RE: Estoppel ?
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RE: Estoppel ? - 9/11/2006 9:06:19 AM
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wscook
Posts: 85
Joined: 4/19/2004
Home base: Orlando, Fl
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Coverage can never be created by estoppel.
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RE: Estoppel ? - 9/11/2006 9:57:12 AM
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catadjmartin
Posts: 5
Joined: 5/13/2005
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There is on old saying among adjusters "You can create esstopel just by ringing a door bell." This is why some insurance companies used to send the "reservation of rights letter" before the adjuster shows up. The best thing to tell insured's is I'm just here to write an estimate of the damages(not to afford coverage).
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RE: Estoppel ? - 9/17/2006 3:07:31 AM
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yumadj
Posts: 71
Joined: 4/19/2004
Home base: Yuma, Arizona
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Estoppel, legally, requires detrimental reliance. This means the insured would have to change his position, to his deteriment, in relying on your representation. However, we all know it takes less than this when the adjuster represents to the insureds that an item is covered. As first party representatives, we have an obligation to the insureds to be open and frank. If there is a coverage issue, I outline the issue to the insureds. I also tell them my job is to scope the facts surrounding the cause and origin of the loss and prepare an estimate. I make it clear to them that any decision re coverage or payment is made by the insurance company.
_____________________________
Jeff Finley
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RE: Estoppel ? - 9/17/2006 11:22:27 PM
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gordon1
Posts: 88
Joined: 9/16/2004
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I was told to put a very extensive caveat at the end of my estimate stating something like the adjuster doesn't have the authority to approve or deny claims or authorize payment. All claims are subect to policy provision & the decision to approve or deny claims from the carrier, etc....I am shocked that just measuring something is considered estoppel. It is part of the policy to allow the insurer to perform an inspection & investigate the facts. Measuring is part of the investigation, isn't it?????
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RE: Estoppel ? - 9/18/2006 1:28:55 AM
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racko
Posts: 228
Joined: 2/17/2006
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quote:
ORIGINAL: gordon1
I was told to put a very extensive caveat at the end of my estimate stating something like the adjuster doesn't have the authority to approve or deny claims or authorize payment. All claims are subect to policy provision & the decision to approve or deny claims from the carrier, etc....I am shocked that just measuring something is considered estoppel. It is part of the policy to allow the insurer to perform an inspection & investigate the facts. Measuring is part of the investigation, isn't it?????
Of course it is...and just as was stated previously (by a PA, at that!) coverage cannot be created by estoppel. Perhaps scope, but not coverage, in my opinion. Now, on a liability claim...I may differ. You're on the right track, your profile shows 15 years experience...don't question yourself too hard now.
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