When Can You File an Errors and Omissions Claim

[upsetstudent1]

My question involves insurance law for the state of: Kentucky


Around March 3rd, 2010, I transferred my auto and renter’s policies from Indiana to Kentucky to reflect the fact that I had moved from Indiana to Kentucky. The agent from whom I purchased the new policy stated to me that, because I moved from Indiana to Kentucky, a “whole new policy had to be written” (in regards to both the renter’s and auto policies) and as a result, the coverage and policy limits had changed (for example, my policy limits for my renter's insurance increased from $10,000 to $15,000). The agent did not describe the policy in any detail, so the information that I received from him was limited.

I did have some valuables which were in storage and he explained to me that they would be covered up to an extent, and that anything over "the policy amount", i.e., over $15,000, "would have to be scheduled separately" (I asked this because I had a few antiques given to me by my grandmother in storage a few states away and had always been concerned about the potential of something happening to them).

The agent explained to me that any loss up to $15,000 would be covered, and stated that "the only things you have to schedule (i.e., the only things that we limit loss to) are jewelry, furs, antiques, and guns."

Upon hearing this, I asked the agent for clarification, and he stated that “…only items that fall under those four categories need to be scheduled. Any other loss will be covered up to the policy limits.”

I felt pretty confident that this meant if I lost something that was valued highly that was not an item in those categories, I would be covered up to the full amount of the loss up to the policy limits (i.e., if I had a loss that exceeded $15,000, I would only receive $15,000 in reimbursement due to the fact that my policy limits were set to $15,000).

Since the policy had changed, the agent stated to me that the insurance company would be sending me new policy documents for both my auto and renter’s policies. After a week, I had still not received the documents, so I returned to the office where I purchased my policy to explain the situation. The agent realized that he had recorded an incorrect address for (at least) the auto policy, so I requested that he resend both policy documents to the correct address so that I could have something to refer to in case I needed to amend my policy.

To this date, I never received a packet in the mail describing my policy terms while living in Kentucky. In fact, the insurance agent had to print out a document for me to keep in my glove compartment stating that I had auto insurance due to the fact that I had never received my insurance cards!

On March 27th, 2010 I had a family issue that I had to tend to which necessitated that I take a trip. I returned to my residence on April 7th , 2010 at approximately 11:00 am, at which time I discovered the loss.

After I discovered the loss, I contacted the police, filed a report, and had the police officer accompany me back to the apartment so that I could remove the remainder of my belongings.

Shortly thereafter, I contacted the insurer’s claim department and described the loss. The items that were stolen were described clearly in the settlement documents. The jewelry that was stolen was not scheduled, and this decision was of my own volition, because the jewelry was more sentimental than anything and was not highly valuable financially.

However, I was authoring a textbook (manuscript) which was also taken. The final copies of the manuscript and the corresponding answer key were backed up on two flash drives, due to the fact that my hard drive had been having issues.

When I contacted the insurer’s claims department to report the loss, the claims agent asked me how many hours I had worked on the textbook, to which I replied, “well over 1000 hours,” as I had been working on the textbook for, at minimum, 25 hours per week for over one year.

In May, I received a statement describing my claim (the Contents Estimating System document), and found that my manuscript had been valued at $15,000, but due to policy limits, I would only be paid $1,000 for that particular item because it wasn't scheduled.

Here are my issues with this:

1) The insurance agent that sold me the policy explained to me that the only things that had to be scheduled were jewelry, furs, antiques and guns, and that anything else could have a value up to and exceeding $15,000 (my policy limit) and still be covered, but only to the policy limit.

2) I never received the renter's insurance packet (or the auto insurance packet) in the mail (I did have the old one from Indiana, but my insurance agent in Kentucky explained to me that all the terms changed so I would have to follow the terms in the new packet).

The textbook that I was writing was not for hobby, and I am still expected to produce viable work. I put in well over a thousand hours’ of my time into creating this manuscript, and had I been apprised of the fact that I needed to schedule it separately on my policy, I would have done so; however, I was told that the only things that needed to be scheduled were those items which fell under the categories of jewelry, furs, antiques, and guns, and that any other loss would be paid out to the policy limits.

I'm happy to get some reimbursement for my work, but it really bothers me that the insurance agent gave me the wrong information regarding scheduling, which is going to end up costing me quite a bit. I really feel that the mistake is on their end, and not mine, and honestly, had I known that this manuscript had to be scheduled, I would have paid the extra $10 or so dollars additional to my policy to do it...

I have contacted the owner of the agency, and went through hell to find out how to get E&O documents from their insurer (the manager of the agency claimed that I could not do so). I guess my question is, is there any recourse for their actions? Can I get the value of my textbook if the mistake was on their end? Also, have I waited too long to file a claim? I’ve been busy with school work, moving, and work, and this has been on my ‘to do’ list for a while, and I figure I’d better see what I can do about it at this point. How would I contact an attorney to file an E&O claim, and how much would it cost to do so?

Thanks so much for reading!!

[Mr. Knowitall]

If the short version is, "When can you file an E&O claim with somebody's insurance to see if they pay it," any time you want to do so and you're aware of who their insurance company is. Nobody has to provide information about their insurance to a person who merely asks for it - the only way to compel somebody to provide insurance information is through discovery after filing a lawsuit.

You had no paper copy of your manuscript? The thieves took two flash drives? Are you stating that they took your computer, or that they didn't take it but that your hard drive is "flaky" - if it's the latter, if necessary, use a data recovery service and recover the data.

Is this a text that you were writing "just because" or are you under contract? I assume you're not under contract, as if you were your editor would have received at least portions of the manuscript to approve and edit. Have you ever published a textbook before? These are issues that are likely to come up if you try to make a claim - whether the value of your textbook is "pie in the sky" or whether your track record as an author will substantiate that it has true value.

When you purchase insurance, unless you actually sit down with the agent and read through the contract - and I don't know of anybody who does that - you're going to get a paraphrase or synopsis of the policy and its coverage. Does the agent you work with remember the conversation in the same way you remember it? Or is he stating that his memory is different? (Or don't you know.)

Do they claim that they sent the renter's policy to the correct address, or that they mailed it along with the auto insurance policy to the wrong address? The wrong address was your old residence and, if so, did you have mail forwarding in effect? Do they claim that they did, in fact, resend the policies to your new address and, if so, when do they claim to have mailed the copies relative to the theft? What have you received if anything and, if you have received something, when were the envelopes postmarked? (I'm leaving open the possibility that you've received something since you posted the thread.)

If you want to know how much a lawyer would charge to make a demand or file a lawsuit, you will have to contact some law offices in your area and ask. My thoughts are that you'll have a difficult time finding a lawyer who will take the case on continency or without charging a substantial retainer and hourly fee, but you won't know for sure until you call.