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darock
USA
1 Posts |
 Posted - 04/14/2003 : 07:52:17
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ok I live in Michigan, on 12/31/02 I was in my home and I put my foot through the floor, I called the ins company to file a claim. I read my policy and it covers collapse due to hidden decay. The insurance company never sent an adjuster out, the adjuster called a contractor she knew and he did the estamate and it was denied. Well we found decay in the floor joists, and main beam as a result of my going through the floor, I live on a crawl space and now one of the floor joist are laying on the ground. I have H03 4-91. What should I do now I feel like they dont care that we have never filed a claim before and that we have always paid our premiums.
Angie |
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JimF
USA
1014 Posts |
Posted - 04/14/2003 : 11:14:05
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You should send a letter to your insurance carrier by registered mail with a copy to the Michigan Insurance Commissioner requesting that the carrier fulfill the obligations of your insurance contract by sending out an adjuster for an inspection of the loss.
You may also want to engage a structural engineer to inspect and write a report which you can also send to the carrier.
There is really not enough information contained within your post to make any kind of coverage determination here, nor would it be realistic nor feasible to do so without an inspection.
Out of curiousity, what did your insurance company say and what reasons were given in denying your claim?
Please recall that "collapse" is not a "peril" under the insurance policy and results from some other event, fortuitous or otherwise, and there are exclusions which may come into play to effectuate denial of a claim.
Good luck and please keep us posted of what happens. |
Edited by - JimF on 04/14/2003 11:14:54 |
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william s cook
53 Posts |
Posted - 04/14/2003 : 20:35:24
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Sorry Angie, but I may have bad news for you. If your entire home has not fallen down or caved in and is not a pile or heap of rubble a collapse loss has not occurred and collapse coverage will not respond to your claim. It appears that collapse has been construed to have the above meaning in your state.
See the most recent case law in Michigan. The information provided should not rise above the legal advice of a licensed attorney in your state.
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Pioneer State Mutual Insurance Co. v. Splan, No. 220477 (Mich.App. 03/18/2003)
[1] STATE OF MICHIGAN COURT OF APPEALS
Under the commonly-used definition of the term set forth in Section II, a collapse did not occur because the house did not fall down or cave-in, suddenly crumble or break down. The plain and ordinary meaning of collapse also contemplates a sudden event which, in this case did not occur. Rather, while a cave-in may well have been "imminent" after the Splans filed their insurance claim, the record reflects that the damage began, at the latest, in December 1993 and continued for months until the Splans installed temporary bracing. Further, as described by Roswell Ard, the damage appears to be excluded under the explicit terms of the policy because the initial crack in December 1993 triggered the sagging, "settling, cracking . . . [and] bulging" which resulted in the Splans' insurance claim. Again, if the terms of the policy are clear and unambiguous, "[w]e will not hold an insurance company liable for a risk it did not assume." Frankenmuth, supra at 111.
*fn4 Clearly, the policy excludes coverage for the damage at issue here.
Just my thoughts others may have differing opinions or observations.
William S Cook
Public Adjuster
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Edited by - william s cook on 04/14/2003 20:36:57 |
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