Am I Really Covered for my Own Stupidity?

[OldGeek]

Hello, and thanks for this useful forum.

I did something really stupid yesterday and am having a hard time believing that I'm covered for it. Here's what happened. (I'm sorry, it's kind of a long story...)

I bought a used car a few weeks ago. It's 10 years old and was driven by a college student for the past six years. That being the case, a lot of the routine maintenance items (timing belt, plugs, wires, etc.) were neglected. So I set about fixing it up.

Yesterday morning, I was complimenting myself on the fact that the needed work was pretty much done, but I decided to degrease a few spots on the engine and hose down the radiator (it was full of bugs and such). So I sprayed the degreaser on, and while it was foaming, I checked the various fluid levels, belt tension, etc.

I had just pulled the transmission dipstick when someone called me about two used tires I'm selling on Craig's List. I walked over to where the tires were and absentmindedly set the dipstick down on the rock wall. When I hung up the phone, I walked back to the car and started hosing down the engine and radiator -- with the transmission dipstick still on the rock wall!

A little later, I made a roughly 60-mile trip to buy a workbench from someone on Craig's List. Then I visited a bunch of garage sales and such looking for other stuff I can buy and fix up, and then I just kind of drove around sightseeing for a while. I don't get to that side of the river very often. Then I headed home.

A few miles away from my house, the transmission started slipping. By the time I got to the road I live on I thought sure I was going to have to call for a tow, less than a hundred feet from my house. But the car made it -- barely.

After I parked, I looked under the hood to pull the tranny dipstick, and you know the rest: It was still on the rock wall. I immediately knew what had happened: I'd gotten water in the tranny when I was hosing down the engine. That's fatal to a transmission. Frankly, I surprised it took as long as it did to break down. Probably it's because only a very small amount got in there.

I was furious at myself. After all the work I'd put in, I couldn't believe I'd gone and done something so incredibly, colossally, epically stupid. I cussed and sulked for a while, and then I decided to call my insurance company. Frankly, I thought it was a long shot, but what the heck.

When the agent told me that yes, that damage would be covered under comp, assigned me a claim number, and told me the adjuster would be calling me, I was flabbergasted. I truly couldn't believe it. And I'm still having a hard time believing it, which is why I'm posting here. Is it really possible that stupidity of such epic proportions is covered?

Thank you, and again, sorry about the long post.

Richard

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Well, I guess it's true. The adjuster just called and he'll be here tomorrow morning.

Richard

 

[WinoBlues]

Looks like you have good insurance on that old car. Do you have replacement cost Life Insurance on you?

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Richard

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[OldGeek]

Looks like you have good insurance on that old car. Do you have replacement cost Life Insurance on you?

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No replacement cost insurance on the car or on myself.

I guess the insurance is pretty good. The company has a fondness for amphibians. I don't have a whole lot of experience with insurance (other than paying premiums) to compare it to. I haven't had a lot of claims. I had one at-fault fender-bender more than five years ago, and a road hazard comp claim on the rental car they gave me for that claim (hit a chunk of rubber on the New Jersey Turnpike). They handled those pretty well.

Other than that, I've had no claims, and I've been driving since I was 16.

I do hope they fix this car, but I suspect they're going to total it. I did gather up, copy, and submit the receipts for all the work I've had done on it. I'm hoping that the fact that it's now current on all its required (and expensive) maintenance might sway the decision. But I fear it's probably just wishful thinking.

Thanks.

Richard

 

[INSUREGEEK]

Around here we often joke that there is no "Stupid Exclusion". I've seen claims paid where people change their own oil and forget to put the drain plug back in before the motor blows up.

 

[djs]

Simply said:
Do not believe you are covered till you have the check in hand.

This is one of the type of claims that will get reviewed by a claims panel and they may call it a maintenance issue rather than 'sudden and unexpected' insurance issue. If your agent is experienced and has had similar claims in the past, he will know the outcome, but, as an agent with years of experience, I would not give a definitive answer to this claim till I checked with the adjuster, or at least could site the section of the policy that showed it was covered and checked the exclusions to make sure it wasn't excluded in some manner.

Also, how do you know the transmission failed from the work you did? Does a little water in the fluid cause a transmission failure in less than 60 miles? I truly don't know the answer to this, but expect it to be asked.

Or is it possible the transmission was slipping when you bought the car?

Dan

 

[OldGeek]

Simply said:
Do not believe you are covered till you have the check in hand.

This is one of the type of claims that will get reviewed by a claims panel and they may call it a maintenance issue rather than 'sudden and unexpected' insurance issue. If your agent is experienced and has had similar claims in the past, he will know the outcome, but, as an agent with years of experience, I would not give a definitive answer to this claim till I checked with the adjuster, or at least could site the section of the policy that showed it was covered and checked the exclusions to make sure it wasn't excluded in some manner.

Also, how do you know the transmission failed from the work you did? Does a little water in the fluid cause a transmission failure in less than 60 miles? I truly don't know the answer to this, but expect it to be asked.

Or is it possible the transmission was slipping when you bought the car?

Dan

I know that it's not possible that the transmission was slipping when I bought the car because I drove it about 1,000 miles before this happened, and there were no problems. It also was driven by two mechanics who were working on other things (overdue timing belt change in one case, and a CV joint that was making noise in the other), and neither of them noticed any possible transmission issues.

The problem is that although I know that, the insurance company doesn't; and they want to make sure that the water caused the failure. To that end, they want me to agree to a transmission tear-down -- at my own expense -- so they can inspect it. If their inspector agrees that it's water damage, they will provide a used transmission.

I've spoken to five shops, all of whom refuse to do the work. Three were the only three tranny shops within a 50-mile radius (I live in the boonies), and none of them want to be bothered. There's no money in it for them, plus they don't want to be bothered waiting for an adjuster, and then for a tranny, with no guarantee that they're going to be paid. The other two shops are local garages that can swap a tranny, but don't consider themselves qualified to tear one down.

The owner of one of the shops (an AAMCO franchise), after telling me he had no interest in the job, did tell me that he believed the tear-down demand was probably unnecessary. According to this fellow, the probability of a sudden failure like that with no previous symptoms due to normal wear is unlikely in general, and virtually zero considering that we know that water was introduced into the transmission. He also says that draining and examining the ATF would probably be sufficient to make the diagnosis, and should certainly be tried prior to tearing down the transmission.

A lady at the state agency that regulates these sort of things also told me by phone that if I file a complaint with the state, the demand that I pay for a tear-down that the insurer is demanding probably will be ruled unreasonable because removing and tearing down the transmission is actually more costly than replacing it with a used one would be.

I should mention that if the insurer decides that the damage is due to the water, then they would pay for the tear-down. But initially, it would be at my own expense.

I do understand the insurer's side of things. They don't cover normal wear. But I also think it's unreasonable to insist on the most expensive way of making that determination -- at my expense -- as a first course of action.

Also, I'm a man in my 50's who's been driving since I was 16 and has had exactly two claims: One collision over five years ago, and a comp claim on the rental car they provided while my car was being repaired due to my hitting a big hunk of tire that a tractor-trailer shed and damaging the plastic bumper of the rental car.

So what I'm saying is that I'm not one to make frivolous claims. In addition, I've been with this insurer for 11 of the last 12 years (I switched for a little less than a year, then switched back), so it's not like I signed up with them just to file some bogus claim.

I'm considering going ahead and filing a complaint with the state board, which is what the lady from the state strongly recommended that I do after I told her my story. If nothing else, the insurer may decide that it's more of a hassle to deal with the complaint than to just replace the tranny. I'm also told by friends that I should look into retaining a public adjuster, but I have no idea whether it's worth it considering the amount of money involved.

Perhaps the most frustrating part of this (other than my own stupidity) is that I do understand everyone's concerns. The insurer doesn't want to pay for normal wear, the transmission shops don't want to do work they're not making money on, and the general shops don't want to do work that they're not qualified to do.

Quite frankly, at this point I'm ready to propose that the insurer have a used transmission dropped off at my house (the adjuster claims they can get them on the cheap, anyway), give me a check for $500.00, and call it settled. Then I'd hire a roving mechanic from Craigs List to do the swap for a grand and pay him myself. I'd even get under the car and help him.

The angrier side of me also knows that my proposal would be a good deal for the insurer. I'm semi-retired and I have the time to create enough expense for the insurer through complaints and litigation that my idea would be by far the less-expensive option. But I'm really not that kind of person, so I don't want to take that route. But if I'm forced... well, I'll do what I have to do, I suppose.

What it comes down to is this: I was surprised that my own stupidity was covered by my insurance. But now that I know that it is, then I want the company to honor their commitment. I've always upheld my end of the deal, and now they should hold up theirs.

Thanks,

Richard

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Around here we often joke that there is no "Stupid Exclusion". I've seen claims paid where people change their own oil and forget to put the drain plug back in before the motor blows up.

Thank you. I would never have believed that I could do something so idiotic. Now I'm a bit more humble....

Richard

 

[OldGeek]

Here's a followup:

fuckedbygeico.com (sorry, I'm too new to post full hyperlinks)

They shouldn't mess with semi-retired Web designers with time on their hands and their own Web servers.

Richard

 

[WinoBlues]

Here's a followup:

fuckedbygeico.com (sorry, I'm too new to post full hyperlinks)

They shouldn't mess with semi-retired Web designers with time on their hands and their own Web servers.

Richard

You broke it by your "own stupidity".

 

[OldGeek]

You broke it by your "own stupidity".

Indeed. The day I am perfect, I will no longer need insurance. Your entire industry exists because of human fallibility. I'd be grateful for it, if I were you.

Richard

 

[WinoBlues]

Indeed. The day I am perfect, I will no longer need insurance. Your entire industry exists because of human fallibility. I'd be grateful for it, if I were you.

Richard

I am a Life Insurance agent Xs 30 years. I have delivered Millions of dollars to families and a few Million dollars to companies that employ thousands. Most were grateful to me.

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Indeed. The day I am perfect, I will no longer need insurance. Your entire industry exists because of human fallibility. I'd be grateful for it, if I were you.

Richard

What reason did they give you for the denial?