Stol wrote:
I agree 100 %.. And by paying a claim that clearly does not meet the language of the policy makes the other rate payers have higher premiums that are charged to cover that loss..... A deal is a deal..... massage it to fit each circumstance and you are on the road to hell.. IMHO.

I hope you have read and thoroughly understand your deal...that thought process is a dangerous one to live by. Above and beyond does not happen often, but it does happen and is greatly appreciated by most of us when it does. Can't please everyone all the time and you can't please some people any of the time.

In reference to the claim John mentioned...the CFI being in the backseat did not contribute to the loss, if anything it prevented it from being worse. Even without a current medical, or BFR his experience and skills were valuable to have in the aircraft and I have no doubt that this is what the adjustor took into consideration when approving the claim payout. Had the passenger not been a CFI or had this CFI been the one to cause the claim, the outcome would most likely have been a denial. Even insurance companies use some common sense...most of the time.

lowflybye wrote:
LIMITS OF LIABILITY


From the policy with reference to Liability Coverage

ADDITIONAL EXCLUSIONS APPLYING TO COVERAGE A
This coverage does not apply to:
4. Bodily injury to:
a. an occupant unless Item 5 of the Data Page shows “including occupants”;

Occupants are defined in the policy as: “Occupant” means a person while in, on, or getting into or out of your insured aircraft.

Better make sure "including occupants" is listed on your Data page or there will be no coverage for them by default in the event of an accident. Sounds like a horseshit exclusion don't you think Alaskaflyer?

My data page includes occupants. Of course Alaska has a state law restricting liability of the pilot/owner to occupants on personal flights. Wonder how that affects payouts, regardless of the underwriter?

And just one more example for good measure...again from the Avemco policy:

16. “Policy territory” means the Western Hemisphere between 13° and 67° North Latitude and between 52° West Longitude and the International Date Line. It does not include Bermuda, Central America, or Cuba.

Not only does Avemco not insure off airport operation in parts of Alaska, but the don't insure anything north of the Artic Circle...I hope you were not planning to make any trips to Kotzebue, Barrow, Deadhorse, Prudho Bay, or Point Hope on your journey to Alaska...may as well just check off the entire North Slope. And for those seeking a more tropical climate...forget Bermuda, Panama, Costa Rica, Martinique, Barbados, or Trinadad & Tobago.

I'm going from memory here of conversations I've had with others but I believe that policies written for Alaskans normally state it a bit differently. The northern latitude exclusion does not include the state of Alaska, or put another way the entire state is specifically included in coverage. Can't speak to lower 48 Avemco policies. Either way I know that is how MY policy is written by default since I didn't specifically request it.

How many policies out there specifically include Central America and Cuba by default? I'm guessing not many. Avemco does cover Mexico which they don't define as Central America. Many others don't without a rider.

once&futr_alaskaflyer wrote:
My data page includes occupants. Of course Alaska has a state law restricting liability of the pilot/owner to occupants on personal flights. Wonder how that affects payouts, regardless of the underwriter?

The policy will work within the law and not apart from it. Policy wording has to be approved in each state that the policy may be issued which is why changing policy wording is no small task. This is also the reason that you will find a *ENTER STATE NAME* AMENDATORY ENDORSEMENT or similarly titled endorsement on many policies...it is there to add, limit, or remove a specific coverage on the base policy to comply with the state regulation in which it is being issued.

once&futr_alaskaflyer wrote:
I'm going from memory here of conversations I've had with others but I believe that policies written for Alaskans normally state it a bit differently. The northern latitude exclusion does not include the state of Alaska, or put another way the entire state is specifically included in coverage. Can't speak to lower 48 Avemco policies. Either way I know that is how MY policy is written by default since I didn't specifically request it.

Pretty sure that you are correct on that...if the policy address is in AK then all of AK should be included and any off airport restrictions that may exist on policies with an address in the lower 48 should be removed. This would be a contributing reason that you fellows have much higher rates for your policies along with a limited number of underwriting companies willing to issue AK policies. I said "Pretty sure that you are correct on that" because we "southerners" are not permitted to act as agents for AK based policies due to the differences in risk...even if we have lived there in a past life. Agents from within AK and some of the NW states are normally the only ones permitted by the underwriters to do so.

once&futr_alaskaflyer wrote:How many policies out there specifically include Central America and Cuba by default? I'm guessing not many. Avemco does cover Mexico which they don't define as Central America. Many others don't without a rider.

You are partially correct...again basing it on lower 48 based policies. Many of them cover Central America, Islands of the Caribbean, Islands of the Bahamas, etc, and while en-route between these locations. Most of the policies specifically EXCLUDE Cuba & Haiti. The territory varies by company so again READ YOUR POLICY to be sure. The coverage will be found in early in the policy in a section titled POLICY PERIOD, TERRITORY or WHEN & WHERE YOU ARE COVERED, etc. If you have an expansion endorsement (many policies do) you will want to look for territory expansion in that section as well.

All of the policies I can think of off the top of my head include Mexico as a territory, but (and I assume this is what you were thinking of) the Mexican government wants their piece of the pie so (in most cases) they require a Mexican certificate issued by a Mexico based insurance company in order to be legal to fly within their borders. Without the Mexican certificate your insurance policy will still respond, but you could have some serious problems with the federales hence the Mexican operations warning found in most policies. Some of the underwriting companies have agreements with a Mexico based company and can provide this certificate while others do not. In the case of the latter, I normally recommend contacting Baja Bush Pilots to get this done as they do it on a routine basis and know the current requirements of the Mexican government. The Mexican Certificate historically has run about $250...again, this is a requirement and fee handed to us by the Mexican government...gotta grease those palms a bit to play with the seniorita's.

Stol wrote:John points out a very real issue..... He admits with the complete details of his claim that it was invalid and should not have been paid. But the insurance company did, him and his partners cashed the check and fixed their plane... All at the cost of others who lived by their terms of the "contract". So, in reality John and his partners commited fraud...
Am I wrong here ???

ben

Ben, that's a very myopic way of looking at this. The insurance company made a "business decision" to pay the claim. I don't know why, and didn't ask why. It's well within their purview as insurers to make that decision, and regardless of their rationale, there was no "fraud" as you so indelicately put it. We did not submit an invalid claim. We submitted a claim with the assistance of the adjuster, who the consulted with their firm after reviewing all of the relevant details. If they had denied the claim, we probably would have had further discussions, in accordance with the terms of the policy.

From http://www.dictionary.com: fraud is "deceit, trickery, sharp practice, or breach of confidence, perpetrated for profit or to gain some unfair or dishonest advantage".

As we clearly did not trick, lie, cheat or steal, or breach any confidence with our contractual partner (the insurance company), no fraud could occur. Did it negatively impact the insurer's bottom line? Probably, just as a questionable claim denial would positively impact their bottom line. Both instances probably affect everyone's rates. And I'll point out that at that time we were paying $8,000 per year per plane on a/c with less than $50,000 hull coverage.

It's a LONG freakin' leap from having an accident and the insuring company paying for a claim they could have denied, to making accusations of fraud, which is criminal conduct according to every state in the union - unless you're a member of Congress.

And in the best traditions of this site, use spell check if you're not going to proof read your notes