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Insurance claim denied

Old 08-30-2017, 10:18 AM
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Default Insurance claim denied

Hit something (submerged log? Bottom?) when entering the Swinomish channel last month, between the shallow water and the several knots of current I kept going and an hour or so later as I pulled into the dock at the other end the engine won't go back into gear. Towed and hauled the boat and the mechanic tells me that there is metal throughout the outdrive (Bravo 3). We pull the drive and the mechanic explains that there are broken teeth on several gears - he explains that this is fairly typical of B3 and that the props are actually much stronger than the internal components of the drive and that this could only have been caused by hitting something. One gear breaks and then the metal spins around and breaks everything else. The insurance inspector describes basically the same thing when we're setting up time for him to inspect the drive, he essentially says that he looks for broken teeth - if there are broken gears, its impact (covered) - if its broken bearings then its mechanical failure (not covered). Fast forward and you guessed it, the insurance company has denied the claim saying its wear and tear / mechanical failure. The inspector basically tells me that because there is no damage to the outside of the drive that they can't "prove that it was caused by impact".

I'm not really sure what lessons are to be learned here, other than A. find another insurance company and B. make sure if I hit something, to hit it really hard.

Is there any way to damage a B3 drive in a way that doesn't require complete replacement?

It seems like the rebuilt drives are a bit hit and miss, anyone have good luck with one?

Many Thanks
Old 08-30-2017, 10:20 AM
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Oh and I should also mention that I'm in an extra 1k for labor to take the drive completely apart for inspection which actually resulted in destroying the otherwise rebuildable case of the lower unit.
Old 08-30-2017, 10:26 AM
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sounds low rent on the insurance side. You could have taken a hammer to the outdrive pre inspection.

I say hunt down the insurance adjuster and beat the shit out of him
Old 08-30-2017, 10:30 AM
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What insurance company?
Old 08-30-2017, 10:30 AM
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Please name the insurance company, it might help the next guy.
Old 08-30-2017, 10:33 AM
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Appeal the denial. They often say no he first go round to see if you will go away. Is there any damage to the prop or the outside of the case? Even paint damage.

Why is the case damaged beyond repair? If it was rebuildable before, then there was a problem caused by the person taking it apart, it would seem.
Old 08-30-2017, 10:33 AM
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Originally Posted by GH02050 View Post
Please name the insurance company, it might help the next guy.
Well, what he's saying they're denying on is pretty cut and dry. If there's zero damage to the outside of the drive, its hard to prove you hit something.

Kinda like driving into a telephone pole, your radiator blowing up, and having zero external damage.

The adjuster is in a sticky situation as they like evidence of hitting something, and if there was zero indication of hitting something, and the insurance company made a second pass and deemed nothing hit, he would be liable for insurance fraud.

All that said and done, appeal it. Have your mechanic write up the facts about the drive and what would cause the damage.
Old 08-30-2017, 10:35 AM
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Progressive - I was sent to them after USAA stopped providing insurance for boats. I guess that like many insurance companies they are great at TAKING money, but PAYING isn't part of their business model.
Old 08-30-2017, 10:39 AM
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Originally Posted by STEELA View Post
sounds low rent on the insurance side. You could have taken a hammer to the outdrive pre inspection.

I say hunt down the insurance adjuster and beat the shit out of him
Perhaps the thread starter is sleeping w/insurance adjuster's wife on thread starters boat thus insurance adjuster hypothesis if he deadlines mans boat, his hussy wife won't be banging the guy baller boat no more???

Regardless, pic of insurance adjuster's wife should be posted...
Old 08-30-2017, 10:40 AM
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Sorry to hear this. Tough one. I would ask for an appeal, although you do admit that you hit something and kept going and there does not seem to be evidence of hitting something. I am not doubting just reading facts.

I cannot reiterate enough- I am in the insurance business and I have said it even this week and probably last week here on THT. Get a marine insurer not a non standard auto carrier who dabbles in marine insurance.
Old 08-30-2017, 10:41 AM
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If there is no external damage then your going to have a hard time convincing any insurance company to pay that claim. Think of all the blown lower units where people could just say "Oh, I hit something" with no external damage. Did you have the outdrive torn down or was it requested by the insurance co.?
Old 08-30-2017, 10:45 AM
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The props appear fine - I suppose that it was my fault for getting my hopes up after initially talking to the mechanic and then to the inspector. They were the ones that explained to me how the internals of the Bravo 3 break so much easier than the props. In fact the inspectors notes read "Likely caused by impact". Kind of put a damper on boating this year.
Old 08-30-2017, 10:46 AM
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Originally Posted by nealj View Post
Progressive - I was sent to them after USAA stopped providing insurance for boats. I guess that like many insurance companies they are great at TAKING money, but PAYING isn't part of their business model.
I believe it's up to you to prove your claim.
Old 08-30-2017, 10:47 AM
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If the insurance company asked to have the outdrive torn down then they should pay that amount. You do have an appeals process or you may want to start by calling a local mgr. With having no external damage its going to be tough to get that claim paid.
Old 08-30-2017, 10:50 AM
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Definitely finding a better insurance company is in my future and I think that the company's lack of experience dealing with boats played a large part. Most of the people that I talked with had no idea what an outdrive even was (I ended up describing it as "kind of like the transmission in a car" a couple of times).

I got the impression (though he didn't say it) that the inspector disagreed with the company but was stuck with it (ha! he got to explain it again to my less than happy wife).
Old 08-30-2017, 10:57 AM
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Pics of adjusters wife needed before solid advice on how to continue may be given.
Old 08-30-2017, 10:59 AM
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should have smacked it with a sledge hammer...
Old 08-30-2017, 11:02 AM
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Personally, I have seen Progressive pay a shitload of lower unit claims. the people taking your info on the phone have no idea what a lower unit is, but, the handling adjuster normally would - assuming he/she is a Progressive adjuster.

Couple things:
- Appeal it, as mentioned above. Go back and say 'my mechanic is adamant that the damage was caused by an impact'. Have another Mechanic corroborate this.

- Add Lower Unit damage coverage to your policy (covers even if it is just for a failure).

Honestly, there is normally some sort of exterior damage if it was truly caused by an impact. There should at least be a nick of some sort on the prop(s).

Finally, I will say that I have experienced lower unit failure in the past, and, the act itself of the lower unit failing can / will feel and sound like you impacted something. Not saying this is what happened in your case - just saying it feels like an impact sometimes when the unit fails.

Good luck.
Old 08-30-2017, 11:03 AM
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How does the prop look? and the case?

If they look good...you probably didn't hit anything hard enough to cause damage and the drive just failed.
Old 08-30-2017, 11:06 AM
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Your statement that you hit something should be given great weight. Did you make the same statement to the person who towed you in (and who could then corroborate your story)? That might be very helpful. You should be given the benefit of the doubt. That's what good insurers do.

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