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Home My WebLink AboutClaim No. 541 - AIG Auto Ins./James CollingsCITY OF PALM DESERT COMMUNITY SERVICES DIVISION CITY CLERK OPERATIONS STAFF REPORT REQUEST: CLAIM AGAINST THE CITY (#541) BY AIG AUTO INSURANCE/JAMES COLLINGS IN THE AMOUNT OF $2,821.79 DATE: January 13, 2005 CONTENTS: I. Staff Report II. Claim No. 541 Recommendation: By Minute Motion, reject the Claim and direct the City Clerk to so notify the Claimant. Background: Based on a review of the subject Claim and the recommendation of the Claims Adjuster, Risk Manager, City Attorney, and staff, it is recommended that the Claim be rejected. Discussion of this item should be held in Closed Session pursuant to Government Code Section 54956.9(b), potential litigation. Submitted by: RA HELLE D. KLASSEN, CMC CITY CLERK Approved: CARLOS L. ORTEG CITY MANAGER rd k Attachment (as noted) S REILA R. GILLIGAN, CMC ASST. CITY MANAGER FOR COMMUNITY SERVICES H: \WPdata\WPDOCSICLAIMS1541-reject-staff report. wpd AIG American International Companies® Services Provided by a Member of American International Group, Inc. Central Subrogation Unit P.O. Box 8133 Fort Washington, PA 19034-8133 City of Palm Desert Rachelle Klassen, City Clerk 73-510 Fred Waring Drive Palm Desert, CA 92260 Re: Our Claim Number: Date of Loss: Our Insured: Total Amount of Loss: Insured's Deductible: Your File Number: Claims Department: CITY. OF PALM DESERT ASSIGNED. CLAIM NO. November 18, 2004 E1V ED CITYCLERK'S OFFICE t"':1L'i'"i DESERT. CA 'R NOY 30 AMU: 16 Underwriting Company: AIG Indemnity Insurance Company M040164898 10/20/2004 James Collins $2821.79 $ 500.00 541 Your company has been designated as the insurance carrier for the above captioned party. We are presenting a subrogation claim for damages to our policyholder's vehicle, as a result of your insured's negligence on the above date. Please accept this letter as a notice of our subrogation rights and contact us regarding your position on this matter. We have attached our supporting papers for your review. Please forward a check in the amount of $ 2821.79, payable to: AIG Auto Insurance P.O.Box 105795 Atlanta, GA 30348 - 9864 We anticipate your prompt settlement of our claim. Sincerely Romona Je'Juan Ward American International Recovery Recovery Rep I 800-272-5378 ext 5323 Fax: (866)'315-0720 romona.ward@aic.com Nov-18-04 10:15am From -PALM DESERT CITY CLERK 7603400574 T-643 P.03/03 F-400 ▪ Give a general description of the indebtedness, obligation,' injury, damage, or loss incurred so far as it may be, known at. the tir�ri a_ of prese atio of the cla• im. If there were no injuries, state "no injur}es': ,C. ' d; G - C r LA III or r C� *1c� P.�-� C7(\ On poS rCZ-_!' �',c (i%:�{ Phi • Give the name(s) of the City -employees) causing the damage or injury: b. Name andaddress of any other person(s) injured: 5 • Name and address of the owner of an damaged property: c -e5 w (,A IY>ss i\f� Igo • Damages claimed: a. Amount claimed as of this date: b. Estimated amount of future costs: c. Total amount claimed: d. Basis for computation of amounts estimates, etc.): $ Sal ,. 61 Asa 1 9 claimed (include copies of all <bills, invoices, . Narne and addresses of all witnesses, hospital doctors, etc.: 10. Any additional i formation, including police reports, which might b elpful in considering this claim: c Is/ t: < ve-r Si (A.ur'4 WARNING:IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! (PENAL CODE 72; INSURANCE CODE 556.1). 1 have read the matters and statements made in the above claim, and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief as to such matters I believe the same to be t ue. I certify under p nalty of perjury that the foregoing is TRUE AND CORRECT. . Signed this day of N .). -r>(` 1 L \ , 20 , at SIGNATUR ik) 1 F CILAIMAINT SIGNATURE OF CLAIMANT Office of the City Clerk, Palm Desert, California DOC. NO. DATE FILED Page 2 of 2 Nov-16-04 10:15am From -PALM DESERT CITY CLERK 7603400574 T-643 P.02/03 F-400 CITY OF PALM DESERT ASSIGNED CLAIM NO. CLAIM AGAINST THE CITY OF PALM DESERT (For Damages) to Person(s) or Personal Property) Received by: via: U.S. Mail Interoffice Mail Over -the -Counter A CLAIM MUST BE FILED WITH THE CITY CLERK OF THE CITY OF PALM DESERT WITHIN SIX MONTHS AFTER WHICH THE INCIDENT OR EVENT OCCURRED. BE SURE YOUR CLAIM IS AGAINST THE CITY OF PALM DESERT, NOT ANOTHER . PUBLIC ENTITY. WHEN SPACE IS INSUFFICIENT, PLEASE LJSE ADDITIONAL PAPER AND IDENTIFY INFORMATION BY PARAGRAPH NUMBER. COMPLETED CLAIMS MUST BE MAILED OR DELIVERED TO THE CITY CLERK CITY OF PALM DESERT 73-510 FLED WARING DRIVE PALM DESERT CA 92260. TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Palm Desert, California: The undersigned respectfully submit(s) the following claim and information relative to damages) to person(s) and/or personal property: 1. CLAIMANT -INFORMATION: NAME nib 14)6k-C�,(! in.5ADDRESS c St -o 3 -t- 'Sh,nc PP Kl PHONE NO. ( ) '' ce—P-I .0 %53 3 DATE OF BIRT SOCIAL SECURITY NO. - -� _ DRIVER'S LICENSE NO. • Name, telephone number and post office address to which claimant desires notices to be. sent, if ojher than above: ▪ Occurrence or event from which the claim arises: • DATE: l C: - ?? G' b. TIME: 1ecation �:. Vcx c r\ . CA- C%1, 4 k C> c. PLAC (e act and specific 3)S 12(o ▪ How and under what circumstances did damage or injury occur? Specify the particular occurrence, event, act or ommission you claim caused the injury or dam ge. (Use additional paper if necessary.) e , - - `tym C ( f, t 0 w A (r$f -t5 -„a-1,,,( 0 � �' z ( 1? Lv n dv e. What particular action by the City, or its emplo ees, caused the alleged damage or injury? (•`f l-f.r) }.(fie} � h Q,10.� Ctfc Pagel of 2 Romona J. Ward - RJWA SCRN( CMI , PAY ) CO ( _ ) ACCT( M040164898 ) PERS( _ ) SEL( 01 WS= TODAY PAYMENT INQUIRY FOR ( COLLINGS J ) CLMT# 01 NAME COLLINGS J OPEN RESERVES/TOTAL PAID TO DATE 410 R P 2321.79 PAYMENTS: FNC TRN ISSUE LOSS CK/DR CONTROL OR ACCT POST WTH S CODE CODE DATE CODE AMOUNT NUMBER CHECK NUMBER PAY DATE CD P _ PAY FN 10/22/04 410 2321.79 4000147275 0047839115 10/22/04 INVOICE PAYOR M08 TAX-IND TAX-EXC VOID PEND Date: 11/18/2004 Time: 1:15:00 PM Estimate Page 1 of 4 Estimate #3164337 Print Toggle Pictures Insured/Owner Information JAMES COLLINGS JAMES COLLINGS 1111111.1111 0.1111111111.1111. Insured Owner Address City State Zip Home Work Claim Information Claim No M040164898 Claimant No 01 Loss Date 10/20/2004 Policy No 00834159813 Loss Type Insurance Company Information Insurance Address City State Zip Phone Fax Deductible Amount Estimate Notes AIGC - Phoenix, AZ 2323 W. Rose Garden Lane Phoenix AZ 85027 (800) 523-4040 (623) 587-3010 $500.00 SCA Appraisal Company ESTIMATE OF RECORD Adjuster Information Adjuster Phone Email Christine Lage christine.lage@aig.com Appraiser Information Written By Est. Code Office Address City State Zip Work Mobile Fax Pager Email JAVIER FIGUEROA, JAVIER FIG SCA Appraisal Company 3815 W. Magnolia Blvd Burbank CA 91505 (800) 572-8010 Ext: 352 qualitycontrol@sca- appraisal.com Estimate Information Supplement 0 Estimate PenPro4 UF0000FE Inspection Location Information Location Address RESIDENCE City PALM DESERT State Zip CA Phone Repair Facility Information Repair Facility Address City State Zip Cont. Name Phone Fax Email Fed Tax ID State Lic./BAR No. Calendar of Events Loss Assignment Inspection Estimate Upload JESSUP AUTO BODY" 68111 E PALM CANYON CATHEDRAL CITY CA 92234 LINDA (760) 328-2571 (760) 321-4645 10/20/2004 10/20/2004 10/21/2004 10/21/2004 Year Style Color VIN Prod. Date 2001 BLUE aMIONIONNIMMII 0/0 Vehicle Information Make Engine Odometer License Point of Impact #1 Point of Impact #2 BUIC 17643 1.1111121111 Left Rear Right Rear Model LE SABRE Type Condition Lic. State CA Equipment Options http://www.processclaims.com/web/clients/generic/EstimateForm. aspx?docid=14969082&... 10/22/2004 Estimate Page 2 of 4 No. Oper. Description Labor Units Type Paint Units Tax Misc Parts Cost Qty Type Each Total 1 R&R 2 Refinish 3 R&R,Partial 4 Refinish 5 R&R 6 R&R 7 Repair,Partial 8 Refinish 9 R&R 10 Refinish 11 AddlOps 12 Addl Ops 13 R&R 14 Sublet 15 Sublet 16 Blend 17 R&R 18 Remove/Install 19 Removellnstall Type Panel Assy,Body Side RT Panel Assy,Body Side RT Panel,Quarter RT Panel,Quarter RT Nameplate,Qtr Panel LT Nameplate,Qtr Panel RT Panel,Quarter LT Panel,Quarter LT Cover,Rear Bumper Cover,Rear Bumper Rear Bumper Cover R&I Color Sand And Buff Cover Car Exterior Flex Additive Hazardous Waste Removal Pnl,Rear Door Outer RT MIdg,Rear Door Lower RT Handle,RR Door Outer RT W/Strip,Belt Outer RT Labor Units Labor Rate Refinish 6.6 Yes 15.0 Body Refinish 1.2 Yes 0.2 Body 0.2 Body 2_0 Body Refinish 2.9 Yes 0.5 Body Refinish 3.2 Yes Yes Refinish 1.0 Yes Refinish 0.3 $7.00 $5.00 Refinish 1.1 Yes 0.4 Body 0.9 Body Yes 0.2 Body Yes Labor Rate Information Paint Units Paint Rate Additional 1 OEM $628.52 $628.52 1 OEM $8.50 $8.50 1 OEM $8.50 $8.50 1 NM $291.75 $291.75 1 AIM $10.00 $10.00 1 OEM $51.40 $51.40 Type Total Parts Body Paint Paint Materials Miscellaneous Tax 19.4 $38.00 $1,348.67 * 7.75% 16.3 $38.00 16.3 $21.47 Parts Body Paint Paint Materials $12.00 Miscellaneous $998.67 $737.20 $619.40 $350.00 $12.00 Tax $104.52 Total Previous Total This Supp $2,821.79 $2,821.79 $0.00 Adjustments Deductible Total Betterment $500.00 $0.00 Customer pay Insurance Pay Part type legend: OEM = Original Equipment Manufacturer LKQ = Like Kind and Quality NM = Aftermarket R = Reconditioned/Rebuilt/Remanufactured/Recored $500.00 $2,321.79 This estimate has been prepared based on the use of aftermarket crash parts supplied by a source other than the manufacturer of your motor vehicle. The aftermarket crash parts used in the preparation of this estimate are warranted by the manufacturer or distributor of such parts rather than the manufacturer of your vehicle. ***THIS ESTIMATE IS NOT AN AUTHORIZATION FOR REPAIRS*** Do not repair this vehicle until all guidelines listed below are acknowledged and accepted. Failure to do so may result in additional cost to the vehicle owner. This estimate report is based on our initial inspection and does not cover any additional parts or labor which may be required after the vehicle is in the repair facility and is torn down. The repair facility must review and concur with the scope and methodology of the repair estimate before beginning repairs. Occasionally additional damage is discovered after the vehicle is torn down. If this happens, it is the repairer's responsibility to notify AIG's appraiser as soon as possible and to obtain authority do complete the additional repairs needed to restore the vehicle to its pre -loss condition. Any supplemental work must be made available for inspection by AIG's appraiser and approved by AIG. Verbal authorizations by the field appraiser are not binding. Supplemental repair requests presented after the completion of repairs can be legally denied based on this disclaimer. Failure to obtain prior authorization may be result in AIG's being unable to honor supplemental charges. Any supplemental charges must be supported by documentation in the form of invoices and receipts. The deductible may or may not be listed on the appraisal. All deductibles and betterment must be collected from the owner before http://www.processclaims.com/web/clients/generic/EstimateForm.aspx?docid=14969082&... 10/22/2004 Estimate Page 3 of 4 releasing the vehicle. All repairs must be completed in strict accordance with the manufacturer's specifications and recommendations. It is understood that the repair facility listed on this estimate, if one is listed, agrees to complete and guarantee all repairs listed on the estimate for the amount listed on the estimate. AIG does not warrant or guarantee the work of any repair facility or technician and assumes no responsibility or liability for the quality of repairs or workmanship of any repair facility or installer. ***THIS ESTIMATE IS NOT AN AUTHORIZATION FOR REPAIRS*** Do not repair this vehicle until all guidelines listed below are acknowledged and accepted. Failure to do so may result in additional cost to the vehicle owner. This estimate report is based on our initial inspection and does not cover any additional parts or labor which may be required after the vehicle is in the repair facility and is torn down. The repair facility must review and concur with the scope and methodology of the repair estimate before beginning repairs. Occasionally additional damage is discovered after the vehicle is torn down. If this happens, it is the repairer's responsibility to notify AIG's appraiser as soon as possible and to obtain authority do complete the additional repairs needed to restore the vehicle to its pre -loss condition. Any supplemental work must be made available for inspection by AIG's appraiser and approved by AIG. Verbal authorizations by the field appraiser are not binding. Supplemental repair requests presented after the completion of repairs can be legally denied based on this disclaimer. Failure to obtain prior authorization may result in AIG's being unable to honor supplemental charges. Any supplemental charges must be supported by documentation in the form of invoices and receipts. The deductible may or may not be listed on the appraisal. All deductibles and betterment must be collected from the owner before releasing the vehicle. All repairs must be completed in strict accordance with the manufacturer's specifications and recommendations. It is understood that the repair facility listed on this estimate, if one is listed, agrees to complete and guarantee all repairs listed on the estimate for the amount listed on the estimate. AIG does not warrant or guarantee the work of any repair facility or technician and assumes no responsibility or liability for the ,quality of repairs or workmanship of any repair facility or installer. NOTICE This estimate has been prepared based on the use of crash parts supplied by a source other than the manufacturer of your motor vehicle. Warranties applicable to these replacement parts are provided by the manufacturer or distributor of these parts rather than the manufacturer of your vehicle. Such parts can be identified by the letter "A" on this estimate. If the use of an aftermarket part voids the existing warranty on the part being replaced or on any other part, the aftermarket part shall have a warranty equal to or better than the remainder of the existing warranty. For your protection California law requires the following to appear on this form: Any person who knowingly presents a false or fraudulent claim for the payment of a Toss is guilty of a crime and may be subject to fines and confinement in state prison. AUTO BODY REPAIR CONSUMER BILL OF RIGHTS -A CONSUMER IS ENTITLED TO: 1.Select the auto body repair shop to repair auto body damage covered by the insurance company. An insurance company may not require the repairs to be done at a specific auto body repair shop. 1. An itemized, written estimate for auto body repairs and, upon completion of repairs, a detailed invoice. The estimate and the invoice must include an itemized list of parts and labor along with the total price for the work performed. The estimate and invoice must also identify all parts as new, used, aftermarket, reconditioned, or rebuilt. 2. Be informed about coverage for towing services. Unless the insurance company has provided an insured with the name of a specific towing company prior to the insured's use of another towing company, the insurer must pay all reasonable towing charges of the towing company used by the insured. 3. Be informed about the extent of coverage, if any, for a replacement rental vehicle while a damaged vehicle is http://www.processclaims.com/web/clients/generic/EstimateForm. aspx?docid=14969082&... 10/22/2004 Estimate Page 4 of 4 being repaired. 4. Be informed where to report suspected fraud or other complaints and concerns about auto body repairs. 5. Be informed of where to report suspected fraud or other complaints and concerns about auto body repairs. COMPLAINTS WITHIN THE JURISDICTION OF THE BUREAU OF AUTOMOTIVE REPAIR Complaints concerning the repair of a vehicle by an auto body repair shop should be directed to: Toll Free (800) 952-5210 California Department of Consumer Affairs Bureau of Automotive Repair 10240 Systems Parkway Sacramento, CA 95827 The Bureau of Automotive Repair can also accept complaints over its web site at: www.autorepair.ca.gov http://www.processclaims.com/web/clients/generic/EstimateForm.aspx?docid=149690826... 10/22/2004 Page 1 of 1 http://photoserver.processclaims.com/Upload/1309/32856/2246806_509B56-1.JPG 10/22/2004 Page 1 of 1 http://photoserver.processclairns.com/Upload/1309/32856/2246806_508655-3.JPG 10/22/2004 Page 1 of 1 http://photoserver.processclaims.com/Upload/1309/32856/2246806_508655-2.JPG 10/22/2004