can insurance companies endanger lives?

[boatpoker]

Originally Posted by valhalla360

NO, the insurance company hired a 3rd party to determine how much they should pay out.

Anything beyond that is incidental and a bonus. The only reason they would have to share is if there is disagreement and you are arguing for a higher payout. Even then, it's about the payout not the specific issues that count.

In all the claims surveys I did, I was told to determine " Cause, Nature, Extent" of damages related to the claim. "payout" was never discussed with me.

I was asked to review estimates and occasionally found them padded by the yard and a little negotiation straightened that out.

Every claim I was involved with,my report was available to the claimant.

[goboatingnow]

Originally Posted by boatpoker

A few decades in the business and this is the first time I've ever heard of an underwriters surveyors report being denied to the insured.

In my lightening claim Pantenious appointed a surveyor to review my claim. I asked Pantenious and FG FG confirmed that unless there was a disagreement , they would not normally give me scraps to their surveyors report.

They confirmed their surveyor accepted my claim and hence paid my claim in full

Sure for all I know their surveyors could have recommended all sorts further professional investigations , so what. The responsibility lies with me to submit a claim and justify that claim. If I needed professional opinions in order to establish that claim. Again that’s up to me.

My insurers renewed with zero mentions of any issues or further requirements.

But at all times the onus falls on me to remain within the parameters of the policy.

I fail to see the OPs point , it’s not the insurers fault to tell him how to ascertain the damages. No doubt Pantaenius would have coughed up for the OPs own professional opinion. Why did the OP not a quote that. To me that’s seems negligent on his part.

[goboatingnow]

Originally Posted by the dude abides

so there have been a lot of questions and chat about roles and responsibilities but no one has brought up this. Say they don't have to disclose anything or really investigate anything, the bare minimum of responsibility. When its time to renew your insurance, should an insurer be renewing with the same insurance when they are in knowledge from their surveyor that this vessel has not been examined fully as he suggested when under a insurance claim?

That’s up to them. The onus is up to you to remain within the conditions of the insurance policy. It’s not for the insurers to tell you that.

[goboatingnow]

Originally Posted by boatpoker

A few decades in the business and this is the first time I've ever heard of an underwriters surveyors report being denied to the insured.

Pantenious confirmed to me that unless there was a claim dispute they would not provide a copy of their surveyors report.in the end they merely confirmed their surveyor accepted my claim and paid in full.

[boatpoker]

Originally Posted by goboatingnow

Pantenious confirmed to me that unless there was a claim dispute they would not provide a copy of their surveyors report.in the end they merely confirmed their surveyor accepted my claim and paid in full.

I guess some due diligence is required before one writes a premium cheque.

[valhalla360]

Originally Posted by boatpoker

In all the claims surveys I did, I was told to determine " Cause, Nature, Extent" of damages related to the claim. "payout" was never discussed with me.

Sure, those go into how much they payout.

If it wasn't a coverable event, the payout is $0.

[goboatingnow]

Originally Posted by boatpoker

I guess some due diligence is required before one writes a premium cheque.

Yes that’s clearly the purpose of the insurers surveyors. He’s not there to help me.

[boatpoker]

Originally Posted by goboatingnow

Yes that’s clearly the purpose of the insurers surveyors. He’s not there to help me.

No he is not there to help you. Neither is he there to help the underwriter.
His job is to determine "Cause, Nature, Extent" ... period.

At no time did an underwriter ever try to influence my work.

[the dude abides]

Its about disclosure and safety. This is taken from the Commonwealth Law website regarding good faith and disclosure. This is Australian Law.

The duty of utmost good faith is central to and regulates all aspects of the contract of insurance, from inception through to the terms of the contract, to each party’s responsibilities in the event of a claim under the contract of insurance. One of the reasons why the duty of utmost good faith was developed under the common law is because often information of vital importance to the insurance contract is only known to one party, for example, an existing structural defect in a building for which the owner occupier wants to purchase home insurance. Under this duty the party possessing the knowledge must disclose all material and relevant facts to the other party to the contract so that the other party can make an accurate assessment of what they are undertaking.

If i was was arguing about payout and I talk about payout and deductions for lightning which are quite heavy, although after being in SE Asia a while I can see why. It must be the highest risk where I am, which makes me think they could in high lightning areas create a lightning product specifically tailored for lightning as it is such high risk and every strike can create a wide range of damage, or non at all sometimes it seems, lightning is undeterminable and things can break over the course of a prolonged period. Also it would give people the option of third party and lightning insurance but I digress

[the dude abides]

also that year I had to undertake a full survey as preconditional for insurance. The year before I had to undertake a rigging survey. Surveys have to be disclosed for both parties so both parties can ascertain the risk.

On a separate issue, would you expect a surveyor to ask for your agreement and then have a section in his report called relevant clauses that deny someone insurance? Do they normally have a section about clauses in their surveys? Digressed a bit

[the dude abides]

This is about disclosure. You asked your insurance company about disclosure and they replied their protocols to you about disclosure. I asked about disclosure and protocols and I was ignored. They did not say "we dont do that and this is the reason why. They didnt tell me anything. At least you got a reply. Well done

[TrentePieds]

I think you are failing to understand the fundamentals or perhaps refusing to accept them: YOUR duty to disclose is relevant both when you make your claim, and when you make application for insurance (via a broker, no doubt). To induce the insurer to accept the bet and issue the insurance policy, that application may well have to be accompanied by a survey. It is the APPLICANT'S duty to find and employ a surveyor to furnish that support documentation. BECAUSE the surveyor is an independent professional, he is, under the doctrine of "utmost good faith", assumed to be scrupulously honest until and unless it is shown that he is not.

The INSURER'S duty to disclose is met by the "wordings" of the policy.

The surveyor's report to the underwriter will state any deficiencies of the vessel found by him to be either contrary to sundry legislation regarding safety, or of such a nature that they would clearly impose a probability of "risks" (in the insurance meaning of the word) materializing that the insurer would be ill advised to accept.

Because YOU are the one OFFERING the insurer the opportunity to bet, it is the insurer's prerogative to say "you are on!" or "not today, thank you" as his mood strikes him. You have no RIGHT to be insured, nor has the insurer any DUTY to insure you.

If something happens to you during an insurance term that is an "insured risk", YOU win the bet, and the insurer settles the bet in gentlemanly fashion. If NOTHING happens to you, the Insurer wins the bet and is entitled to keep your "stake", to wit, the premiums paid so far during the insurance term.

At the end of the insurance term the insured's relationship with the insurer is at an end. The insured (the "offeror") is free to offer the insurer (the "offeree") another bet, and the insurer is again free to say yeh or nay. Normally the insurer will assume that the insured will want to bet again, and will APPRISE the insured that he, the insurer, might be willing to enter into another, new bet if one is offered.

That doesn't alter the fact that the insured, who is no longer insured because the insurance term has expired, is the offeror, and the insurer as the offeree is again free to accept or reject this new offer to bet. The insurer may do as he lists with the offer.

When an insured makes a claim during the insurance term, the insurer is quite free to tell the insured (the "claimant") to "prove his claim", i.e. to place the only for getting a survey on the insured. Indeed, the insurer would be a fool if he did not. That is why the onus is on the insured to hire a surveyor to furnish the professional opinion required to "prove the claim", unless he has some other way of doing it to the insurer's satisfaction, which he won't have. Normal procedure would be for the insured's surveyor to remit his report DIRECTLY to the insurer in order to preclude defalcation by the insured. The report becomes the property of the insurer, and he is quite free to refuse to disclose what is in it. He is also free, having "paid out", if the claim is for an "insured risk" as defined in the policy, to refuse to have anything further to do with the insured because his act, the insurer's act, of "paying out" concludes the bet - the bet he lost. The bet does NOT survive the "paying out"! It does not continue for the remainder of the stated insurance term.

If the insured's claim has been for an insured risk and he has been reasonable in the making of his claim, the insured can look forward to the insurer entering into another bet with him, although at altered odds, i.e. possibly at a higher "premium".

If the insured has NOT been reasonable, the insurer may well refuse to enter into another, new bet with the claimant. That is the effect of the doctrine of "utmost good faith", and would all show wisdom by acknowledging that!

All the best.

TrentePieds

[RaymondR]

In theory the assessor, or loss adjuster, is an independent party whose responsibility it is to ascertain the circumstances of the potential loss. However, the assessor, or loss adjuster, is paid by the insurer and one might suspect that an assessor, or loss adjuster, who persistently found the insurer might have a problem with repeat employment.

Good post TrentePieds.

[boatpoker]

Originally Posted by TrentePieds

That is why the onus is on the insured to hire a surveyor to furnish the professional opinion required to "prove the claim",

Must be different in Canada, here the underwriter hires the surveyor. This does not preclude the insured from hiring his own, tho' I've never seen it done.

PS. I'm in the middle of my first ever claim for about $40k. The underwriter has already ok'd my engine removal for complete dismantling for evaluation. All they are asking from me is a diagnostic report and recommendation from the yard doing the work. after that they will decide if they will pay for the new engine. No surveyor required.

[the dude abides]

Thank you for such a comprehensive reply TrentePieds.

The Surveyors report to the underwriter that will state the deficiencies. In this report what if it is stated that he needs an expert to ascertain the full extent of damage