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Question DetailsAsked on 2/19/2017



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2 Answers


Not quite clear what you mean - and obviously an attorney (no Angies List category for that) would be needed to give a definitive legal opinion.

But generally - if a contractor was injured or had damage to equipment from a falling tree or branch, then in most states while you can file a "forced denial" paper with the insurance company basically saying you don't want them to pay (as long as you do pay any valid claim directly). Most states are "claim notice" states, whereby any party claiming injury can contact your insurance company (though they should go through you) and that constitutes a "claim" under your policy, whether or not they actually pay anything out and whether or not you consider the claim to be legitimate or not.

In general, most policies delegate your defense of claims to the insurance company - so as soon as they become aware of a potential claim they can and commonly will take action to mitigate the claim amount. Say someone says they are going to sue you - they can defend against that before an actual suit if filed, and the very knowledge of that threat (say you tell your agent about it) entitles tham to consider that a "claim" in most or maybe all states.

If you mean a contractor filing a claim on your insurance to have a tree removed from your property (presumably because it is a hazard tree ?) then if he is a contractor not related to you in any way - say working for a neighbor - I would talk to the insurance company about rejecting the claim on the basis the contractor is not a valid claimant because HE is not at risk from the tree - that if a claim was to be filed it should be by the neighbor, and should go to you as a notice of demand asking you to remove the hazard tree to mitigate an imminent risk to his property or person - so a contractor going to your insurance company would be premature because he/she has not yet been injured.

Also - generally an insurance company will NOT pay for hazard tree removal - they consider that general yard maintenance and YOUR responsibility.

If this is a contractor working for you, say trying to get your insurance company to pay for tree removal so he does not have to do it as part of his scope of work, then I would say that is at least civil and maybe criminal fraud under the contract - trying to use your insurance to get work done that is part of his scope would be trying to avoid his responsibilities under the contract, so he would be in violation of the contract.

If you mean an out-of-the-blue off-the-street contractor trying to get your insurance company to pay for a tree removal by that contractor, I would contact the insurance company and tell them he has no relation to you, you did not authorize him to come on your property or do any work or contact them, and that you consider this insurance fraud. I have heard of roofing and siding scammers finding out who is insured with certain lax insurance companies (or out-of-state companies with no local adjusters) and filing roof or siding damage repair claims (supposedly on behalf of the homeowners) and getting payment for them which the homeowner sometimes never hears of. If this is the case I would also contact the police with a fraud complaint, and the state licensing board and the business licensing agency if that company if licensed - or should be by law. Also - the state insurance licensing board might (or might not) keep a list of known scammers of this type.

If the above did not respond to your specific case, you can answer back with more details using the Answer This Questions yellow button right below your question.

Answered 3 years ago by LCD



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Answered 3 years ago by Member Services

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