When to Challenge Your Insurance Company Over ‘Wear and Tear’
When an expert is hired by an insurance company to investigate a large claim, it is usually advisable for the insured party to contact their own experts to participate in the investigation. For a marine insurance claim this usually means hiring a marine surveyor who is experienced in litigation and insurance investigation. An attorney may not be necessary during the early stages of an investigation, but an experienced maritime attorney will be a good resource for a referral to a qualified surveyor that the attorney is comfortable working with.
Your surveyor will participate actively in the insurance investigation, and in some circumstances he may recommend a referral to a second expert if scientific investigation is involved. For the claim described above by the reader, the surveyor would probably refer the boat owner to a metallurgist or engineer who is qualified to review and comment on the findings of the insurance company’s expert.
The insurance company’s expert will render an opinion as to the cause of the damage, and the insurance adjusters will determine whether those findings fall within the coverage of the insurance policy. In the end, the opinions of the boat owner’s experts may confirm the findings of the insurance company, or they may provide support for possible litigation against the insurance company for a wrongful denial of coverage. In either case this is money well spent.
It may be possible to recover part of the loss even if the boat owner’s experts agree with the findings of the insurance company’s experts. For example, if the damage was related to a “latent defect,” such as a manufacturing defect in the damaged part, the boat owner may recover for any damage caused by the defective part, even though the damage to the defective part itself is expressly excluded from coverage.
A boat owner may also recover some or all of his costs to return to port or otherwise protect the boat after a casualty, under a principle known as the “sue and labor clause.” This “clause” is not actually spelled out in most insurance policies, but it is nonetheless imposed as a mutual duty upon both the boat owner and the insurance company. In short, it requires the boat owner to take all reasonable steps to protect the boat from further damage after a casualty, and it requires the insurance company to reimburse the boat owner for those actions. In the case described above by the reader, the tugboat fees for towing the boat to San Diego will probably be covered under this provision since the boat needed to return to port to prevent further damage.
Marine insurance is a complicated subject which may consume an entire semester in law school, and an experienced maritime attorney should be contacted in the event of a disputed claim.