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Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 11:52 am
by ChefCarey
you suck.

Four of the chef-owned restaurants in New Orleans I mention in my Creole book, are up and going strong again - Bayona, Herbsaint, Peristyle and Lilette, reputations firmly intact.

The fifth, sadly, will not reopen again, ever. I had several of the best meals I've ever had in New Orleans at Chef Peter Vazquez's Marisol.

The insurance company would not pay for the Katrina damage.

I will really miss Peter and Janis and this wonderful little bistro on Esplanade.

Re: Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 1:04 pm
by Jenise
Chef, that's very sad. From what you say, I'm presuming they had insurance but their insurer found some loophole with which to deny it, or did they simply have insufficient coverage?

Re: Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 1:30 pm
by ChefCarey
Jenise wrote:Chef, that's very sad. From what you say, I'm presuming they had insurance but their insurer found some loophole with which to deny it, or did they simply have insufficient coverage?


From what I understand it was a combination of the two - had there been any concessions from the insurance company they would have been able to pull it off. Last I heard Peter was looking for a job in Vietnam.

Re: Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 2:59 pm
by Ian Sutton
I do think in these "loophole" situations, it's down to the ethics of were the restaurant made aware of the loopholes / restrictions (unlikely) and was there a realistic expectation to be covered. Awfully difficult to verify, but in a case such as Katrina, there's a large number of similar claims and if they can find another company that has paid out despite a similar exclusion, then there's potential to push back against the insurer.

Insurance companies do get a hard press, sometimes fairly, sometimes unfairly. Sadly a few people see them as faceless & heartless big business (which some of them are!), but don't appreciate that paying out on a risk that wasn't covered means higher premiums for all in the future to recoup the loss. For an insight into a very public instance of ambiguous coverage, look no further than the WTC claim (which basically needed to decide was it one event or two).

Loss adjusting IMO requires a mindset totally different to most that work in the industry. It appears the key skill is a healthy degree of distrust and a keen understanding of not just what was covered, but what was not.

In this instance, there sounds like some grey area. Insurance companies can be challenged, though I'm assuming the owners took legal advice and were warned off pursuing such a course of action.

N.B. I used to work for three different insurance companies (I'm now in IT) in the actuarial field (aka the grey eminances!). My closest experience to this however was a personal claim when my flat was broken into.

regards

Ian

Re: Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 5:01 pm
by Redwinger
I too find it inexcusable that the restaurants had flood insurance and their flood insurers won't pay up. (Surely they must have had flood insurance since any prudent business person operating an enterprise below sea level would have made purchase of flood insurance a priority).
Bill

Re: Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 5:16 pm
by Ian Sutton
There must have been a reason (valid or not in our eyes!). Perhaps some key information wasn't disclosed, perhaps they were underinsured (but in this case insurers normally proportionally reduce the claim), perhaps they chose a really cheap policy and chose to ignore any thoughts of why it would be cheap. We can all speculate, but there might be a very legitimate reason, and as a premium payer, I should want the insurer to ensure everyone is subject to the rules of the contract - otherwise my premiums will go up in order to pay for their generous payout to others.

It's fair to say that most people, myself included, do not look at the precise details of the cover. We often buy blindly on hope that we'll be covered and naivety that we'll never claim.

Before I can agree or disagree I'd need to know why this claim was disallowed and have some indication of the wording of the relevant section and the sales method employed.

regards

Ian

Re: Apologies to all you insurance agents out there, but...

PostPosted: Wed Oct 25, 2006 6:43 pm
by James Roscoe
I assume lawyers are litigating this one. If they aren't then the "loophole" was fairly tight. I hope the lawyers have advised the chef-owner correctly. It definitely sounds like a case that needs to be litigated based on the few facts given here.

Please remember that insurance companies are businesses like every other business and are in it for their stockholders, not for their insured. Any person with an insurance policy who has any other point of view is living in a dream world. Their are laws that protect the insured, but my suspicion is that the laws in Louisiana don't offer the same protections as those in New York or California.