[BC] Acts of Mice

[Bill Jacobs/WRDV]

 >    Has anyone had experience with a claim of this type, and what was 
the outcome? Is there some subtlty which classifies lightning but
 >    not damage from wildlife as an uncovered "Act of Nature" loss 
which I'm not aware of? This is several thousand in repairs, and the
 >    client is a small mom-and-pop, with very shallow pockets. This is 
why he has insurance, but as most companies, they are looking for
 >    an out. What say the brain trust?

Task # 1: Read the insurance policy carefully.  VERY carefully.  The 
entire analysis depends on precisely what it says, and policy language 
differs from insuror to insuror, from state to state, and from year to year.

Task #2 : Read the denial letter equally carefully.  Note the time and 
manner to request reconsideration of a denial of coverage (it may be in 
the letter; if not, it will be in the policy).  If you conclude that the 
insuror is wrong, make sure to seek reconsideration on time (you can 
also call the adjustor to discuss the matter, but don't let the appeal 
time run while you do).

Task #3 : Talk to a "public adjustor" in the area to find out what he or 
she thinks.  If you hire one, you'll probably pay 1/3 of the recovery, 
but getting 2/3 of something is better than getting 100% of nothing.

Task #4 :  If, after doing the above, you still think you're getting 
hosed, talk to a lawyer about suing.  Insurors are generally required to 
process claims in good faith.  If an insuror denies a claim without 
proper basis, you may be able to collect a multiple of the claim amount, 
perhaps plus attorneys' fees and even punitive damages.  This varies 
widely from state to state, and -- though I'm a lawyer here -- I'm 
probably not licensed in your state.

And, of course (to make my malpractice carrier happy) you aren't my 
client, and this isn't legal advice.

Bill