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6 Insurance Claims So Crazy They Must Be True

Posted By Patricia Harman, Shawn Moynihan, Thursday, December 28, 2017

by Patricia Harman and Shawn Moynihan, PropertyCasualty360.com, December 22, 2017

Members of the NAIIA Share Some of Their More Memorable Claims

Property & Casualty adjusters encounter plenty of mundane claims: flooded basements, trees falling in attics, and cars backing into one another at the grocery store. But every adjuster has at least one unusual claims story. You know — the ones that are shared over drinks at a conference or during lunch at an industry event.

The stories are probably embellished a little over the years, but they’re memorable because of the situation or the policyholders involved.

1. Slip-sliding away

Everyone knows about floater policies, but this tale takes it to a whole new level. David LeNorman, senior investigator and adjuster for Alaska Adjusters in Anchorage, recalls one homeowner’s claim that literally went off the rails.

The family who owned the property in question were longtime residents of the village of Aniak in Western Alaska. Some 60 years prior, the claimant’s father had built a 1,000-square-foot store and the family lived above it. Not too far from the structure, a river flows.

In Alaska, a “break-up” is what happens when ice breaks up, typically in the spring, and travels down river. Several immense blocks of ice had created a dam that blocked the water behind it, causing the water level to rise in the river by the store.

“The family was watching TV and said they felt like the house was floating,” LeNorman recalls. The structure was indeed moving, as it had been built atop a series of logs; the sediment at the location was too sandy to build on without having a solid foundation to hold it in place.

A corner of the store was damaged, and the entire building shifted about 3 feet. Luckily, the store had been placed it on the riverbank near a rock outcropping; a corner of the platform got caught on the rocks, which protected the store from floating away down river.

“How many people can say they were sitting there watching TV, and an iceberg floats by the window?” LeNorman quips.

2. The 300-pound stripper

When Mark Nixon, president of St. Louis-based Nixon and Company, was a new adjuster, he experienced one of his more memorable claims. “It was a sewer backup,” he recalled. “I called and made the appointment with the policyholder.”

When he arrived, the woman took him downstairs to the basement to see the damage. “It was a legitimate claim. She had some evening gowns and other items that were in a basement and had been damaged.”

As he was reviewing the claim, the policyholder mentioned that she needed her wedding dress for Saturday. Nixon thought, “Oh no — she’s getting married on Saturday.” When he asked for more details, she told him she had an event and handed him a business card that read, “The 300-lb. Stripper.”

It turned out that all of her dresses were costumes for her act. She gave him a brief demonstration and said, “Usually I do adult-only parties, but for you and your friends, I’ll do it all.”

Needless to say, her offer left him speechless. He took her card and said thank you.

3. Mountaintop retrieval

Northern Adjusters Inc. serves all of Alaska with claims handling and administration; one of the tag lines on its website reads, “For over six decades, we’ve traveled to remote villages and crossed glaciers to get the job done.”

On one such mission, agency principal J.D. Daniels had to retrieve a wrecked four-wheeler (ATV) off Crown Pointe Peak, located near Moose Pass, Alaska. It was a task that involved Daniels and a colleague transporting their own ATVs 100 miles, unloading them, and then riding them up to about 4,000 feet, the elevation of Crown Pointe.

During the ascent they had to pass through a miners’ site at the base of the mountain, and the miners didn’t exactly feel the intruders belonged there. They purposely made their sidearms visible, and in a very gruff manner let the interlopers know they didn’t want Daniels to take the ATV off “their” mountain.

The miners knew where the vehicle was and had put together their own plan to retrieve it, Daniels explains: “This didn’t include us, and there was a very awkward and antagonistic conversation that took place. They made it very clear that they would challenge anyone for the ATV.”

The insurance carrier needed to retrieve the ATV before it faced an environmental claim from the government, as it was on federal land. But the miners were less than impressed with the adjusters’ predicament.

Seeing that the conversation was going nowhere, Daniels finally put his boot down and stated that they were going to get back on their ATVs, pass through the miners’ site and retrieve the wrecked ATV from the top of the peak, like it or not. Things were getting tense.

Whether the miners were unprepared or impressed by such boldness, they let the “insurance guys” pass through the site, unharmed. “Later that day as we were retrieving the ATV, a group of the miners had made their way to the site and were watching our every move,” Daniels relates. “But honestly, I think I was more scared of encountering a moose or a bear along the way so I was relieved that neither of those crossed our path!”

If another adjuster should find himself or herself in the same position, what advice would Daniels give them? “My advice would be that it is best to communicate openly and firmly,” he adds. “If you find yourself at an impasse, take the action you have openly communicated.”

4. Madame Butterfly

A young woman had been in a car accident that involved her T-boning a truck that was making a left turn in front of her. Nixon received the claim and the insured gave him the address where they should meet.

It turned out to be a biker bar in rougher part of town. Dressed in khakis, Nixon felt as awkward as he looked. Fortunately, the bar was relatively empty when he entered.

“It looked like a set out of the movies,” he described. “The jukebox was playing ‘Bad to the Bone’ pretty loudly, and there was a woman in the back of the bar in a completely see-through negligée.”

Nixon noticed that she had a giant butterfly below the waist, but the more immediate problem was, how would he get a recorded statement from a scantily clad woman?

As he was asking her about the accident and getting the details, Nixon thought he was being careful to just look at her eyes. “In reality, I was looking at her butterfly.” She noticed where he was looking and casually said, “It’s a butterfly.”

5. Mice in the house

Usually, a mouse or two in the house isn’t a big deal. But one couple had an experience that’s worthy of a horror movie.

The couple were married and left for a month-long trip to Greece. While they were away, the power went out and their upright freezer defrosted. The food coagulated and spilled out onto the garage floor.

Nixon received the claim and learned that the couple’s house was infested with mice from the freezer melting. “When I arrived, the house smelled like it was infested by mice. I told them I didn’t think they had coverage because it was damage from rodents.”

The claims manager confirmed that the couple did not have coverage for the loss, but the claim was escalated to someone else at the insurance company who said the company would pay for the loss.

Nixon went back to the house and assessed the damages. An exterminator was hired, and he stopped by daily to remove literally dozens of mice. When Nixon was talking to the exterminator, he learned that mice don’t usually eat meat. “Are you sure the house wasn’t infested before?” asked the exterminator as he pointed out the field behind the house.

Nixon held up the claim again, but it was reinstated. The damage to the house was substantial. “Mice were eating the bait and going into the walls and dying,” explained Nixon. The ceilings, walls and carpets had to be pulled out because the entire house was infested. By the time the job was completed, the exterminator had pulled hundreds and hundreds of mice out of the house.

But that’s not even the end of the story …

6. Fluffy is missing!

While their home was being exterminated and rebuilt, the owners stayed at a motel in St. Louis. Their little dog, Fluffy, got loose and was kidnapped. The owners told Nixon, “We want to put up a reward. Will the insurer pay for it?”

Again, Nixon told them he didn’t think there was coverage, but the insurer agreed to pay for the reward.

The following night, Mr. & Mrs. Insured were on the local news saying, “Our dog, Fluffy, was kidnapped because the insurance company put us up at this hotel. We’re offering a $500 reward to get our dog back, and the insurance company has agreed to pay it.”

When they didn’t get a response to the $500 reward, the president of the insurance company authorized an increase in the reward to $2,000. When no one responded, the insureds asked if they could keep the money and use it to purchase a new dog. The insurer agreed. The owners went on the news again and shared that the insurer had let them keep the reward money to get a new dog.

When the policyholders returned home, Mr. Insured said that some contents were missing from the inventory. Nixon told the policyholder to put it on the list, and he would contact the restoration contractor about the missing contents. Mr. Insured said he wanted a meeting with everyone involved in his claim because some very personal items were missing.

Nixon gathered representatives from every vendor involved in the claim — the cleaners, restoration company, electrician and exterminator — for a meeting. The homeowner said, “We are missing some very personal videos that my wife and I made in the bedroom.”

Someone said they were probably already on the internet. This was not good news. The wife was a professor at a local university and was concerned about who might see the videos; however, they were never returned.

Tags:  claims  crazy but true 

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