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One of Your Claims Stories

One of Your Claims Stories | Risk & Insurance Last month, we asked readers to submit some of their most dramatic, confounding and/or representative insurance claims stories. Here's a doozie:

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It comes from Lisa C. Hartman, a senior consultant with Albert Risk Management in Needham, Mass.

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I have a lot of crazy claims stories, but the one that stands out the most was a rape claim that I adjusted in or around 1987.

At that time, I was a senior adjuster working for a large national insurance company. The claim is one of my most memorable because it was one that I was very passionate about due to the severity. The claim also stands out because it angered me, as I had the claim settled for far less than the verdict--if not for our corporate examiner refusing to provide me with the needed authority.

Prior to the rape, the tenant had complained to management twice, once over the phone and once in writing that the door to her business was broken and she needed to have it fixed. Our insured had received the complaint about the door, but they had not yet been able to come and fix it.

One night, while working late, the tenant who had complained about the lock to her door being broken was brutally raped. The rapist had broken every bone in her face, leaving the woman permanently disfigured.

Liability, I thought, was pretty clear against our insured. A week and a half earlier, the tenant had complained about the lock over the telephone and in writing. The building was in a high crime area, and so our insured had a significant duty to respond quickly to her request.

These days, they would be liable even if the door wasn't broken. They would have simply alleged negligent security!

The plaintiff attorney and I met twice before the trial. He spoke with his client, and she agreed that, if we could settle the claim for $400,000, she would accept. No game playing--they would take that amount and no less, but the claim would be settled.

I went back to my office and drafted a full formal report to the corporate examiner providing all the details of the investigation, liability and injury. I requested the $400,000 I had discussed with plaintiff counsel and explained that it was a take-it-or-leave-it amount.

The examiner reviewed the report and sent a note to say that we could offer $200,000. In his note, he asked why she would be working so late if she knew the door was broken.

At the trial the following week, the tenant was awarded $9.5 million dollars.

(If you have a tale of past claims that you would like to share, surely do send it to the editors here ... if only to get it off your chest, or to have it posted on our site.)

October 1, 2008

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