking the lady let me in the house, we talked and started out to see the pool. As we started out the back door the lady asked if I minded her TIGER. Yes sirree this woman had a full grown Bengal tiger loose in her yard.
Some time later I was at home, watching the news, and realized that on the news was a story about this same woman and her tiger. The tiger had torn a child's arm office.
Some internet research revealed that there are more pet tigers in Texas than there are wild tigers in India. |
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CCarr
Canada
1200 Posts |
Posted - 02/06/2003 : 21:40:32
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I tried, really did. But when the memories of one bruiser or nightmare filled my mind, a couple more would take their place. Perhaps a short blurb via a few perils or class of insurance; will satisfy the melancholy recollections raised of years gone by to the question posed.
For homeowners, I guess it would have to be a sewer back up claim. A $1M home (based on professionaly calculated RC after the loss), written at $500K on a guaranteed RC basis. Basement (bad name for it) was fully finished to the same quality level as the grade level. It was my first experience with a wood foundation and the 'perimeter canal' created around the slab due to construction technique. The claim came as an ordinary SBU claim in a finished basement, and was opened and reserved that day at $10K. The next day the adjuster calls and is telling me all about the uniqueness of the situation, and trying to suggest a $100K reserve. Many, many unique things, situations, circumstances, and attendences to the site by myself - and 2 months later I'm trying to convince the ivory tower that a best case scenario is $250K, and if all the remediation and circumstances don't proceed perfectly, it could be $400K. There was a total lack of understanding a/o denial of the issues by my peers - they just kept saying how can a home insured for $500K have $400K damage to just the 'finished rec room' in the basement? Executive politics got involved way beyond the parameters of any claims issue, providing in hindsight, a fascinating inner look at the 'dark side' of how the wheel turns. Even today, I gained a little more comfort from the long lingering bad taste I developed. I read an article today where Chubb Insurance spoke of a $400K water loss (not mold) in a single room of a properly insured $700K home.
For a CGL, like a good portion of those claims, it came as a simple notice regarding the insured as a road contractor - 'insured started a forest fire last week after pushing blasted rock for the new highway over the embankment. Fire is out after water bombers called in and crews attended, bills to follow'. How do you set a reserve with that? Got hold of the insured, he didn't have the 'bills' yet, but had got a call from the fire suppresion department of the Forestry Service, telling him bills in the amount of $265K were being sent to him. That is why he reported the claim. Always looking for a chance to be a 'hands-on' manager - I had to have a look and feel for the situation. Rounding up a control adjuster and a forestry engineer, we flew out and met at the nearest small town to the loss site. Being a new highway development through the Rockies, there ws no public access down this 40 mile blasted right of way. How do you explain you took this time, incurred this expense, and only got within 40 miles and know no more than when you started out? So, we arranged to rent a Bell Ranger helicopter, that dropped us in for the day to do our thing and take us back out in the evening (yea for the corporate Amex card). That, plus all the usual intricacies of a liability claim of this type, with a $265K bill hanging over you; made it a great adventure and resolution exercise.
For Auto, it was a commercial fleet - heavy equipment hauler. In a small town about an hour east of Jasper National Park, a tractor with a low boy trailer was hauling a large cat earth mover across the main line tracks of the CPR; and got the trailer hung up on the tracks, and yes a freight train came along - spit the trailer and earth mover off the tracks like you would flick a cigarette butt and then derailed 14 cars. Sure doesn't look good liability wise, and didn't get the claim till it was a week old, and because it wasn't assigned properly, the investigation did not advance in proportion to the dollars at risk. So, 6 months later, we pulled the file and started from scratch, with CPR invoices by the box full amounting to $675K for every imaginable cost and type of claim. This claim makes the list because of the fight with the railway. It was my second time on the bad side of their boxes of invoices. As a corporate entity, a railway was and still is the greatest fabricator of claims I have ever encountered. It was a stiff challenge and a great adventure in many ways to sift the wheat from the chaff, get sufficiently acquainted with the Railway Act, get access to and understand the 'black box' recordings from the lead engine and try and patiently wallow through all the lies and misconceptions they throw at you very authoritatively.
On the D&O side, it was the year the Corporation of the Municipality of Calgary was awarded the Miss Universe Pageant. That municipal committee set up as a not for profit company to plan and administer the event, carried a D&O policy to cover their stupidity. It became a fiasco and the city lost the pageant, and the committee and the directors of it were sued, for many reasons by many entities. It became a very interesting exercise, mostly holding the shirt tail of our defense counsel, as the frivilous claims were sorted and decisions made regarding duty to defend. It was a dry claim, mostly worked in boardrooms and lawyers offices; but a fascinating journey into the economics of the pageant, and the wheelers and dealers behind it. |
Edited by - CCarr on 02/06/2003 21:43:36 |
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Dadx9
USA
143 Posts |
Posted - 02/07/2003 : 11:44:36
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I think the most humorous was while on inside assignment at CNA National Catastrophe Center / Auto. Although not really an auto adjuster, my Supervisor (Sandy) liked the way I handled all the trouble calls.
Anyway.
Some of you may remember the spring of 2000 and all those hailstorms in Shreveport, Louisiana?
I had a loss that evidently the Insured had called in earlier but must have thought wouldn't be covered.
She reported a hail loss. Something in her responses made me question, perhaps she has had previous claims. I excused myself and pulled up her history. I was right! She had previously reported damage, but the claim was closed without anything being done.
Previous claim - "While in attendance at a Grambling State football game, the Grambling State University marching band marched over and on top of the insured vehicle".
I called Mrs. Insured and asked her about the previous claim? She said she didn't rightly now anything about that claim. I asked her if she noticed the damage (including footprints)? Nope, not till the hail came.
Still brings a smile to my face.
Also, at CNA, I received the moniker BIG DADDY. For obvious reasons. I had one customer who were Big Daddy Odell and Big Mama Udell. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
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Jimbo
USA
10 Posts |
Posted - 02/07/2003 : 13:32:36
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| The most unusual insured name: Richard N. Hand. The first time I saw the claim I thought it was a joke. |
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Janice Toll
USA
40 Posts |
Posted - 02/07/2003 : 13:47:51
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My most unusual claim ever was during Hurricane "Andrew". I was assisting Tom, before I started working on my own, and it was actually several aircraft claims. Admittedly, I knew very little about handling aircraft claims, but in this one instance I was quite invaluable in assisting Tom.
Prior to "Andrew", at Homestead General Airport, 57 airplanes were moved into one large hanger, approximate 300' X 120', for safety. What no one could have foreseen, was that a tanker truck, parked about 100 yards away and fully loaded with fuel, would blow over and slam into the side of the hanger. When that occurred, all 57 planes were blown to the west end of the hanger on top of each other. Most were either total losses or extensively damaged.
Tom was handling claims on 12 of those planes, and had to identify by "N" Number and aircraft serial number, usually located on the pilot's left door post. In Tom's words, he could not get his "lard a_ _ in the jumbled up mess.
I, being a "little" bit smaller, was able to accomplish this task of locating the numbers by crawling over, under, and around the debris with a polaroid camera - with the flash turned off. There was aviation fuel in the tanks of the aircraft, and on the floor, due to the tanker truck spilling its 8,000 gallon content. The airport fire department and the town fire department were present in the event of a mishap (EXPLOSION!).
At the time, and in my willingness to help, I did not fully realize the seriousness of the situation, nor did I understand why he wanted me to turn the flash off. He was very patient in explaining why. Just proves we'll do some strange things to work a claim.
Tom has always done whatever is necessary to execute the loss and instilled that in me, therefore I had no hesitation in taking the necessary risk, as that's what we do as adjusters.
Unbelievably, there was one Piper Commanche tied down with ropes, approximately 200' from the hanger, that sustained absolutely no damage - not even a scratch. GO FIGURE!
Below is a photo of some of the wreckage in one area on the west wall.
Image Insert:
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Janice R. Martin-Toll |
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JimF
USA
1014 Posts |
Posted - 02/07/2003 : 14:02:13
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Janice, do you and Tom still handle aviation claims from time to time?
And can you talk Tom into perhaps opening a new topic thread to discuss this often overlooked but highly specialized area of claims adjusting?
I'm sure the nuances of this specialty claims area would especially require the skills not possessed by most of us, including an understanding of flying and likely a pilot's license. Please tell us more.
Tom seems the only one around here with the background and experience in aviation to allow others to learn through sharing his knowledge. What do you think? |
Edited by - JimF on 02/07/2003 14:05:41 |
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Tom Toll
USA
154 Posts |
Posted - 02/08/2003 : 00:09:29
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Jim, it has been a while since I have investigated an aircraft accident, which leads me to the most interesting claim I ever worked. This claim was really the topping on the cake and one reason I lost interest in aviation investigation.
Early 1982 I was at my office at the North Little Rock airport in the terminal building which I leased from the city. I had a scanner and would listen to it from time to time. Several GADO (at that time, general aviation district office) and members of the FAA were friends of mine. I heard on the scanner that a plane had gone down just south of Hot Springs. I called a friend of mine at the GADO office and learned he was being dispatched to locate the wreckage. He asked if I would fly over and meet him at the Hot Springs Municipal airport, which I agreed to do. He was driving and had given me some co-ordinates for the approximate sight of the wreckage. It being only a few miles south and west of town, I decided to make a few passes in that area to see if I might spot the wreckage. After 3 or 4 passes, I was able to spot what was left of the plane. I always carried toilet paper with me for events such as this. Needless to say I threw out the paper just before the wreckage and it left a paper trail in that general area, hopefully to make spotting it on the ground easier. I owned a 1964 "G" model Cessna 182 with a STOL kit on it and could fly safely at 42 knots, so throwing the paper out was a safe procedure.
I met Archie at the airport and having flown the highway back to the airport, had a general idea where the wreckage was. I rented a car, as I was not allowed to ride with an FAA investigator. I followed Archie and was giving him signals from behind, when I felt we were on the right roads. After several hours of hit and miss, we finally spotted the toilet paper in the trees. From there it was easy to find the wreckage of the twin engine Piper Commanche.
Archie had told me this was a IFR training flight out of Tulsa. There were supposed to be four souls on board. One an IFR certified instructor, his student, and two friends of the student. There were four souls on board, we could tell by looking at the red pile of meat that four heads were visible. The plane had impacted the ground in a straight down attitude and dug a hole about 5 foot deep. You could not tell that humans were on board they impacted so hard. We began looking around and I found a pipe that looked unusual and a bag of, what looked like cigarette tobacco, but it did not smell like tobacco. Archie smelled it and said it was pot.
My beeper went off from my office manager with a certain code to indicate there was a new loss assignment, (didn't have cell phones then). I felt it was probably this one, so I stayed until the NTSB boys arrived. They roped the area off and then would not allow me to inspect any further. No thanks for helping find the wreckage, or any kind of howdy do. They had the right to do that, so I did not say anything. It was beginning to get dark, so I said my goodbyes and left. Sure enough, it was that crash that I was assigned.
Archie called me at home that evening and told me that both wings had separtions and could not be found in that general area, which might indicate an in flight airframe failure. I was not representing the manufacturer or engine manufacturer, but needed to determine why the wings broke off. I called a friend of mine that had also been in the CAP and was a good spotter. We took off and headed back to the crash sight. Again I armed myself with several rolls of toilet paper, (see, its good for several things). After many fly overs we spotted both wings and papered them. We landed at the HS airport and rented a car to go to the sight. The Board boys were there, as was archie. They had seen us flying around and saw the paper discharged and had walked to the areas where they found the wing panels. They had broken off clean, with very little metal twisting, which would indicate a high speed break.
The bodies? had been sent for an autopsy and toxicology. It was later discovered that all four remains had high concentrations of marijuanna. Their filed plan was for 10,000 feet. Needless to say the air is less dense with less oxygen. We discovered through research that the lungs absorb pot at high altitudes very quickly. In other words, the four souls on board were very intoxicated with marijuanna. They never declared an emergency, just disappeard from controls screens.
I had to deal with the wives of the instructor, student and occupants and that was brutal. They were all married, all had children, and all were gainfully employed. How do you tell someone that their husband had a total disregard for their family's lives. I was raising four girls by myself and got very emotional with this crash. I never could understand why people let dope ruin their lives and really had a hard time with this one. After having investigated a number of fatal crashes and unfortunately viewing bodies too long, I decided to leave that end of the adjusting field. I sold my company six months after that incident and have never regretted it. I still fly, but not as often as I would like to.
Airplanes were a part of my family. I soloed in an old PT-19 my dad had bought after WWII. That was my 13th birthday present and have been flying ever since and will continue to do so as long as I can. It has been a while since I have been at the controls, but that is something you never forget, just like adjusting, it gets into your bloodstream and you can't let go. Janice knows when we are working a loss and an airplane flys over that I am going to look. I hope I have not bored all of you with this story.
Oh, by the way, the engines were fine, the airframe was fine, as was all instrumentation. The pilot and instructor just lost control, did a death spiral, causing too much g-force on the wings, and they separated just aft of the engines. In other words, they were riding a bullet straight into the ground. The engines were running at full rpm when it hit.
Ten years later I was asked to be the Florida and Carribean aviation manager for a company. Janice and I talked about it and decided to take another adventure. She was appointed office manager for that company. That was in 1992 and then the big one hit. After working claims on 47 aircraft,I was then pressed into service to work commercial property claims. That is another story. That was the last time I worked aviation losses.
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KileAnderson
USA
875 Posts |
Posted - 02/08/2003 : 00:20:56
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| No, Tom, I don't think you bored anyone at all. As someone who has dreamed of flying since I was a boy I envy you. I've taken a grand total of 2 lessons and if time and money every permit I will pick it up again. |
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JimF
USA
1014 Posts |
Posted - 02/08/2003 : 08:13:17
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Tom that was a story which riveted my attention to each and every word.
But you mentioned your entry into the wonderful world of commercial property claims during Hurricane Andrew, and I 'smell' an equally interesting and informative story from you there as well. Please share your story so others may learn!
Thanks Tom for highlighting your experience with such a gruesome and sad aviation loss. |
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Dadx9
USA
143 Posts |
Posted - 02/08/2003 : 08:39:44
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Tom,
A slight detour. I am currently reading the last two chapters of 'The Cannibal Queen' by Stephen Coonts. His story of his cross country adventure in a 1942 Stearman. A great read for those who love to fly.
Thanks for the detour.
Don |
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JimF
USA
1014 Posts |
Posted - 02/08/2003 : 08:46:36
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Don's comment about The Cannibal Queenand your reference to the plane crash in Hot Springs, made me think as well of an interesting book which I read recently too. Hot Springs by Stephen Hunter was supposedly a fictional story based on the real world of Hot Springs, Arkansas back in the good old days. A easy read you just can't put down, interesting and worth reading.
Sorry I went off topic. |
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ChuckDeaton
USA
373 Posts |
Posted - 03/15/2003 : 08:48:25
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How about a turkey fire in a limestone cave.
CNA insures the cave and ConAgra has 10 million pounds of stored frozen turkey. |
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CCarr
Canada
1200 Posts |
Posted - 03/15/2003 : 08:53:32
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| Chuck, there is going to be some bones of contention. |
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ChuckDeaton
USA
373 Posts |
Posted - 03/15/2003 : 09:03:13
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| Yes, the feathers are going to fly. |
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What is the Most Unusual Claim You Have Handled?
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