Jul

Case Study: The “Grey Area” claims revisited

2011-07-01 14:12
These pictures of the truck and the damage were submitted by the client with the claim.

The Subject this month: An Isuzu 8 tonner.

The Claim: A gearbox/bell housing/ propshaft “mess’.

Apparently driving through carnage, the truck suffered this mechanical damage. The fun part of the Claim is , and I quote from the Claim Form Attachment letter…

“My Driver avoided the boulders by moving onto on-coming traffic. The driver managed to stabilize the vehicle by using foot brakes as well as engaging to a lower gear, only to find that there were men standing at the end of the hill. The men threw more boulders under the truck. Naturally the driver panicked – he further changed down in pani while the truck was being lifted up only to hear a loud bang. Please bear in mind that the driver is only human – due to the truck being unstable the gearbox could have jammed’.

The letter continues in the same vein (a copy sent to FleetWatch).

If only all our Claim files were as colourful! I love it because although the driver drove the truck, it clearly must have had a Drive Cam fitted because the owner has so expertly described the unfolding carnage and “damage’ in the letter to our Claims people! If anybody in the insurance industry believes these Claims are straight forward, I would debate differently. I would proffer a suggestion that this is the classic variation of an over-rev, i.e. too fast for the conditions or gearbox failure’¦ okay any of the above!

These pictures of the truck and the damage were submitted by the client with the claim.

These pictures of the truck and the damage were submitted by the client with the claim.

Let’s be honest and suggest some points:

1. What is the subject of the Claim, a shattered gearbox/bell housing/engine damage?

2. How many Underwriters would repudiate this Claim?

3. If there is “betterment’ how does one begin to calculate it?

4. Is there negligence on the part of the driver?

5. Was it speed and driving or a straightforward lack of maintenance as is so often seen in the South African truck park?

Let’s try answer the above points:

These pictures of the truck and the damage were submitted by the client with the claim.

These pictures of the truck and the damage were submitted by the client with the claim.

1. The gearbox “failure’ caused the conventional peripheral damage to the propshaft and other surrounding components. I would suggest the classic excessive speed in the wrong operating conditions.

2. Many would repudiate this out of hand as a maintenance issue. If I am wrong let’s debate this aspect.

3. Difficult, because the vehicle is relatively old. If Betterment was applied, how and what proportion?

4. I would definitely suggest the driver, assuming this is our Case Study over-rev situation, was negligent in the inappropriate driving style for the conditions.

5. This particular incident doesn’t portray maintenance but so often it is the routine preventative maintenance.

These are always the most difficult types of claims for more reasons than highlighted and my point is, we are seeing so many more of these incidents reported because operating conditions, the economy, the stresses of operating are becoming harder and harder for our clients and colleagues. Hopefully we always do the right thing and meet the expectations.

By Chris Barry, MD of HCV Heavy Commercial Vehicle Underwriting Managers (Pty) Ltd (HCV)

Tags:
COMMENT ON THIS STORY
0 comments

Add Your Comment

4 × 1 =