Insurance Help w/ USAA Please

[Brian_W]

So a little less than 2 years ago I bought my now wife this engagement ring from Peter Storm. I had a 1.43 ct. G; eye clean SI1; triple ex.

A couple months ago, the top came off (Halo, Main Diamond, and halo) of the band and was lost. Obviously we were devastated. She loved her ring.

Insured value was $18,500. I contacted jeweler where I purchased, and she got a repair estimate from Peter Storm, which was $15,000. That was reasonable to us. USAA required we have the ring sent in for their gemologist to review. Their repair estimate is $9,200.

Do I have any ability to refute their estimate? I assume they picked a virtual diamond that is not as high within the respective grades. The setting had 150 diamonds totaling 1.40 ct; f/g vs1 and a sizable amount of gold given its a ring.

 

[kb1gra]

What type of policy was this insured under?

 

[tyty333]

How big was the center stone (specs also please).

 

[meesmom]

Im very sorry that happened...
I have a personal property policy with USAA. I would get your policy and read it. From my experience, they always want you to agree to a lower amount, but I hope you can contest the estimate.

 

[Brian_W]

Thanks for the replies. We were a bit shocked when we heard the estimate, but I need to wait until tomorrow. Dealing with two claims people. The person I spoke to, may have thought we were only missing the center stone.

She sent a message through the center, and it only mentions the center stone. She is waiting for an answer on scrap value for what is left.

I will update as more information becomes available.

I have a VPP plan specific for the ring.

The specs of the center stone are:
Carat: 1.43
Color: G
Clarity: SI1
Cut: Excellent
Polish: Excellent
Symmetry: Excellent

 

[MissGotRocks]

Thanks for the replies. We were a bit shocked when we heard the estimate, but I need to wait until tomorrow. Dealing with two claims people. The person I spoke to, may have thought we were only missing the center stone.

She sent a message through the center, and it only mentions the center stone. She is waiting for an answer on scrap value for what is left.

I will update as more information becomes available.

I have a VPP plan specific for the ring.

The specs of the center stone are:
Carat: 1.43
Color: G
Clarity: SI1
Cut: Excellent
Polish: Excellent
Symmetry: Excellent

Did the center stone have a GIA or AGS grading report? Generally the more specific. Information you provide the better off you are at time of replacement. Hopefully they will work it all out with you.

 

[Bron357]

Sorry, but how on earth does the whole top come off Unnoticed?
you need to read the policy very carefully. What are the arrangements for repair? Can you use your own jeweller? Do they replace as per specified valuation ie matching carat cut, color, clarity Or better?
insurance companies love you paying your premiums but aren’t your friend at claim time.
Years ago I worked for an insurance company. We had preferred jewellers and suppliers who we would get a 10% discount on wholesale prices for the volume we offered them. The claims dept were always expected to a) try as hard as possible to decline the claim or b) replace as cheaply as possible the lost item. I resigned after a lady who had had her jewellery stolen (Holding the policy for over 15 years not 5 minutes) was declined because she couldn’t “prove” break and enter theft (she had left a window unlocked). She was only covered for loss due to theft or destruction (ie fire) of the house

 

[kb1gra]

Does the jeweler's repair estimate include a new center stone? if so, which one?

Stones in that size range spread from $8k to $11k with that color and clarity. Your best bet is the purchase receipt from the exact stone you purchased, and a GIA or AGS report with the inclusions mapped. "Eye clean SI1" isn't a category, but you could make a case for the type of inclusions.

I'm not clear how this kind of damage could happen, but especially after only 2 years. I'd be hesitant to have a new ring made with similar apparent quality issues, if an entire piece of this ring just "popped off."

 

[ls430FL]

It's best that you read every line of your policy so that you are well educated on your rights as a policy holder. By paying premiums they owe a special duty to you. Knowing the basics of your states insurance laws including bad faith acting by insurance companies can really help you out. Today it seems everyone must be their own advocate regardless of whether they are a lawyer or not. Insurance companies are quick to collect your premiums or cancel policies for non payment but slow to pay out and often times want to pay you as little as possible. Sometimes lawyers in your area will offer free consultations as well.

 

[tinatark]

You will have some play. When my insured, lost ring was claimed, insurance said it could be replaced for about 40% less than insured amount. We ended up using one of their "recommended" jewelers (a local jeweler, very high end) and was within $2000 of appraised amount in the end.

Not sure that setting is even repairable? They may replace.

For future reference, and I discovered the hard way, "Agreed Value" coverage is the best for jewelry. Not much higher premium but you don't have to go through the negotiating with insurance company (for a total loss).

 

[Dancing Fire]

A couple months ago, the top came off (Halo, Main Diamond, and halo) of the band and was lost. Obviously we were devastated. She loved her ring.

How is that possible??...

 

[YadaYadaYada]

If she wasn't doing anything unreasonable while wearing the ring that caused this damage then wouldn't this be a possible manufacturing defect? It just seems strange that the whole top just came off.

It would be worth pursuing with the jeweler if that is a possibility since any claim that is filed under a homeowner's policy can be reason for non-renewal. I used to work at an insurance agency and when it comes to home policies companies can be very unforgiving with claims.

 

[MollyMalone]

* * * For future reference, and I discovered the hard way, "Agreed Value" coverage is the best for jewelry. Not much higher premium but you don't have to go through the negotiating with insurance company (for a total loss).

Just as a FYI: an "agreed value" policy -- whereby you receive a check for the amount agreed upon before the policy is issued, instead of replacement with a like item -- is not necessarily available for the asking. Some insurance carriers where you live ** have general parameters for agreed value policies & won't issue one if the value is above or below their internal "caps"; others will issue an agreed value policy only for antique jewelry, unique collectible pieces or similar rarities in today's marketplace. And even if the insurance company doesn't have that kind of restriction, the premium for an agreed value policy can be appreciably higher than the usual replacement kind of policy. The insurance companies are (understandably) trying to reduce the odds of people filing fraudulent claims for a cash pay-out.

** Insurance coverage offered by the same company can vary from state to state. So you may not be able to get an agreed value policy even if someone in another state has one.

 

[Karl_K]

If im reading it right it looks like a branded piece(just dance by Peter Storm) so "made whole" would be a branded piece that only the original maker can provide and repair and it would still be a branded piece.

A google search confirms its branded.
@denverappraiser

 

[kb1gra]

If im reading it right it looks like a branded piece(just dance by Peter Storm) so "made whole" would be a branded piece that only the original maker can provide and repair and it would still be a branded piece.

A google search confirms its branded.
@denverappraiser

Only if the branded piece was documented as being branded on the paperwork submitted to insurance.

We don't know what the documents say.

 

[tyty333]

Could USAA replace the diamond and Peter Storm do the repair? I believe USAA has access to diamonds so perhaps you can give them
some specs/numbers/parameters for them to find you a stone and the leftover amount can be used to have Peter Storm repair/replace
the setting? (Unless the stone was some kind of branded stone through Peter Storm.) Perhaps this is why the quote is so low through
USAA because they could replace the stone at their wholesale prices vs Peter Storm's retail prices. I hope this makes sense!

 

[Karl_K]

Only if the branded piece was documented as being branded on the paperwork submitted to insurance.

We don't know what the documents say.

That makes it easier however if you have evidence that is what it is you can make a good case for it. I'm not saying it works all the time but it can work if you can document it.