AboutJay K. Williams, AAI, AIP, CIC, CRM Expertise I can answer questions relating to the following coverages: personal auto; homeowners; commercial auto; commercial liability; commercial property; business income and all other property and casualty coverages.
Experience I have been in the insurance industry in Florida since 1979. I am currently the president of a Florida domestic insurance company subsidiary. I've taught continuing education classes in Florida and across the country. I am quite familiar with all coverages including Florida Condominium master policies and unit owner policies. I also specialize in agent professional liability. I have been a professional educator since 2001.
Organizations I am a member of the Florida Associaion of Insurance Agents, the state affiliate of the Independent Insurance Agents and Brokers of America.
Education/Credentials I currently carry the following professional designations:
Accredited Advisor in Insurance (AAI)
Associate in Insurance Production (AIP)
Certified Insurance Counselor (CIC)
Certified Risk Manager (CRM)
Question Hello Jay, I hope you can help. We were denied a claim from our contractors insurance company regarding the collapse of a retaining wall he built. We understood that we could not recoup what we paid him (apparently liability ins does not cover faulty construction??) We were looking only for lost lanscaping costs. This was a 4000 tow wall that damaged all new landscaping and sewer drains. The insurance company sent denial based on " a investigation" that was completed. No investigation was ever done. We filed a complaint with the Department of Insurance (who at times seemed to be on the side of the insurance company ) finally admitting they indeed should have sent a 3rd party engineer to investigate. We have a court date against the contractor in a few weeks, and have come to find out that the ins company tried to get a continuance of that court date saying their client had no knowledge of any such court date. They were denied because the constable office had a signed document from the defendant regarding the date. His agent also tried to get all info faxed to him regarding our lawsuit. Again, denied. I guess I have two questions 1. Is an insurance company obligated to do a 3rd party investiagtion? 2. Do I have any recourse against the so called "consumer protection" office of insurance? They have been trying to make me go away for 2 months. They asked me for the constables phone # , then in turn gave it to the agent and advised him to call for a continuance. That did not work, so the supervisor of the insurance dept tried to persuade me to postpone my court date. I questioned him on this, and he got very defensive. Some thing fishy is going on. I am going to court with all documentation from everyone and let a judge figure this out. I think this ins. company has something to hide. What do you think? Sorry for the rambling.
Answer Hi Susan,
I'm very sorry to hear about your situation. It's situations like this that give the insurance industry a bad name with consumers. Fortunately, this is not a typical case.
I would agree there is no coverage in the liability policy for the collapse of the wall. The policy specifically excludes "damage to your work", which in this case is the wall. However, any resulting property damage caused by the collapse of the wall should be covered.
When a company denies a claim, they must cite the portion of the policy that shows the claim is not covered. An "investigation" does not necessarily have to be conducted by an independent third part. The company's adjuster may be capable of doing one. If it's pretty obvious that it is a faulty workmanship issue, it would not require someone with engineering experience.
That being said, I restate what I said above...the resulting damage caused by the collapse should be covered.
I cannot speak to how your state's insurance department has responded, but it is their job to fully investigate the complaint from the consumer's viewpoint. They should also NOT be giving an legal advice or counsel.
I would continue to pursue the insurance company. It's obvious that the court system seems to be working in your favor. By pressing on, you may get the company to settle prior to the court date.
Best of luck to you...let me know if you have more questions.
