Issues with insurance. Suggestion / experience needed.

[Fluker]

Only July 18th I took my boat out to the MS River. Ran for a couple hours that morning and the boat/motor ran like a top just like it has the 130 hours I've put on it. (Bought it with about 30 hours on it) I hit a rock in shallow water at idle speed as I was making a 180 degree turn. Prop was brand new basically (2nd time on the water) so that was my immediate concern. Took a look at the prop and it had some damage, but not major, so I swallowed the knot in my throat and off I went. On the next run I heard a single knock. On the next run I heard a few knocks and I thought something's not right. The next run it started knocking like crazy, so I just headed in (about 1.5 miles).

I pulled the boat out and there was a tiny hole in the lower unit casing, so I knew I'd lost my lower unit. (First time for me.)

To make a long story short, there are 2 pieces broke. One is a piece on the trim that is causing only 1 cylinder to work. The 2nd is the lower unit. Insurance (who shall remain nameless at this point) claim agent and appraiser are telling me that they'll fit the bill for 25% (the trim piece) but won't for 75% (the lower unit). There stance is that the pinion gear in the lower unit was misaligned and finally came loose allowing the gears to become out of sync and the damaged was caused from that. In response to my "it ran fine before the impact, and bad after" is that is was just a "coincidence" that the pinion gear completed failure at that time. That is a tough pill to swallow.

The next step is for my shop to call the adjuster and give them there opinion (that this could have been caused by impact) and then the claim agent has to make the decision.

IF the claim agent sticks to not covering, what do I do? I've already been in touch with my agent, who seems to want to help, but so far has not. The fact that all damage seemed to occur after the hit leads me to NOT "give" on this. I can not fathom how the impact did not cause the damage. I do NOT want to get an attorney and bring that in to the equation, but at this point, I see that as the only next option. I just wonder if my attorney fees will be more than the lower unit cost, thus making it a wash?

I've had some sort of insurance for 15 years, and home, car, truck and boat insurance with this company for the last 7. This is my first major claim with insurance of any kind with the exception of a very small claim last year on fiberglass repair. I've paid my premiums all these years, I finally "wrecked" something, and now I need help. But I'm not gonna get it?

Any experience or suggestions would be welcome. Probably would be best to e-mail me. [email protected]

Thanks in advance,

Fluker

[Slob_Samurai]

My suggestion is to learn from this and switch insurance companies. I have State Farm, pay roughly $80/yr on a $6,500 boat.

I heard a clunk while at top speed, I hit a rock and the lower unit was toast. I brought it to a family friend to look at to confirm the damage. I called my agent, found a replacement lower unit, submitted the pricing for a new lower unit, got a check from the State Farm - $250 deductable, went out and got a refurbished lower unit, ended up making money on the deal.

State Farm has been very good to me and I would recommend them to anyone. In the past 2 years I've had 3 claims with absolutly no problems

My latest claim was for hail damage from the big Hugo storm.

totaled out 2000 F150 Supercab w/91,000

I was trying to sell it for $8,700 in this horrible truck market. With no takers, God sent racquet ball size hail to the rescue. State Farm sent me a check for $11,500.... One word: amazing

[Doonbuggy]

Fluker - My recommendation is to ask the adjuster/agent where in the policy they find coverage excluded. Make sure you have a copy of your policy.

Most policies provide coverage based on "direct physical damage", i.e. motor hitting a rock.

Hopefully your mechanic can help by stating that the damage appears to have been caused by hitting the rock since you noted that for 130 hours it's been fine.

An adjuster cannot deny coverage based on what he "thinks" happened; has to be made in accordance with the terms and conditions of the policy.

From the sounds of it you should be covered less your deductible. I wouldn't get an attorney involved at this time, just get written documentation and keep pushing. Good luck.

DB

[TonkaBass]

I had my lovwer unit go out. I took it to the dealership and was quoted $4200 for everything that had to be done. They said that it was more than likely from an impact that happened weeks before, but since I bought a new prop and sold my old one to the repair shop, the insurace would cover me. So instead of paying the full amount, I went through a one man shop and got the thing back on the water for $1500, an he did more work on it than the dealship had in their proposal. Been running it for two years now without an issue.

I know it's not the answer you're looking for, but it is an option. After that, I will never take my boat to a big dealship for big repairs.

[TonkaBass]

Doonbuggy's advice sound like the best thing to do to me.

[MNBassGuy]

Hi Fluker,

I am an insurance agent, so I know a bit about this stuff. On top of that, I just had a very similiar incident with my boat.

What happened to your boat is simple, but not surprisingly, your adjuster doesn't understand the mechanics of a boat's lower unit. Many times when you hit an object (especially if you have a stainless prop) the impact is transfered from your prop into your gear case. When this happenes it puts direct stress on your pinion, which in my case, almost shot a hole through the side of a 225 HP Evinrude lower unit. When that happens it's bye-bye lower unit.

From what you are saying, I would say that 100% you should be covered. I agree with Doonbuggy about asking where it is excluded. In addition to that, there are services out there that will fight for the consumer in these case. Before I went that route though, I'd get a statement from your repair shop saying that they believe this damage all happened in the same incident, and then threaten to go to the state insurance commission with your problem.

Maybe we can trade some emails and I can help you out more directly. I'd be happy to help you out if need be. jholmer at farmersagent dot com.

[Ray Esboldt]

MNBassGuy,

I am sure Fluker will thank you, but thanks for helping all of us out. That is some great information. I for one really appreciate it.

[NCLaker]

Thanks for the helpful info! I've never had to use my boat insurance and hope I never have to. But if I do, your info may come in handy.

[Fluker]

Jason - Thanks a bunch. E-mail will be heading your way for any assitance, and likely to possible look at using you for insurance in the future!!!

By the way, latest news is my claim agent asked my shop to talk to the adjuster. My shop told me that the adjuster told them that they don't believe I hit anything. THere are 2 things that I can't stand in this world. A liar and a cheater, and I've just been called one of those (and maybe both). So I'm not a happy camper.

The saga continues.

[kg2]

How can they say you didn't hit anything when you have a brand new prop that is dinged?

[Fluker]

That's the next question that I have as soon as they call me back.

[CaptZ21]

Sounds like your agent should be taking a more active role in your claim. I haven't had a claim in over 20 yrs, and that one was a gem in that I was using a borrowed boat. Long story short, it basically came down to the owner's agent being a great guy and working with me when my agent said he couldnt help. Obviously, I changed guys, for everything, house, trucks, cars, the whole enchillada. You might remind your agent he does work for you. Sounds like you will prevail, just need to hold the course and INSIST on fair treatment. I would not get a lawyer involved so early in the game. Good luck. By the way, it was a State Farm guy who jumped in and helped me...

[MNBassGuy]

The biggest mistake I see made in the insurance industry, and it's by customers and agents alike, is that everyone wants the cheapest policy! Insurance is no different from anything else, you usually get what you pay for.

The mistake agents make is two fold. First, many tend to align themselves with cheap companies because its an easy sell. Second, they don't eductae their customers enought about the policies that they are buying.

90%+ of all of my clients come to me and say that price is what they will use to make their buying decision. By the time I educate them about insurance, they usually not only let go of that price requirement, but they ask about other polcies that they didn't intend to buy. It's not that I'm some magical salesperson, it's that when people know what they are buying, they tend to make better decisions.

Again, in Fluker's case, this is a no brainer in my opinion, and I agree that his agent should be beating down the adjuster for denying this claim. He'll win in the end, but it shouldn't be so hard.

Here is one more piece of ammo to ask the adjuster:

He is clearly taking the stance that they aren't going to fix something mechanical, which is completely accurate. Just like how insurance doesn't cover your car when your brakes go out, or any other mechanical issue happens. The catch is simply that if you have an accident, then you insuance will cover any mechanical problems. Why is your boat any different?

Sounds to me like the main issue to getting them to agree that you hit something. Do that and they have no leg left to stand on!