Engine Fire - Insurance Claim Considerations

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The verdict is.......no payout on the claim. No explanation and no summary that details the proposed cause. I may just try to fix it. Undecided at this time.

 

no way! How is that even possible if you have comprehensive?

I would 10000000000% get a public adjuster. They are wrong.

 

Update...After drafting the letter below on 8/7 i recieved a phone call on 8/8 explaining that everything is fine and they will be paying the claim. The voicemail translation is attached below and loosely translated. Keep in mind, this is the same adjuster who told me they don't pay out on mechanical failures and advised it may not even be worth my money to tow it to a local repair shop for the the field adjuster to view it because they just don't pay these types of claims, and the tow would be on me. Recall the fire occurred on 7/25 and was reported over that weekend and the claim findings issued on 8/4.


Dear Dennis,

I am writing to formally appeal the denial of my recent claim for fire damage to my 2015 Toyota Tacoma, as outlined in your final claim report. After reviewing the cited exclusion in my policy and the details of your report, I believe the decision to deny coverage was made without sufficient basis and contrary to the terms of my policy.

The exclusion cited in the denial applies only to “any part or equipment of a covered vehicle if that part or equipment fails or is defective, or is damaged as a direct result of mechanical, electrical, or electronic breakdown or malfunction of that part or equipment.” This language is “part-specific” and does not exclude secondary damage caused by a covered peril. Under the doctrine of proximate cause, when a covered peril results from an excluded peril, the loss is covered if the covered peril is the dominant or efficient cause of the damage. While I acknowledge that the fuel line (mechanical part), if determined to have failed mechanically, might not be covered, the fire damage to the rest of the vehicle was not the direct result of the part’s failure. Instead, it was caused by a fire — a sudden, external event — which is a covered peril under comprehensive coverage. The policy does not explicitly exclude fire damage resulting from a part failure, and under established insurance law, any ambiguity in policy language must be interpreted in favor of the insured. I have comprehensive insurance, and this is exactly what comprehensive insurance is intended for.

Moreover, your final claim report contains no determination of the cause of the fire. It does not conclude that the loss was caused by a ruptured fuel line, an electrical failure, or any other specific event. While you noted in my statement that I did not hit anything, it is entirely possible that my tire picked up debris and threw it into the engine bay, initiating the fire. I did not perceive hitting anything immediately prior to the fire on my way home from work, but that does not mean a road hazard was not involved. Furthermore, a road hazard does not need to be immediately prior to inflict damage to a component ultimately leading to a fire. I should point out that I was run off the road earlier in the day on the way to work and did run over multiple unknown objects at that time. I was not asked about that. Without a definitive finding of cause in the report, it is unclear how the denial can be based on the mechanical or electrical breakdown exclusion. Given that the field adjuster neither identified the clearly ruptured fuel line nor offered any proposed cause of the fire in the final report, I have serious doubts as to the thoroughness and reliability of the cause determination in this claim.

To deny coverage under this exclusion, the insurer must demonstrate that such a failure was, in fact, the direct cause of the loss. In the absence of such proof and given that the proximate cause of the damage was a fire — a covered peril — I respectfully request that you reconsider the denial and approve coverage for all fire-related damage to my vehicle, excluding only the specific failed part if proven to be excluded under the policy.

Please provide me with a written response to this appeal and any additional information or documentation you used in determining the original denial. I look forward to your prompt review of this matter. I do plan to continue escalating this if needed.

 

I knew it!!

heck ya congrats man

 

Glad you got it sorted!

 

I would not be surprised if they drop you at your next renewal

 

Statefarm? Lol no but you will see a good hike in insurance.

 

Nice work, sounds like the adjuster tried to snow you, that letter of yours basically puts them on notice and becomes a permanent part of the claim documents. All the claims are reviewed (paid or not) and the situation apparently should have been covered/paid. When the brush off didn't work and he (the adjuster) saw you were weren't letting it go I think he had second thoughts. Glad it worked out. SF screwed me and 1000s of others after Katrina.

 

Sorry that happened to you on Katrina. We had Helene here and I got a good 3 feet of water in my house.

Didn’t lose any of our cars as we took off but my neighbors M2 floated into my house and was summarily totaled. He was not done well by the insurance companies as they like to treat the flooding ones differently as you note.

Tough year but life continues!

 

Your response is well written, logical, professional, respectful and represents your clear intension.
A perfect example of standing up, speaking up when you been wronged.

So glad you can now move forward from this.

 

State Farm payout offer is $20,000 and buy back is $5000. I think this is probably fair. I dont know if it makes sense to buy back and fix with a mechanical estimate range of $4-6k and body work will at least require a new hood. I have the stock fenders as the current are fiberglass.

Replacing the suspension with the same Fox/Deavers/hammer hangers/bumps that i already have is probably $6k in parts but I damn sure dont want to do the labor (again) nor do I want to do the labor of swapping. Can also retain JL door speakers, JL sub with box, dual Odyssey batteries and a yellow top and probably a few odds and ends. I have no idea what the labor is on all this shit cuz always done stuff myself.

Can sell the front pelfrey bumper $1000+, sliders $700ish, camper $750-1000. Beyond that, I dont mind a true part out as I did it before with a 911 Turbo and did pretty well.

Really don't know what to do here.

 

Take the 20k and find another vehicle imo.

It's a lot of work and time and no guarantee you'll get what you want parting things out.

Let it go, start fresh.

 

So the cause of the fire was? all the aftermarket mumbo jumbo or something else?

 

Take the money and run

 

Take the very important shit off (that is not insured anyways), then take the money and run.

A few told ya so’s just a be a jerk:

• Paying your claim
• Paying a fair amount
• Taking your mods off in advance

 

Undetermined really however, there was a ruptured fuel line squirting gas right in the area. So I dont know if it was electrical that caused the line rupture or the rupture caused the fire.

 

in retrospect, yes…strip the important stuff before the adjuster sees it. I did pull my roof rack, 2 light bars, and fogs.

Pulling the suspension and wheels/tires is the next big ticket items at around $7500 retail. This is fine, but this would have required me to have something to put back on it and I did not at the time so this isn’t realistic in many situations. I definitely didn’t have the time during that period at all. Had I been able to swap the suspension I’d have been willing to eat the other costs and take the check.

I put all the financial factors into chatgpt and I come out well ahead (like $5k) by buying back, swapping what I can, selling big items (bumper, camper, slider) alone. If I can manage to sell engine/tranny or significant other parts it’s just gravy.