Neighbors House Caught on Fire and Mine Received Damage Due to the Fire...

[BigIVU]

My fault, not his. When I provided the scenario, I left out the part about the loss being within the deductible.

 

[joebob]

i'm looking at my condo insurance and it has sections A through F. for A and B it says "not cov". is that normal? below that section it has about 10 "endorsements".

 

[BigIVU]

An "ISO standard" HO-6 condo policy has no Coverage B for Other Structures, but usually there is SOME Coverage A, either a little or often a lot.

 

[Accelerated]

(not legal advice disclaimer)

You have a "gap" in coverage $0 on your policy and HOA starts at $5K. So any loss under $5K you are gonna have this problem. I would be raising this question to who sold you the policy.

I would bring a small claims suit against owner of property of fire, tenant (if applicable) and agent/company that sold you the policy.

Small claims in many jurisdictions is very plaintiff friendly (you) and very anti-insurance (them). It should be fairly low cost to file and time off work. In certain jurisdictions, you can even serve "discovery" requests - google it but essentially you can ask them for information - finding out cause or even origin of fire very beneficial.

good luck & switch agents (or companies if direct writer) immediately - they screwed up here.

I think you did not read the scenario as well as you could (and should) have before offering up advice to take people to court. My issue with your post is not that you advised litigation, but the parties against whom you advised it. You named everyone except the party with which there is an issue, lol.

The dispute is between him and his HOA, not anyone else. There is no "gap" in coverage; the HOA simply does not want to absorb their deductible and is trying to get someone else to foot the bill.

As an independent adjuster, I am one of the quickest people around to find (and point out) the mistakes that agents occasionally make, and I see absolutely nothing like that here. There was no "screwup" on the agents part. The agent insured the risk that the insured actually owns, and did not extent coverage to someone else's property (that being the condominium).

If you read a bit back in the thread, I am pretty sure I spelled out "unit boundaries" in a manner that you should be able to grasp, and the agent would have "screwed up" if they had insured anything beyond those boundaries.

 

[xrac]

Another issue with litigation is that in some states there is a dollar limit on the amount you can seek in small claims court. In Indana it use to be $3,500.

 

[Accelerated]

HOA doesn't have to "foot" the bill - they have bylaws for a reason - and they (HOA) decided to have a $5K deductible - it is up to each individual unit owner to "close" the Gap in coverage by carrying the proper Coverage A. The agent/company not reviewing these documents is in itself an "error or omission"

Lets review what the HO-6 policy language actually says shall we?

COVERAGE A – Dwelling
We cover:
1. The alterations, appliances, fixtures and
improvements which are part of the building
contained within the "residence premises";
2. Items of real property which pertain exclusively to
the "residence premises";
3. Property which is your insurance responsibility under
a corporation or association of property owners
agreement; or
4. Structures owned solely by you, other than the
"residence premises," at the location of the
"residence premises."
This coverage does not apply to land, including land on
which the "residence premises," real property or
structures are located.
We do not cover:
1. Structures used in whole or in part for "business"
purposes; or
2. Structures rented or held for rental to any person not
a tenant of the "residence premises," unless used
solely as a private garage.

7. Other Insurance. If a loss covered by this policy is
also covered by other insurance, except insurance in
the name of a corporation or association of property
owners, we will pay only the proportion of the loss
that the limit of liability that applies under this policy
bears to the total amount of insurance covering the
loss.
If, at the time of loss, there is other insurance in the
name of a corporation or association of property
owners covering the same property covered by this
policy, this insurance will be excess over the amount
recoverable under such other insurance.

As I said earlier, the articles of incorporation and bylaws should clearly define what the "residence premises" is.

I don't see anywhere where "unit" was defined unless you include your post ASS-U-ME ing what the unit is as defined in the by-laws.

It was not defined in this thread, and if you paid attention, I made no assumptions about any particular bylaws. Instead, I gave an example of bylaws that I have encountered, and stated that if he has similar bylaws, the boundaries of the unit would be defined clearly. Assuming that the bylaws say something different would be as careless as you implied that I was.

I think the interesting question is what your "insurance responsibility" as defined by the by-laws - if vague or silent - then the HO-6 pays.

Again, since we do not know what the bylaws say, or how a unit or premises boundary is defined within the bylaws, we cannot assume that the bylaws are "vague or silent".

I believe this a forum primarily for agents - agents have an obligation to "close" gaps in coverage - and inherently that is every condo/HOA type situation - agents should be requesting this documentation prior to binding policies.

It is indeed a forum primarily for agents. That said, when discussing claims related questions, I would think that any agent would appreciate insight from those of us who actually handle the claims side of the business. If that is not the case, the moderators and creators of this forum are more than welcome to request my silence here.

I do completely agree that agents should be requesting docs prior to insuring a risk, but it not an agents responsibility to try to offer a coverage to an area not owned by the insured.

Until the bylaws are shown to us, the argument is pointless, and telling people to go to court and/or file claims against their agents for improperly insuring a risk, when we do not know that to be the case, is completely irresponsible.

 

[Norwayguy]

As I said earlier, the articles of incorporation and bylaws should clearly define what the "residence premises" is.

It was not defined in this thread, and if you paid attention, I made no assumptions about any particular bylaws. Instead, I gave an example of bylaws that I have encountered, and stated that if he has similar bylaws, the boundaries of the unit would be defined clearly. Assuming that the bylaws say something different would be as careless as you implied that I was.

Again, since we do not know what the bylaws say, or how a unit or premises boundary is defined within the bylaws, we cannot assume that the bylaws are "vague or silent".

It is indeed a forum primarily for agents. That said, when discussing claims related questions, I would think that any agent would appreciate insight from those of us who actually handle the claims side of the business. If that is not the case, the moderators and creators of this forum are more than welcome to request my silence here.

I do completely agree that agents should be requesting docs prior to insuring a risk, but it not an agents responsibility to try to offer a coverage to an area not owned by the insured.

Until the bylaws are shown to us, the argument is pointless, and telling people to go to court and/or file claims against their agents for improperly insuring a risk, when we do not know that to be the case, is completely irresponsible.

Love having an adjuster on here.

 

[Accelerated]

So you do you expect all of these issues to be resolved - a strongly worded letter?

The OP has $0 for coverage A - and it is clear no matter the loss it is under the policy deductible - the by-laws are only important in a claim vs. the agent (i.e. $0 Coverage A is an error).

The suit against the neighbor is relevant as to the cause of the fire- which without going into further details is the only avenue to determine the cause.

Irresponsible is your response - mine gets an answer one way or another. But your arrogance is astounding.

Are we talking about the OP or the condominium post now? We were talking about the condominium one posted by Joebob later in the thread, as were were talking about the bylaws that none of us has seen, and none of us (except maybe Joebob, since he probably has taken the time to read them by now) knows the content of.

With regards to the OP, if the OP had insurance, it would be a non-issue, as any subrogation against the neighbors policy would have been handled by the carrier. On similar losses though, barring intent or accident by the neighbor (such as burning leaves or igniting a turkey deep fryer) when there is no determined C&O, each carrier will generally just pay the claim on their insured's policy. Sure, the OP can file suit, and pretty much anyone in their position would do so. I can tell you from experience what the likely result would be, absent a good C&O report that indicated negligence on the part of the neighbor though. Lots of legal fees and a burned out house (unless the neighboring carrier decides to settle for less than defense would cost, which does occasionally happen). Absent proof that the neighbor or neighbors carrier is liable, which according to the OP, has not yet appeared, it does not look good for the OP. This is why in similar situations, carriers tend to simply pay the loss out on their own policies. A long legal battle regarding who was responsible for what, when there is no clear answer, is an expensive gamble.

With regards to the post by Joebob about his condo association, who would you recommend he sue, and for what? Since you do not know what the bylaws say, and we have yet to determine unit boundaries, telling him to sue everyone and anyone without knowing how those bylaws define unit boundaries is indeed irresponsible.

As far as determining the cause of the fire, you could simply go down to the local fire department and secure the fire report (at least for Joebob.. according to the OP, the fire report was incomplete with regards to the C&O on the OP's loss).

What if Joebob does not even own the exterior of his condo? About 75% of condominiums retain exterior ownership per their bylaws (number based on the vast number of HO6 losses and investigations that my company has handled on a national level).Are you recommending that Joebob sue the neighbor, neighbors tenant (if applicable), his agent and his carrier for damages to property that he may not even own?

Chances are very good, based on Joebob's description of the condos ("our complex is about five physically separate buildings each of which has 2-6 units in it"), that his condominium has bylaws similar to the 75% that I mentioned earlier. Still, until we know for sure what the unit boundaries are, it would be irresponsible to advise anything beyond "find out what the boundaries are and see if it is actually your problem, or even your property for that matter".

How in the world does saying "get a little more information before you advise people to sue everyone who comes near" equate to "astounding arrogance"?

Are you even an agent?

 

[Accelerated]

The arrogance part is in respect to other's point of view that differs from yours is automatically ridiculous and should be discarded immediately.

So you accusing the agent of incorrectly insuring Joebob, when you had zero knowledge of whether or not Joebob was properly insured, and then advising Joebob to file claims against his agent and the carrier that sold him the policy was not irresponsible?

Yes, I do indeed think that the idea as you presented it was ridiculous and should be discarded. If you want to toss out advice to take such decisive action, and in the process, venture into the possible realm of libel (we will not know that until we know if Joebob was properly insured though, so I won't outright accuse you of it), you should be very sure of your information, or you should articulate your thoughts in a much better manner. If you consider it arrogance to point out the BS, so be it.

 

[InsuranceHelperGuy]

Best of luck to you my friend. Why you don't have insurance on your home is anyones guess. I'm sure for future reference you won't do this again.