March 12, 2019

If You Have a “Hall of Claims” Event, You Might Not Have Coverage At All

by Bryan Holtzman

JK Simmons, we love you – but those TV commercials are going to drive us crazy!

You know the ones: a national insurance carrier depicts an outrageous, catastrophic property loss.  A dog starts a fire by playing with laundry detergent, for example.  Or a mountain lion drags its claws extensively over a homeowner’s property – stuff that basically NEVER happens.  And what does JK have to say?

“We covered it.”

For the TV-viewing public, the idea is that this insurance carrier will cover anything – any remotely imaginable scenario that may befall your property will get reimbursed through your insurance policy.

Why does this drive us crazy?  Because it’s not true!

How is it misleading?  Very simply: exclusions.

If you look at a standard homeowner’s insurance policy, it will contain various exclusions for damage caused by random incidents – whether by animals, Mother Nature or homeowner carelessness.  Typical policy language might stipulate that the insurer will not cover damage caused by:

“birds, rodents, insects, or vermin. Vermin means animals that tend to access, or enter into or under, structures for foraging or shelter, and, as a result, cause loss or damage. Such animals include, but are not limited to, armadillos, bats, beavers, coyotes, lizards, opossums, porcupines, raccoons, skunks, snails, snakes, slugs, or squirrels.”

The above definition of “vermin” is telling – and explains our frustration with JK Simmons and his ads.  It’s true that Farmers Insurance did indeed cover the loss for the events depicted in its “Hall of Claims” ads – but they probably only did so once or twice.  After that, their lawyers no doubt updated all of their policies to ensure that such events were thereafter included in a policy exclusion or limitation so that similar events would then trigger a denial of coverage.

When events occur a few times, insurance companies will clarify wording in policies to exclude such events.  Attorneys crafting this language for insurers will add wording explaining specifics as to what, for example, is included in the definition of “vermin” for coverage purposes.

So, keep right on lovin’ JK and his fine work as the Farmers spokesman.  But recognize that insurance companies don’t just hand out checks every time you have a property loss.  Insurers won’t always tell you that – but a public adjuster will!

Bryan Holtzman

Bryan Holtzman is Vice President of Swerling Milton Winnick, with more than 15 years of experience helping businesses and homeowners navigate complex insurance claims. He specializes in building estimates and policy interpretation.
If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.