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Order Information

Client

LIBERTY MUTUAL/SAFECO PERSONAL LINES

Claim ID

046940660

Order Date

9/26/2021 9:41:20 AM

Inspector

KH201

Contract Number

F3173500

Insured Party

TERESA ROMERO

Vehicle Year

2000

Vehicle Make

JAYCO

Vehicle Model

CAMPER

Vehicle VIN Number

1FDXE45S0YHA20405

Vehicle Mileage

Inspection Location

Name

RESIDENCE

Address

789 BURNHAM RD

City

BRANDON

State, Zip

MS, 39042

Phone

6012149478

Contact(s)

TERESA ROMERO

Adjuster Name

JENNIFER DANICO

Extension

4074304758

Email

JENNIFER.DANICO@LIBERTYMUTUAL.COM

Reason For Inspection

PLEASE CONFIRM THE CAUSE AND ORIGIN OF DAMAGES TO THE D/S FRONT SIDING OF THE CAMPER AND WATER INTRUSION INTO CAMPER. CHECK FOR IMPACT CAUSING LEAKAGE, CHECK FOR FAILED SEALS OR ROOF MEMBRANE DETERIORATION, ETC

Report Information

Location Contact

TERESA ROMERO

Contact Title

TERESA ROMERO

Inspection Date

10/4/2021 12:30:00 PM

Vehicle Year

2000

Vehicle Make

MOTOR HOME

Vehicle Model

E 450 JAYCO DESIGNER<

Current VIN Number

1FDXE45S0YHA20405

Vehicle VIN Number Originally Submitted as

1FDXE45S0YHA20405

Vehicle Production Date

10/99

Current Mileage

30082

Vehicle Mileage Originally Submitted as

Vehicle Trim

WHITE

Labor Rate / Type

1.0000 PROVIDED VERBALLY

Engine Type

6.8L

Engine Emissions

N/A

Transmission / Model

AUTO

Wheel Drive Type

REAR WHEEL DRIVE (RWD)

Vehicle Plate #

RAR 1515

Engine Oil Level

N/A

Engine Oil Condition

Fair

Coolant Level

N/A

Coolant Condition

Fair

Transmission Level

N/A

Transmission Condition

N/A

Power Steering Level

N/A

Power Steering Condition

N/A

Brake fluid Level

Full

Brake Fluid Condition

Good

Front Differential Fluid Level

N/A

Front Differential Fluid Condition

N/A

Rear Differential Fluid Level

N/A

Rear Differential Fluid Condition

N/A

Transfer Case Level

N/A

Transfer Case Condition

N/A

Oil Filter Brand

N/A

Sample Taken

Sample Type

Miscellaneous Comments

Commercial Use

Signage

Modifications

Collision

Tow Hitch

YES, RECEIVER

Towed or Driven In

DRIVEN

Belts

GOOD

Hoses

GOOD

Tire Size

215/85R16

Factory Tire Size

215/85R16

Overall Condition

GOOD

Customer Complaint, Date Opened, Shop Name on Repair Order

THERE WAS NO REPAIR ORDER.

Facility Repair Order

000

State of Assembly (be specific)

FULLY ASSEMBLED

Related Recalls, TSB's, or Service History

Failed Components and Extent of Damage

THE LEFT FRONT CORNER FIBERGLASS COVERING HAS BEEN TORN OFF. THE OWNER STATED IT BLEW OFF GOING DOWN THE ROAD. THE WHOLE LEFT SIDE FIBER GLASS COVERING IS LOOSE AND BUBBLE OUT IN SEVERAL PLACES. IT APPEARS THAT THE UNIT HAS BEEN LEAKING INTO THE WALLS AND ROTTED OUT THE WOOD HOLDING THE COVERING. SOME OF THE ROOF SEAMS APPEAR TO HAVE BEEN LEAKING IN THE FRONT AND IN THE BACK. THERE WAS NO INDICATION OR EVIDENCE OF THE LEAK ON THE INSIDE OF THE UNIT. THERE WAS NO IMPACT TO THE LEFT FRONT CORNER OR ON THE ROOF.

Measurements

Cause of failure

THE CAUSE OF FAILURE APPEARS TO BE FROM WATER DAMAGE LEAKING INTO THE WALL OF THE UNIT.

Recommendations for Repair

THE UNIT NEEDS TO HAVE AN ESTIMATE PERFORMED BY A QUALIFIED RV REPAIR FACILITY.

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