Protecta Insurance - Claim problems

[DMNTD:Me]

Yeah, that's another one where the insurance industry can 'get' you....
If they find out that $5000 was what you paid, and you didn't provide other proof that it was worth $20,000 - no prizes for guessing what they'll pay out...

...market value
Have seen it happen 5 or 6 times.

[Owl]

Yeah, that's another one where the insurance industry can 'get' you....
If they find out that $5000 was what you paid, and you didn't provide other proof that it was worth $20,000 - no prizes for guessing what they'll pay out...

No, it's still a market value policy!

If you're given a $20,000 vehicle as a gift, is it worth $0?

[schnupfy]

Yep, the fine print says market value. I will have to live with that if I ever get the money from the insurance.

I just got word that it is likely to be declined again today due to the same reason (front tire worn). That took them almost 3 weeks to decide that and now I can apply for a letter of dead lock where it will be reviewed again (which I am sure) will take another month or so... Very Very annoying. I thought having a current WoF done + a service before a trip like that should be reasonable enough to meet the insurance Obligation of keeping it roadworthy at any time...

[schnupfy]

Hi again,

I still have problems with Protecta here. They have now declined the claim and I requested a letter of dead lock to take it to the ombudsman more than two weeks ago and they haven't provided anything yet. When I call them they always say it is with the manager and when I ask to talk to them they just say that the Manager doesn't have a number or is not available.

Another pretty annoying thing is that they said they were sending a VTNZ guy over there to check the bike. The workshop told me that someone was there (which Protecta now denies) and after that a guy from the insurance came by to take some pictures and quickly afterwards the claim was denied again.

What would be the next logical step here? Should I go to a lawyer?

Thanks in advance there.

Cheers Marcus

[Owl]

What would be the next logical step here? Should I go to a lawyer?

Did they decline the claim in writing? If so, you should be able to take that to the Ombudsman.

[Grahameeboy]

Interesting case

Protector can only decline the claim if the roadworthiness issue was the cause of the accident...Insurance Law Reform Act. The fact that the tread depth may have been below the legal limit is not a basis to decline as this is a legal issue..same as if you were drunk in charge and hit in the rear....not a reason to decline claim because the "drunk" issue was not cause of accident.

If this was a car then there would have to be "loss of control" and at least 2 unroadworthy tyres for the claim to be declined so I guess with a bike 1 is enough but the onus is on the Insurer to show that the accident would not have happened but for the front tyre issue.

Cannot use recent WOF as a defence because it is only a test on the day and not evidence that the tyre at the time of accident was okay.

I guess with just 3mm left and knowing you were doing a long trip should have indicated that the front should be replaced...easy to say in hignsight I know...but still a valid point going forwards.

I would go via the Ombudsman route now as it seems Protector are dragging things and to me is an inferred "reached an impass"

[schnupfy]

Thanks for that, will put a letter together and send it to the Ombudsman. Will see how it turns out.

Cheers,
Marcus

[motorbyclist]

Have you actually looked at the front tyre? If the tread is no less than 1.5mm and wear indicators are not showing, then they have nothing to stand on.

If you HAVE worn the tyre to a less than warrantable standard, then you will have to prove that the tyre wear was not a contributing factor in the accident. Probably should have replaced the tyre before the trip, anyway.

so, what's the front tyre look like?

The owner is always responsible for ensuring the value being covered is accurate. The insurer will happily take your premium money, but will not pay out more than the market value. Very difficult to prove your bike was worth more, when it's a twisted wreck, eh?

even worse when it's been stolen and never recovered (as happened with myself and Protecta a few years ago) - they will happily quote the trade-in value of the motorcycle rather than the actual market value.... ever noticed how a dealer will offer you 3 grand for a bike when he's selling the same thing in worse condition for 7 grand right next to him on the shop floor and it would be 5-6 grand from a private seller?

[Ocean1]

Since the rules regarding tread depth for WOF changed I've been meaning to measure up a few new front tyres. I reckon some of them would be bloody lucky to be legal off the rack, there's bugger all tread depth.

I somehow doubt the tyre manufacturers check NZ law before detailing the wear indicators in the moulds for each new tyre either.

[nomnomnom]

I just called Protecta to ask a general question, you can refer to the call if you like (they will be able to track it and listen to it)

today 04/05/2011 @ approx 4:32pm. Called 0800 435 7868, spoke to Rachel who transferred me to Chris in Claims. I called from 09 969 3500.

I asked Chris in Claims, "if a motorcycle is insured through you, has an accident and is a write off, has something wrong with it, but that something does NOT contribute to the crash, will you pay out the claim?"

He confirmed yes. He then went on to say that if the tread depth of a tire is low, but this does not contribute to the crash then the claim would be paid. After he said this, he followed it up with "this is assessed on a case by case basis".

So not too sure how much this will help but hey it doesnt hurt to try

[Owl]

I just called Protecta

Good one!

[slowpoke]

Good one!

How so? I doubt they record every single phone call. If you were a judge/ombudsman and somebody rocks up and says "Look, there's this bloke on the internet,I've never met him but he says he called up the insurance company and apparently they said blah blah" how impressed would you be?

Be realistic.

You have to prove that the tyre was not a contributing cause, not just be kinda sure or fairly certain or similarly vague. You're gonna need photo's of the site and thing that caused the accident (tar lump? WTF?), eye witness accounts, expert opinions on state of tyre/machine etc etc. You need the kinda info that you would be prepared to bet your house on that it's absolutely right, or don't even bother presenting it. Are you prepared to bet your house that the tyre is 100% roadworthy?

[Latte]

I remember there was a claim from a manufacturer that their tyres worked just as well at 1.5mm as they did at full depth.

a) If it wasn't a dream and
b) If you're able to get some official literature

it might help your case.

[Owl]

How so? Be realistic.

Pull your head in!

I said "Good one", referring to making the phone call and getting some clarification.

[Ocean1]

How so? I doubt they record every single phone call.

They do indeed.

You have to prove that the tyre was not a contributing cause

I believe the burden of proof lies with the insurance company. I'd say if you called their bluff and asked your lawyer to drop them a wee note they'd fold.