Insurance nightmare....please help!

[mylifescrazy]

I have a 2- 30 foot c-dory Cats that we run as commercial charter boats. Our boats are insured with Travelers Insurance. Recently one of the boats started taking on water in massive quantity and after putting it up on the grid we noticed a giant crack running horizontally across the port side pontoon. The Captain that had last driven the, said he did not recall hitting anything, but he had been in really rough seas that day and with all the debris in the water from Japan and watershed, he said is was impossible to tell. After the boat wright that we hired tore it all apart for extensive repairs, he photographed clearly, that the boat did in fact hit something......suspect a log because of the shape of the scaring.

Now to my point......my insurance company hired a local surveyor to inspect the boat, they then denied our claim based on the surveyors statements that this boat was not designed to be a Charter Boat, and that the crack was a result of normal wear and tear. Are boats actually "stamped" for Charter use, or for "personal use only", do companies like C-Dory, Bayliner, Baja, Seaswirl or any of the plethora of boat manufacturers actually state whether or not a boat is built differently for Charter or Pleasure use? Do they make one with a thinner hull if it's for Private use and a thicker hull if it's for commercial use?
Or is Travelers Insurance company just trying to get out of paying a rightful claim. Please share any information that you can that may help.

 

[NORO LIM]

What does your policy say? It's a contract between you and your insurer. Ask the insurer to show where in the policy that you signed it says either that they don't cover charter boats, period, or that they do, but only if the boat meets some criteria, which you were told about and which you either ignored or mislead them about. Then decide whether they were bluffing, and whether you should see a lawyer. Maybe call your state's insurance commissioner.

On the face of it, using both the "it's normal wear and tear" defense, and the "it's not a charter boat" defense seems a little suspicious, no?

 

[mylifescrazy]

They definitely know it's a Charter Boat, because I have additional coverage for liability for guest. I had a Survey done on the boat that is 3 years old that shows the boat in near perfect condition. And several experts that say it definitely hit something. The only one saying it didn't is the so called expert the insurance company hired.

 

[hardee]

If it is "normal wear and tear" then at least half of the boats that age should be having that same problem (delamination) right? Since that is not the case, I'd think it would fall out of that category. If it hit something, then it may be covered under a normal "collision" or comprehensive section of the policy. There are some insurance gurus who hang out here occasionally. And a whole lot of smarter folks than me to help you out too.

Good luck. Se if you can get in touch with Ken and Elfin Cove resort. he is a very knowledgeable captain and may be able to offer some "at hand" help.

Harvey
SleepyC :moon

 

[matt_unique]

Well we know insurance companies try to get out of paying claims whenever possible. I would carefully review the language of your policy - did you specifically purchase a 'commercial boat insurance policy? "Liability for guest" is not the same as a commercial policy - I really hope you are able to get coverage!

 

[potter water]

I hate lawyers...the profession, not the people. BUT, my advice is go get a lawyer, and tell the insurance folks you have one. Then tell the insurance company that they will start talking to you through the legal beagle.

The insurance companies bet that you will roll over as most people just don't understand "the game." They also hate lawyers, and will soften a lot if you get one retained. There is no way you will be able to do this battle because of the fine print without the lawyer taking on the insurance co. First mention of a lawyer, you may be surprised at how nice the insurance co. can get.

Most insurance cases, according to the internet, get solved regardless of the fine print, in favor of the insured because most courts make the assumption that insurance is bought by the insured without the insured really understand the fine print. In other words, when you bought your insurance, it was with only a fundamental understanding that the boat was covered. Therefore, courts normally make the judgement that the insurance company must pay up.

(At least that is what I read out on the WWW.)

Tough up and get a legal beagle. It will be worth the few bucks to have their name on your side.

 

[westward]

You should think about contacting an attorney. You might want to make one more courtesy call to your insurer to let them know you are approaching the point of having no other choice, and that if you are forced to hire an attorney all further contact will be exclusively through the attorney; that you will wash your hands of the whole thing. Good luck. Mike.

 

[Adeline]

I too have Travelers and they've been remarkably reliable...they've reliably taken my money every month for years.
I hope you get this straightened out to your satisfaction.
Your experience will influence my attitude come renewal time.

 

[chimoii]

Well we know insurance companies try to get out of paying claims whenever possible. I would carefully review the language of your policy - did you specifically purchase a 'commercial boat insurance policy? "Liability for guest" is not the same as a commercial policy - I really hope you are able to get coverage!

The lawyer approach is a good one though I am sure that he will confirm what Matt says above. "Guests" generally don't pay to come aboard. They pay chip in for gas if you were taking a buddy out fishing, as an example, but only their fair share. Have a read of your policy. It may explicitly not say that you can use the boat for commercial purposes but if that's the case I bet it will say that you cannot. I know my policy is quite clear.

 

[mylifescrazy]

If it is "normal wear and tear" then at least half of the boats that age should be having that same problem (delamination) right? Since that is not the case, I'd think it would fall out of that category. If it hit something, then it may be covered under a normal "collision" or comprehensive section of the policy. There are some insurance gurus who hang out here occasionally. And a whole lot of smarter folks than me to help you out too.

Good luck. Se if you can get in touch with Ken and Elfin Cove resort. he is a very knowledgeable captain and may be able to offer some "at hand" help.

Harvey
SleepyC :moon

Actually the delamination was on the other c-dory we have. I didn't even bother to turn in a claim on that one. We haven't had very good luck with boats this year. The boat that I turned a claim in on is our Boat "The Maverick", which did in fact hit something. Problem is, the person they had come look at it, as the adjuster, has a "history" with both my Captain and Fiberglass guy(Alaska is a small town), they can't stand him. Which made the whole thing personal, and now we're having to pay for it. Or should I say....NOT get paid for it.

 

[mylifescrazy]

Well we know insurance companies try to get out of paying claims whenever possible. I would carefully review the language of your policy - did you specifically purchase a 'commercial boat insurance policy? "Liability for guest" is not the same as a commercial policy - I really hope you are able to get coverage!

The lawyer approach is a good one though I am sure that he will confirm what Matt says above. "Guests" generally don't pay to come aboard. They pay chip in for gas if you were taking a buddy out fishing, as an example, but only their fair share. Have a read of your policy. It may explicitly not say that you can use the boat for commercial purposes but if that's the case I bet it will say that you cannot. I know my policy is quite clear.

I specifically have a Commercial Policy. I've read the adjusters reason for denial which clearly states "this boat was not intended for Commercial Use" my question is this...... What is he basing an ignorant statement like that on? I've been looking for some new boats all year long, and I have yet to see a boat that has a sticker on it that says: FOR COMMERCIAL USE ONLY! or FOR PRIVATE USE ONLY.

 

[mylifescrazy]

What does your policy say? It's a contract between you and your insurer. Ask the insurer to show where in the policy that you signed it says either that they don't cover charter boats, period, or that they do, but only if the boat meets some criteria, which you were told about and which you either ignored or mislead them about. Then decide whether they were bluffing, and whether you should see a lawyer. Maybe call your state's insurance commissioner.

On the face of it, using both the "it's normal wear and tear" defense, and the "it's not a charter boat" defense seems a little suspicious, no?

You're definitely right. It has been suspect from the very beginning. From the first moment I talked to this "adjuster" I knew that he was going to find some way to deny this claim. Unfortunately I am not the type to just roll over and expose my neck. This a right and wrong issue at this point. We buy insurance for the specific reason to protect ourselves against unexpected financial burdens. At the beginning of the season when I wrote the check to Travelers for almost 4000 bucks in premiums, I did so for the financial security of knowing our boats would be taken care of should the unexpected happen. Quite frankly I'm tired of Insurance Companies saying "NO" like an automated machine, and then hoping you'll accept that as an answer. In the meantime, I have a business to run, and I am having to devote my valuable time righting letters to the Insurance Company, letters and emails to my Agent, providing photos and statements from various experts. A lengthy letter to the State Insurance Division, along with a detailed accounting to my Attorney. It's just not right. We've probably paid in excess of $70000 in insurance premiums over the years for these boats. Never have we filed a claim. I feel the same as I would if someone came into my home and stole from me.

 

[mylifescrazy]

I too have Travelers and they've been remarkably reliable...they've reliably taken my money every month for years.
I hope you get this straightened out to your satisfaction.
Your experience will influence my attitude come renewal time.

If you go to Travelers Facebook page, it's pretty scary......one complaint after another about how they NEVER pay up! I wish I would have looked at it when Charter Lakes put our company with Travelers. Lifes all about our experiences right?

 

[berryst]

OK I,m a lawyer and proud to be one. Lawyers are far more generous than doctors as a rule so be careful of your conception. I like doctors too. Lawyers do a lot of good in there lives overall.

That said, the issue does revolve around the what the policy says it is a controlling document and I've argued over many.

First, The adjuster works for the insurance company not you. Even an independent adjuster gets paid by the company and if he renders to many unfavorable denials he/she is history. First, it is a commercial policy. Second, the company knew that that the boat was to be used for the intended purpose. Hence the company cannot now claim that the boat is not suitable since it was aware of the intended purpose and the age and type of boat.

In Wa and most states failure to pay a claim with out a legal basis is bad faith. If your prevail in a bad faith case against the insurance company in WA they pay the attorneys fees. In some states they get bit for triple damages.

I'm wandering a bit but ultimately you could have a lot of fun cross examining an adjuster who make the claims he has. I bet you can find commercial tour pontoon boats. What is his particular expertise in guide boats. How may guide boats has he examined and what course did he take to develop that expertise. What he knows about other boats may not relevant here.

In my approach you can allege that the insurance co is acting in in bad faith in writing to them. Yes, its probably best that you get an attorney to do that ...depends on the size of the claim. Small claims just don't warrant an attorney. You can also negotiate a percentage of the recovery with an attorney...I've done it. The downside there is that if its a quick recovery you may pay too much.

Finally does the peril insured again have anything to do with the intended use.....You can hit a log it your commercial or pleasure boat but the activity does not dictate a greater risk.

Finally, you can respond with a report from your expert. Does the manufacture have and opinion and expertise. How many others use the boat this way.

OK the legal stuff. This is not a legal opinion and is not to be relied on in any way. Particularly since I do not know all the facts and cannot give legal advice out side of washington. By the way one of may cases is pending at the Alaska Supreme Court. I love Alaska and have spent years there over my life.
Looks like bad faith to me.

Chris

 

[potter water]

I'm not a lawyer, but I am a rocket scientist Sounds like good counsel has just been posted. I hope you will keep the thread up to date on your adventure with the insurance company. I'm sure we'll all learn a lot.

 

[thataway]

Lawyers are far more generous than doctors as a rule so be careful of your conception.

Chris

Other than this statement, Chris gives you good advice. You should have hired your own expert. (you refer to an adjuster & surveyor-- they are not the same)

If the boat is one of the 30 x12 foot cats by either C Dory or Black Feather, they were both built as commercial boats for the day charter trade in Alaska. If the boat struck an object in the water, this is generally a covered peril, unless specifically excluded in your policy.


I have seen both boats built by C Dory & Black feather when we were in Ak several years ago (Elfin Cove & Juneau). They are commercial boats and were purpose built for the charter trade.

Hire your own expert; specifically a qualified marine surveyor, who will write a report refuting the adjuster's claim.

 

[mylifescrazy]

OK I,m a lawyer and proud to be one. Lawyers are far more generous than doctors as a rule so be careful of your conception. I like doctors too. Lawyers do a lot of good in there lives overall.

That said, the issue does revolve around the what the policy says it is a controlling document and I've argued over many.

First, The adjuster works for the insurance company not you. Even an independent adjuster gets paid by the company and if he renders to many unfavorable denials he/she is history. First, it is a commercial policy. Second, the company knew that that the boat was to be used for the intended purpose. Hence the company cannot now claim that the boat is not suitable since it was aware of the intended purpose and the age and type of boat.

In Wa and most states failure to pay a claim with out a legal basis is bad faith. If your prevail in a bad faith case against the insurance company in WA they pay the attorneys fees. In some states they get bit for triple damages.

I'm wandering a bit but ultimately you could have a lot of fun cross examining an adjuster who make the claims he has. I bet you can find commercial tour pontoon boats. What is his particular expertise in guide boats. How may guide boats has he examined and what course did he take to develop that expertise. What he knows about other boats may not relevant here.

In my approach you can allege that the insurance co is acting in in bad faith in writing to them. Yes, its probably best that you get an attorney to do that ...depends on the size of the claim. Small claims just don't warrant an attorney. You can also negotiate a percentage of the recovery with an attorney...I've done it. The downside there is that if its a quick recovery you may pay too much.

Finally does the peril insured again have anything to do with the intended use.....You can hit a log it your commercial or pleasure boat but the activity does not dictate a greater risk.

Finally, you can respond with a report from your expert. Does the manufacture have and opinion and expertise. How many others use the boat this way.

OK the legal stuff. This is not a legal opinion and is not to be relied on in any way. Particularly since I do not know all the facts and cannot give legal advice out side of washington. By the way one of may cases is pending at the Alaska Supreme Court. I love Alaska and have spent years there over my life.
Looks like bad faith to me.

Chris

Thanks Chris.....It absolutely is a Commercial Policy. Travelers knew that these were Charter Boats, and I also insure my individual Captains. There were 5 boats made out of this particular mold, which has since been sold to a company called Black Feather I believe. I know for a fact that all 5 are still in the water here in Alaska and being used for Commercial purposes. I did call the Manufacturer because I was so upset when the adjuster wrote in his reason for denial "These boats were NOT intended for use as Commercial Charter, they were intended for Personal use only" So I called the Manufacturer, and asked if there was some kind of "Sticker" on the boats that said "For Personal Use Only".....After he got done laughing his A** off.....he explained to me in detail.....which I can't repeat.....but in short, he said the Adjuster is an idiot, and he would be more than happy to write a statement to Travelers.

We have sent the Insurance Company a letter of intent, and explained in detail that we believe they are acting in bad faith. I have ZERO worry that in a Courtroom situation we will prevail. The facts and photos and testimony are on are side. I'm upset that Travelers Insurance is making us go through this. Something I believed we were completely covered for, now sees me with over $15,000.00 out of pocket, and still being ignored by MY insurance company. 13 days ago, (when I sent them the letter of intent), I gave them until Monday the 23rd to respond. I have yet to hear from them other than one sentence in an email stating "they were looking into it". For those of you who have Travelers, beware, they are more than happy to accept our premiums.

What's worse is that the person that they hired in Juneau "A Marine Surveyor" or should I say an Associate Marine Surveyor (he hasn't passed the test yet) from what I could tell, is not a respected person in his field. I have talked to 3 other Surveyors in Southeast Alaska, all 3 had very low opinions of him. In addition, I forwarded the findings of the Surveyor to the Marine Surveyors Board of Ethics Committee and am in the process of filing a complaint. A Surveyor is suppose to render an unbiased opinion. Outline the facts. Not make statements that are categorically untrue, such as "this boat was intended for personal use.
I have photos that I am going to post that show clearly "even to an untrained eye" the point of impact scarring. Looks like probably a log.

I've also filed a Complaint with the State Insurance Division (but you know state agencies) it will be at least a month and a half before we hear anything back from them.

Bottom line.......If Travelers Insurance thinks for a second I'm giving up on this and just letting them have their way......they better think again. It's inexcusable that they are making us jump through all these hoops.

I'll keep you posted.

 

[mylifescrazy]

Lawyers are far more generous than doctors as a rule so be careful of your conception.

Chris

Other than this statement, Chris gives you good advice. You should have hired your own expert. (you refer to an adjuster & surveyor-- they are not the same)

If the boat is one of the 30 x12 foot cats by either C Dory or Black Feather, they were both built as commercial boats for the day charter trade in Alaska. If the boat struck an object in the water, this is generally a covered peril, unless specifically excluded in your policy.




I have seen both boats built by C Dory & Black feather when we were in Ak several years ago (Elfin Cove & Juneau). They are commercial boats and were purpose built for the charter trade.

Hire your own expert; specifically a qualified marine surveyor, who will write a report refuting the adjuster's claim.

I'm with Elfin Cove Lodge. And you are correct (after considerable research) I've discovered, these boats were built specifically for Charter. All 5 of the original boats that were from the mold sold to Black Feather.
You are also correct about the boat should be covered for hitting an object. But because none of my boat captains recall hitting anything or ADMIT to hitting something.....this Surveyor has concluded it must be wear and tear. I did hire another Surveyor, plus sent the photos to the Marine Surveyors Board, everyone from the Boat-wright to the Surveyors said THE BOAT HIT SOMETHING! Everyone, with the exception of the person Travelers hired to evaluate the boat for them.

 

[Will-C]

I'm not a lawyer but I did sleep at a Holiday Inn Express last night.
What does your agent say? I would try to explain that there is bad blood in between you and the the guy they sent out. Since they can't prove the boat was or was not designed for commerical use that argument is where I would start. If you are going to start a law suit I would name the adjuster/ surveyor, your agent who should have told you your boat was not designed for commercial use before they started tsking your money, and the company. Get you story out there anyway you can fishimng reports,Facebook,fishing forums etc. Be careful to just state the facts. It might end up to be cheaper for them to pay the claim then to have to defend themselves. We are praying for you. I won't ever buy Travelers Insurance
D.D.

 

[berryst]

Bingo!
A. The adjuster is not qualified to render an opinion on suitability for commercial purposes.
B. The boats have a history of commercial use.
C. The policy was insurance for the intended use
D. Even if there was a for profit-exclusion it probably would not apply as the claim does not arise out of the for-profit use...hitting the log can happen to any one.
Does it surprise you that the operator can't recall hitting a log when it's his job on the line.


This claim will settle I predict pretty shortly. But be sure you have your experts examine the damage BEFORE its repaired. Other wise thier "expert" will be hard to refute at a later time in the log/delamination/factory-defect arguments. This is key.

OK other stuff - Don't be too quick trash Travelers. They are better than most and are not on my hit list of "Bad" insurance companies.
Also, did you know that lawyers do three times the pro bono (free) work as doctors. I have known many lawyers and my opinion of the profession is high. I do know some good attorneys in Alaska as I have worked pro-hock-vechi in Alaska

Perhaps you should invite me to show you how to halibut fish in Elfin Cove one of the finest places on the planet. For those who don't know ...this is a first class outfit in god's country. (god leaves for the winter)
chris

OK I,m a lawyer and proud to be one. Lawyers are far more generous than doctors as a rule so be careful of your conception. I like doctors too. Lawyers do a lot of good in there lives overall.

That said, the issue does revolve around the what the policy says it is a controlling document and I've argued over many.

First, The adjuster works for the insurance company not you. Even an independent adjuster gets paid by the company and if he renders to many unfavorable denials he/she is history. First, it is a commercial policy. Second, the company knew that that the boat was to be used for the intended purpose. Hence the company cannot now claim that the boat is not suitable since it was aware of the intended purpose and the age and type of boat.

In Wa and most states failure to pay a claim with out a legal basis is bad faith. If your prevail in a bad faith case against the insurance company in WA they pay the attorneys fees. In some states they get bit for triple damages.

I'm wandering a bit but ultimately you could have a lot of fun cross examining an adjuster who make the claims he has. I bet you can find commercial tour pontoon boats. What is his particular expertise in guide boats. How may guide boats has he examined and what course did he take to develop that expertise. What he knows about other boats may not relevant here.

In my approach you can allege that the insurance co is acting in in bad faith in writing to them. Yes, its probably best that you get an attorney to do that ...depends on the size of the claim. Small claims just don't warrant an attorney. You can also negotiate a percentage of the recovery with an attorney...I've done it. The downside there is that if its a quick recovery you may pay too much.

Finally does the peril insured again have anything to do with the intended use.....You can hit a log it your commercial or pleasure boat but the activity does not dictate a greater risk.

Finally, you can respond with a report from your expert. Does the manufacture have and opinion and expertise. How many others use the boat this way.

OK the legal stuff. This is not a legal opinion and is not to be relied on in any way. Particularly since I do not know all the facts and cannot give legal advice out side of washington. By the way one of may cases is pending at the Alaska Supreme Court. I love Alaska and have spent years there over my life.
Looks like bad faith to me.

Chris

Thanks Chris.....It absolutely is a Commercial Policy. Travelers knew that these were Charter Boats, and I also insure my individual Captains. There were 5 boats made out of this particular mold, which has since been sold to a company called Black Feather I believe. I know for a fact that all 5 are still in the water here in Alaska and being used for Commercial purposes. I did call the Manufacturer because I was so upset when the adjuster wrote in his reason for denial "These boats were NOT intended for use as Commercial Charter, they were intended for Personal use only" So I called the Manufacturer, and asked if there was some kind of "Sticker" on the boats that said "For Personal Use Only".....After he got done laughing his A** off.....he explained to me in detail.....which I can't repeat.....but in short, he said the Adjuster is an idiot, and he would be more than happy to write a statement to Travelers.

We have sent the Insurance Company a letter of intent, and explained in detail that we believe they are acting in bad faith. I have ZERO worry that in a Courtroom situation we will prevail. The facts and photos and testimony are on are side. I'm upset that Travelers Insurance is making us go through this. Something I believed we were completely covered for, now sees me with over $15,000.00 out of pocket, and still being ignored by MY insurance company. 13 days ago, (when I sent them the letter of intent), I gave them until Monday the 23rd to respond. I have yet to hear from them other than one sentence in an email stating "they were looking into it". For those of you who have Travelers, beware, they are more than happy to accept our premiums.

What's worse is that the person that they hired in Juneau "A Marine Surveyor" or should I say an Associate Marine Surveyor (he hasn't passed the test yet) from what I could tell, is not a respected person in his field. I have talked to 3 other Surveyors in Southeast Alaska, all 3 had very low opinions of him. In addition, I forwarded the findings of the Surveyor to the Marine Surveyors Board of Ethics Committee and am in the process of filing a complaint. A Surveyor is suppose to render an unbiased opinion. Outline the facts. Not make statements that are categorically untrue, such as "this boat was intended for personal use.
I have photos that I am going to post that show clearly "even to an untrained eye" the point of impact scarring. Looks like probably a log.

I've also filed a Complaint with the State Insurance Division (but you know state agencies) it will be at least a month and a half before we hear anything back from them.

Bottom line.......If Travelers Insurance thinks for a second I'm giving up on this and just letting them have their way......they better think again. It's inexcusable that they are making us jump through all these hoops.

I'll keep you posted.