Doctor Claims Insurance Claims Solutions

Doctor Claims Insurance Claims Solutions Providing Claims Advice and Solutions to Help Control Your Insurance Costs. Risk Management and Insurance Claims Consultant

11/28/2016

Keep your family and your property safe this Christmas season.
1. Don't leave packages on the porch, on the car seat or where thieves can see them through your home windows. These are all invitations to theft.
2. Put your outside and inside lights on timers whether your'e home or away and remove that "hidden key" outside for now. This makes your possessions and YOU safer.
3. If you see a $20 bill left under your wiper blade or near your car in the parking lot, get away from there quick. It's a new ploy to distract you by carjackers. Be aware of your surroundings and don't leave those valuables on the car seat or in view.
4. Leave the big purses and back pack style bags at home. Its easy for a thief to grab out your wallet without you knowing. Also only keep a small amount of cash with you. Credit or debit cards are much safer this time of year.
5. Facebook is great but don't share your plans about planned shopping trips, travel or even hospitalizations. Send the pictures later. Thieves can and do follow you on media and take advantage of your absence.
6. Make sure to use "https://" websites to do web shopping. That means the site is secure. Also schedule deliveries when you are at home.
Lastly...Stay alert to people and things around you to help protect yourself and your family. Merry Christmas !

11/08/2016

Dear Doctor Claims,

One of our insureds called to say that a store clerks fell on the “strip mall” parking lot here in St. Louis last winter and broke her wrist. She filed a Work Comp claim against them and to their surprise she got paid for the accident. I sympathize with her situation, but I don’t really see how this is the fault of our insured. They don’t own or maintain the lot so they are at the mercy of the building manager for the clearance of snow and other maintenance. They have had very few employee injuries in their store. Why should they have the cost of this claim hurting their loss experience and forcing their premiums higher?

Answer

In a recent decision (Wells Vs Brown), the Missouri Supreme Court acknowledged that injuries that occur going to and coming from work are ordinarily not compensable, but injury-producing accidents occurring on locations “Owned or controlled by the employer” or “So appropriated by the employer or so situated, designed and used by the employer and his employees incidental to their work as to make them, for all practical purposes, a part and parcel of the employer’s premises and operation” and where” That portion of such premises is a part of the customary, expressly or impliedly approved, permitted , usual and acceptable route or means used by the workers to get to and depart from their places of labor” such injuries are compensable.

Under these circumstances the accident would be treated the same as if it had happened on the work premises and the injury would result in a compensable claim.
Doctor Claims

11/08/2016

LIABILITY COVERAGE FOR STOLEN CARS

Dear Doctor Claims,
My commercial building was damaged by a car-jacked vehicle which crashed while fleeing. Unfortunately the police did not catch the driver. I understand that under the Personal Auto Policy, any person who drives the vehicle has coverage under the vehicle owner's policy. In other words, the "coverage always follows the car”, right? Does that mean that the vehicle owner's insurance will pay for my damage rather than our property insurance policy?
A Confused building owner.

Dear Confused,
Sorry, I think you are going to be making a claim on your own business property insurance. Under the current PAP, the second category of insured drivers does include "any person using the named insured's covered auto." So you are partially correct.
Previous auto policies have provided this coverage to persons other than family members only when the owner has given permission and the borrower uses the auto within the scope of this permission; likewise, the named insured and family members have not been covered for driving non-owned autos unless the are used by permission of the owner and within the scope of permission. The current personal auto policy, however, excludes coverage when the insurer can establish that the insured under this category did not have "a reasonable belief" that he or she was entitled to borrow the auto.
Exclusion #8 restricts the following:
8. Using a vehicle without a reasonable belief that this "insured" is entitled to do so. This exclusion does not apply to a "family member" using "your covered auto" which is owned by you.
The key element here is the phrase "reasonable belief", which is not defined in the PAP, and therefore, subject to interpretation. As an example, the insured's neighbor has a reasonable belief that he is entitled to use the covered auto if he is given the keys by the insured, but if the neighbor allows his sons to drive the auto, do the sons also have such a belief? If the neighbor’s sons are of driving age and the neighbor allows them to drive the borrowed auto, a case can be made that the sons do have a reasonable belief that they are entitled to use the car. On the other hand, if the sons are underage (say for example, a 13 year old) or just drove the car because the keys were left on the kitchen table, that son probably does not have a reasonable belief that he is entitled to use the car. In such a situation, the insurer would have a reasonable basis to deny coverage for the 13 year old, since someone that young could not reasonably believe that he is entitled to drive, especially where the state does not allow him the privilege of a driver's license at that age. Even if the son was old enough to drive, he could not assume he had permission to use the non-family auto merely because the keys were available
Hope this helps..... Doctor Claims

10/13/2015

Thoughts on driving for Uber

I spoke recently to a few old friends to find some in their family are becoming Uber drivers to supplement their income. This is one of several new trends in sharing personal assets that started with some of the Generation X folks. It seems to be a good deal both for the car owner who generates some income using low cost methods of competing with the commercial transportation. Its also good for the ride sharing customer whose cost and convenience are better than using a taxi / limo. Sounds like a great deal until you look a little closer.

Did you ever know someone who used one of those super cheap contractors from Angies List, who do side work for less than the regular guys? It works out pretty good until something goes awry. Like a fire starts from some Gerry rigged electrical work or one of his helpers (who works for cash) falls from YOUR ladder and breaks his back. Well there is no insurance to take care of your fire damage and no workers compensation to take care of the injury. Guess who is going to be responsible for these problems? Well it's not going to be Angies List or the cheap contractor!.

Now back to the Uber scenario. So your son is going to drive his car for Uber and Uber has this nice contract he signs and they say they are going to protect him for up to a Million dollars in claims. Sounds pretty good right? They also tell him he has to follow and abide by all the laws and regulations for his jurisdiction. Seems reasonable. But how does that really affect to him

Some states will now consider your son a commercial driver (driving for hire, right?) and in those states he may need a commercial driver’s license. Is he going to inform his personal auto insurance carrier that he is driving for Uber? No doubt most of those will either not want him any more or will insist that he buy a more expensive special insurance policy designed for this ride-sharing purpose. Why does he need to do that when Uber provides that big $1M policy? Because it doesn’t cover all his exposures. Like before he accepts a new fare but is cruising around town or at hotels waiting for a call or after his last fare is done. (There may be coverage while he circles the airport and going directly from one call to the next). But what about the damage to his car in an accident resulting from his own fault or partly due to something done by the passenger? Where the injuries to your son are from that other uninsured driver, Uber may proved some coverage based on State minimum limits. They may also offer a separate, extra cost coverage for damage to his car with a fairly high deductible, but only for incidents while he is “on-the-clock. Making sure he is covered all the time is going to be pretty complicated. It is likely to be a very rude awakening to your son and you when his own insurance company denies his claim because he failed to tell them he is driving commercially and placing them at much greater risk. In any case, it is not a good idea to keep this secret from your insurance agent. His insurance company is unlikely to just back charge you for the additional premium if he has a mishap while he is driving for Uber. They will more likely deny the claim and cancel him.

This is even more significant if your son is on your family insurance program or the car is in your name. Even though the chance of this happening is quite small, the results could be financially devastating. Check this out carefully before you or your family members get involved and definitely discuss it with your insurance broker/agent.

Doctor Claims

09/07/2015

Doctor Claims website is now live. There are a number of good suggestions for business owners. Please take a look and give me your feedback. Jim

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