Mansell, Engel & Cole

House stinks: policyholder says insurer's claim denial does, too

The majority of seasoned insurance policyholders in Oklahoma and nationally are properly cynical when it comes to the companies they contract with to insure them against loss and damage in varying contexts.

Put another way: Although most of us harbor hope that our insurer will respond in good faith when we file a bona-fide claim, we're not exactly stunned by stories where such is not the case.

In fact, insured individuals and families see tales of insurers' nonperformance routinely in media accounts across the country.

Some of those stories are flatly outlandish and even beyond belief. A claim might be denied because an insurance company states that a homeowner's roof that was ripped off in a tornado of tremendous strength was actually damaged by faulty workmanship. Coverage for an emergency room visit might be rejected because an insurer insists that a policyholder in great pain could have waited until the next day to visit his or her regular doctor.

Indeed, stories of denial are legion, with insurers' behavior sometimes being callous and even brazen.

Here's arguably such a tale. A woman from Colorado recently had to vacate her home and either throw away or have cleaned at a premium cost virtually every possession her family owned following the death of a large skunk living beneath her house.

She duly filed a property damage claim. And her insurer (seemingly after taking a microscopic look at her policy language) seized upon the argument that her claim lacked merit because the skunk was "vermin" and not covered under her policy.

That is of course debatable. Multiple dictionaries imply that a skunk, which is a mammal of some size, is not in the same category of irritating insects and small rodents (think rats) that are quickly classified as vermin.

Reportedly, the insurer is stridently uncommunicative with news reporters trying to follow through with it on behalf of the aggrieved policyholder.

We modestly suggest at the pro-claimants' insurance law firm of Mansell, Engel & Cole in Oklahoma City that the woman might get better results from contacting proven attorneys who have a demonstrated history of dealing effectively with resistant insurers.

The bottom line with insurance contracts is that their rights and duties flow two ways. If a policyholder performs in good faith, he or she has a legal right to expect that an insurer will do the same thing.

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