Blackhawk Claims Service, Inc.

Initial Business Response /* (1000, 5, 2015/07/31) */
A review of our claim records revealed that Mr*** presented a claim for damages to his vehicle as a result of
an automobile accident with our insured driver, *** ***After a thorough investigation of the above mentioned loss, we were
able to determine that this loss was caused by our insured driver
After reviewing Mr***'s claim today, I was able to see that we issued him a property damage settlement check as compensation for his property damage claim
If Mr*** wishes to discuss this matter further with me, please do not hesitate to have him contact me
Sincerely,
*** ***
SrClaims Supervisor
Blackhawk Claims Service

Initial Business Response /* (1000, 5, 2015/07/20) */
This loss was reported by the Unlisted Driver of our insured's vehicle on 7/9/The named insured is the person we have to speak with regarding the facts of loss as this policy states that it does not cover losses for anyone other than the
person(s) listed on the Dec pageWhile we were able to get in touch with other parties in this loss, we were unable to speak with our named insured until 7/20/After speaking with our named insured, we have determined that we will be issuing payment to the other party, Ms***
Initial Consumer Rebuttal /* (2000, 7, 2015/07/28) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Thank youI'm just waiting for the payment so that I can get my car repaired and a get rental while it is being fixedThis is my family's only source of transportationI'm glad that we came to a resolution

Initial Business Response /* (1000, 7, 2015/05/20) */
This claim was reported by *** *** on April 27, We immediately made efforts to contact our policyholder to confirm Ms***'s version of the lossThis is standard protocol in the investigation of a third party claim as the accident
was never reported by our policyholderWe ultimately received enough evidence to suggest our policyholder was involved and responsible for Ms***'s damagesA check was issued on May 19, for the minor property damages incurredDuring the last weeks, the claim representative has kept Ms*** apprised of the process and status in full compliance with *** Deptof Insurance Claim regulationsWe are happy to have settled the claim to Ms***'s satisfaction
Initial Consumer Rebuttal /* (2000, 9, 2015/05/22) */
(The consumer indicated he/she ACCEPTED the response from the business.)

Dear Sir or Madame,
Blackhawk Claims Service, Incis a Third Party Administrator authorized to handle claims on behalf of American Alternative Insurance Corporation, a Delaware domiciled property and casualty company
We have reviewed our claim file in reference to Ms*** complaint and
offer the following responseWe believe we have handled Ms*** claim as professionally as reasonably possible and within the fair claims practices guidelines for the State of Texas
When the claim was originally reported by our policyholder on May 19, 2016, we had no contact information for Ms***, as our policyholder stated only his information was exchanged at the scene of the accidentThe accident was described as a minor rear/end type accident with no apparent injuriesOn May 23, we received a call from a law firm announcing they were representing Ms*** for damages from the accidentAt that point, unless otherwise notified, our claim representative is required to respect the attorney client confidentiality rules and cannot discuss the claim unless provided permission by the attorney
On May 25, 2016, Ms*** called and stated she wasn't represented after allWhen the claim representative attempted to take her statement, which is common protocol for handling any liability loss, she became defensive and raised her voice when routine questions were asked. When the claim representative tried to arrange for her vehicle damages to be inspected by an independent appraiser, she stated we did not need to look at her vehicle and must accept her mechanics damage invoicesOur attempt to explain the claims process and the necessity for our inspection was met with resistance and yellingThereafter for weeks, our outside appraisal company attempted to reach her to arrange for an inspection of her vehicle without success
On June 14, 2016, we received a call afterhours from Ms***, which was returned the following dayThen on July 1, 2016, her insurance company, Traveler's, sent us a portion of their supporting subrogation documents confirming the minor rear end damages of her vehicle totaling$It was then apparent that Ms*** was utilizing her own insurance collision coverage for her vehicle damagesWe have since been communicating with Traveler's to send us the complete documents and have requested a partial property damage settlement check to cover her $500 deductibleGenerally the deductible is paid to Traveler's who reimburses their insured, but, we have elected to pay and send her the check directly to take care of her out of pocket expense expeditiously.
Additionally, Ms*** has produced a written demand for $15,for injuries from this minor accidentThis demand was submitted without any medical basis or proofWe have sent Ms*** bodily injury claim forms to be filled out and returned so we can secure her medical records and bills to further evaluate her bodily injury claim
We trust Ms*** understands the due diligence, proofs of claim, medical records, etc., that are necessary for any insurance company to properly evaluate a claimWe will continue to work professionally with Ms*** to hopefully achieve an amicable resolution of her claims
Sincerely,
*** ***

Initial Business Response /* (1000, 5, 2015/08/26) */
Contact Name and Title: [redacted] Claims Mgr
Contact Phone: XXX-XXX-XXXX X[redacted]
Contact Email: [redacted]@blackhawkclaims.com
This loss was reported to our office on 12/30/14 by [redacted]. According to the facts of loss, our insured...

vehicle hit [redacted] pushing her into another vehicle. On 1/2/15 we spoke with the insured and Ms. [redacted]. Also on 1/2/15, we obtained a copy of the police report. On 1/9/15 we spoke with clmt [redacted] and scheduled an appraisal through our appraisal vendor. A message was left for [redacted] on 1/12/15 and on 1/27/15. On 2/24/15 we received return mail for clmt [redacted]. We found a claim through Geico that indicated their file was open for the [redacted] damages. Therefore, we closed our file for this portion of the loss as we assumed Geico was handling the damages for their insured. on 4/15/15, we received a call from Ms. [redacted]. We sent an appraisal request over to our appraisal vendor on this same date. on 4/21, the check for the [redacted] damages was issued and mailed out to the customer, along with a copy of the estimate.
On 5/7/15, we advised [redacted] that rental was reimbursement only and she could send us a receipt. on 8/20/15, we received a supplement request from the [redacted] shop. We issued payment for this supplement and mailed it out on 8/21/15. We spoke with Ms. [redacted] on 8/21 and advised her that additional rental would be considered since there was a supplement. Once the rental receipt comes in, we can issue the payment for the rental.
Please feel free to call my office if you have any additional questions.

Complaint: [redacted]I am rejecting this response because:The information contained in the response is false. I attempted on several occasions to contact them to file a claim and after a week of trying to find a phone number that worked (I received busy signals on three separate occasions using the number listed on their website).  When I finally did contact them, I received a preliminary claim number that consisted of letters and numbers and when I did not receive any contact from an adjuster, as promised, I called them back.  Then, I was informed that THEIR insured had reported the claim.  This is a farce designed to make it appear that I have not been responsible in my reporting or timely in my manner. 
The policy holder and I exchanged photographs of the scene and photographs of our insurance paperwork.  He did not speak English.  I spoke to his friend on his phone when he approached my vehicle.  He shook his head and said "Lo siento." and handed me his phone which was already on and connected on a call.  His friend told me, "I am sorry.  My friend says he his sorry.  He has his insurance information for you. Okay. Thank you." The next day, I began my attempts to contact his insurance company.  After the initial failed attempts, I contacted a lawyer, who was my representation during initial contact.  I called the company again and they told me they would not speak to me regarding an adjuster's visit or contact information because I was represented.  I then contacted the lawyer and released him from service and attempted to contact the company again. 
At no point did I receive a phone call with any adjuster's information.  No one ever left a message with any available appointment times.  No one ever emailed me. No one from the company ever made contact with me despite repeated attempts on my part. Requiring the use of my vehicle for work, I contacted my own insurance company to expedite its repair. 
Of specific note is Mr. [redacted] assertion that he will "continue to work professionally with [me] to hopefully achieve an amicable solution."  At no point during the attempted resolution of my claim have they worked with me at all.  Any attempts to discern when an adjuster could look at my car, where I could bring it for repair, or any other information required was met with a busy signal, an unanswered phone (as described initially, I had to circumvent the contact person's direct line and ask the operator if that person was at her desk and would answer her phone (after going unanswered twice) before allowing a transfer to her line). 
The "written demand" Mr. [redacted]omb references is an invoice reflecting my good faith estimate at that date of the pain and suffering their ridiculous, unprofessional practices have caused.  In addition to that invoice, his company has been provided with more recently incurred medical bills and every medical bill incurred (including the ER visit and CT scan that verified my injury) as a result of the incident. They have also been provided with a calculation for the present value of future care and they have been provided notification of my name change as a result of marriage.  
If Mr. [redacted]omb and his company continue to drag this out, I will be forced to reconsider representation; my time is more valuable than to be wasted on this garbage company and their garbage practices.  This has been the most stressful interaction for no reason other than this garbage company trying to avoid paying a very simple, valid claim where THEIR INSURED REAR ENDED ME! 
The company's request for medical records was far too broad for my approval (I am a Certified Fraud Examiner) and I will in no way allow this company to view, access, request, and certainly not forward my medical records (they requested ALL records for ALL dates without limit) to any entity at any time with no expiration date.  This kind of request is not only ridiculous, it is also burdensome, opens me up to medical identity theft, and is a violation of my privacy.
Sincerely,[redacted] (formerly [redacted])

Initial Business Response /* (1000, 5, 2015/05/29) */
A review of our claim records revealed that Mr. [redacted] presented a claim for damages to his
vehicle as a result of
an automobile accident with our insured driver, [redacted]. After a thorough
investigation and intensive contact attempt...

with our named insured and insured driver, both our named insured and our insured driver failed to cooperate with our investigation of the above mentioned loss, and therefore, we had no other option but to deny coverage due to our insured's lack of cooperation.
Below are the general duties our insured failed to comply with during our investigation of the above mentioned loss:
GENERAL DUTIES
A. We must be notified promptly of how, when and where the accident or loss happened. Notice should also include the names and addresses of any injured persons and of any witnesses. If we show that your failure to provide notice prejudices our defense, there is no liability coverage under the policy.
B. A person seeking any coverage must:
1. Cooperate with us in the investigation, settlement or defense of any claim or suit.
Due to our insured's lack of cooperation, coverage was properly denied to Mr.
[redacted]'s claim. While Mr. [redacted] feels we have not and did not properly
denied his claim, we respectfully disagree. Our insureds' policies are a very restrictive policies which do
not provide coverage to any loss when any insured fails to cooperate with any and all investigations of any losses presented against their policies. And, since our insured clearly failed to cooperate with our investigation of Mr. [redacted]'s loss, coverage was denied to Mr. [redacted]'s claim. This was explained to Mr. [redacted] over the phone and a proper coverage
denial letter with what we're required to disclose in terms of our coverage denial reasoning was mailed to Mr. [redacted].
Again, due to coverage not being applicable to cover Mr. [redacted]'s claim, we have respectfully
denied his claim.
If Mr. [redacted] wished to discuss this matter further with me or have evidence to the contrary to our
decision, please do not hesitate to have him contact me and we will consider evidence he may have.
Sincerely,
[redacted]
Sr. Claims Supervisor
Blackhawk Claims Service
X-XXX-XXX-XXXX Ext # [redacted]
Initial Consumer Rebuttal /* (2000, 12, 2015/07/15) */
Blackhawks did pay for all damages. It's sad that you have to drag them through the mud to get basic service compliance. Their client which they could never reach switched policies and the insurance broker is under investigation by the Texas DOI for insurance violations.
This could have all been avoided by a better customer focused service orientation, but I don't expect that to change based on the last communications received from both them and AAIC the carrier.
I would recommend anyone involved in an accident get a lawyer if they see either names on an insurance card.

Initial Business Response /* (1000, 5, 2015/12/01) */
A review of our claim records revealed that Ms. [redacted] presented a claim for damages to her
vehicle as a result of an automobile accident she was involved in with our insured, Karim Abdul. As
a result, we completed a thorough...

investigation of the above mentioned accident and we concluded
the accident had been 100 % caused by our insured. Further, our investigation revealed that Ms. [redacted] has been paid and fully resolved to-date. Our records also indicate that we have been in constant communication with Ms. [redacted] and all of her messages and calls have been returned promptly.
If Ms. [redacted] wished to discuss this matter further directly with me, please do not hesitate to have her contact me and we will be more than happy to assist her.
Sincerely,
[redacted]
Sr. Claims Supervisor
Blackhawk Claims Service
X-XXX-XXX-XXXX Ext # [redacted]

Initial Business Response /* (1000, 5, 2015/11/11) */
This claim was reported on 9/14/15 by [redacted]. She advised the hood flew up and damaged the vehicle. It turns out that her dealer's shop worked on the vehicle the same day. An estimate was completed and it was determined that the [redacted]...

vehicle was totaled. In addition, it appears this vehicle was totaled from a prior loss and carries a rebuilt title. We also discovered that this vehicle had been in a prior loss the week before our claim. This file was referred to our Special Investigation Unit for further review. At this time, we are moving forward with evaluation this vehicle and will be making Ms. [redacted] an offer this week.

Initial Business Response /* (1000, 7, 2015/10/19) */
Mr. [redacted] had two losses with us - the first one was listed as 6/22/15. The date of loss could not be proven as there was no police report and the other party involved in the loss could not confirm when the loss occurred. Since the policy was...

new, we denied coverage for failure to prove the date of loss. Mr. [redacted] has had a subsequent loss on 9/29/15. That claim was investigated and a check was issued for the damages to Mr. [redacted]'s vehicle on 10/8/15 in the amount of 6764.36. The check was made out to Mr. [redacted] and his lienholder, State Farm Federal Credit Union.

Initial Business Response /* (1000, 11, 2015/10/29) */
As claims administrators for American Alternative Insurance Corporation, we empathize with Ms. [redacted]'s frustration. Unfortunately, our hands are often tied when there are no "independent" witnesses that observed the accident and when our...

policyholder refuses to make contact with their insurance company to validate the facts of the accident. Blackhawk has investigated this claim properly and acted within the fair claims practices of the Texas Department of Insurance. Ms. [redacted] has every right to utilize her own insurance for the repairs of her vehicle. We have been dealing directly with her hired attorney and have agreed to reopen our file for consideration of her property damages. We will continue to attempt to locate our policyholder to provide their version of the accident for determination of liability and consideration of Ms. [redacted]'s claim.
Initial Consumer Rebuttal /* (2000, 13, 2015/11/17) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Until this moment the company refused to paymen for the inccident. Its almost4 months. Please help me they pay me

Initial Business Response /* (1000, 5, 2015/10/02) */
This claim was opened by [redacted] the complainant who informed us of the loss as first notice. We commenced with our usual and customary investigation of coverage and liability. Our insured has heretofore been uncooperative during the...

course and scope of the investigation. As such, we made a business decision to proceed with the resolution of the claim, notwithstanding. Thus, the claim has been resolved with Mr. [redacted]. We are unaware of any other pending claims in this matter.

Initial Business Response /* (1000, 5, 2015/09/01) */
A review of our claim records revealed that Ms. [redacted] presented a claim for damages to her vehicle as a result of an automobile accident she was involved in with our insured, Jonas Lizama. As a result, we completed a thorough investigation...

of the above mentioned accident and we concluded the accident had been 100 % caused by Ms. [redacted]. Further, our investigation revealed that Ms. [redacted]'s alleged witness was not a true-non biased witness. A police report was not filed for this loss, and, as a result, we had to conduct our own investigation of this loss. Unfortunately, Ms. [redacted] made an unsafe lane change into our insured's vehicle, thus we determined that the operator/driver of our insured vehicle did not cause this accident. Therefore, we denied liability to Ms. [redacted]'s claim.
While Ms. [redacted] feels our insured was liable for the above mentioned loss, we respectfully disagree. We have mailed Ms. [redacted] a liability denial letter outlining the reasons we've denied her claim. This was also explained to Ms. [redacted] over the phone.
Again, due to Ms. [redacted] being found as the cause of the above mentioned accident, we have respectfully denied her claim.
If Ms. [redacted] wished to discuss this matter further with me or has evidence to the contrary to our decision, please do not hesitate to have her contact me and we will consider any possible evidence she may have.
Sincerely,
[redacted]
Sr. Claims Supervisor
Blackhawk Claims Service
X-XXX-XXX-XXXX Ext # [redacted]
Initial Consumer Rebuttal /* (3000, 7, 2015/09/02) */
(The consumer indicated he/she DID NOT accept the response from the business.)
what investigation? After a month and half of not getting a hold of him, yall call him Friday morning, get his statement,I call that afternoon to follow up and he isn't at fault. When I have pictures that clearly shows who is at fault and a witness who was sitting in the front seat .That's a pretty crappy investigation if you ask me. I clearly didn't make an unsafe lane change. I was already in the lane like I stated on the recording, they are taking their insure driver statement and running with it.The it was on his phone, wasn't paying attention and hit my car forcing my rear view mirror in the upward forward position. I wasn't not at fault, even Gieco clearly stated it after the investigation. Like I said BH takes the word of their insured drivers and twist up the other party statement, without doing a full investigation. I will not let this go, I will fight this.
Final Business Response /* (4000, 9, 2015/09/03) */
While Ms. [redacted] feels our insured was liable for the above mentioned loss, we respectfully disagree. We have mailed Ms. [redacted] a liability denial letter outlining the reasons we've denied her claim. This was also explained to Ms. [redacted] over the phone.
Again, due to Ms. [redacted] being found as the cause of the above mentioned accident, we have respectfully denied her claim.
If Ms. [redacted] wished to discuss this matter further with me or has evidence to the contrary to our decision, please do not hesitate to have her contact me and we will consider any possible evidence she may have.
Sincerely,
[redacted]
Sr. Claims Supervisor
Blackhawk Claims Service
X-XXX-XXX-XXXX Ext # [redacted]

Initial Business Response /* (1000, 6, 2015/12/01) */
A review of our claim records revealed that Ms. [redacted] presented a claim for damages to her
vehicle as a result of an automobile accident she was involved in with our insured, [redacted]. As
a result, we opened a claim and completed a...

thorough investigation of the above mentioned accident. Our investigation concluded
that the above mentioned accident was 100 % caused by our insured. Furthermore, our records indicated that Ms. [redacted]'s claim has been paid and fully resolved to-date. We show that the repair costs to get her automobile repaired have all been paid directly to her repair facility of choice.
Our records also indicate that we have been in
constant communication with Ms. [redacted] and all of her messages and calls have been returned
promptly.
If Ms. [redacted] wishes to discuss this matter further with me, please do not hesitate to
have her contact me and I will be more than happy to assist her.
Sincerely,
[redacted]
Sr. Claims Supervisor
Blackhawk Claims Service
X-XXX-XXX-XXXX Ext # [redacted]
Initial Consumer Rebuttal /* (3000, 9, 2015/12/07) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Yes, everything was paid for...EVENTUALLY. The following is completely untrue:
"Our records also indicate that we have been in
constant communication with Ms. [redacted] and all of her messages and calls have been returned
promptly."
It took many, many calls from me and the repair shop to get a response from Blackhawk. When I finally got a response, the excuse was "I was on vacation and you should have just called your own insurance if you were in such a rush."
If I am ever hit by a Blackhawk insured again, I will indeed go through my own insurance rather than deal with them again.

Initial Business Response /* (1000, 7, 2015/08/21) */
We apologize for the experience that [redacted] Copean had with our company We don't show any record that we actually spoke to [redacted] but rather we were dealing with "[redacted]" who stated she couldn't help us and a woman named "[redacted]". Virtually every...

time we tried to contact [redacted] Used Cars, we would be given 3 different prompt numbers and when the prompt numbers were selected, the mailboxes were always full, making leaving a message difficult. The claim was delay in part because our policyholder never responded to our calls or follow-up letters to verify the damages or facts as to how they happened. [redacted] repossessed the vehicle from our policyholder and the claim was promptly paid to [redacted]. On [redacted]'s defense, she has been handling claims for 16 years and prides herself in customer service, is very thorough with the claims process and always professional. Without being provided a specific example of her being "unprofessional", it is difficult to address exactly what she said that was deemed unprofessional, but, we sincerely apologize for any behavior that was interpreted as unprofessional.

Initial Business Response /* (1000, 6, 2015/05/21) */
In addition to responding to this complaint, I have also responded to a Georgia Department of Insurance Complaint filed by Ms. [redacted] as well.
This claim was reported to our office on 4/20/2015 by USAA, the insurance carrier for Ms. [redacted]. ...

According to the facts of loss as presented by the other carrier, our insured vehicle rear-ended the [redacted] vehicle. On 4/22/15, we spoke with USAA who advised us that
they had taken care of the damages to the [redacted]'s Ford Escape and would be sending us subrogation documents. USAA faxed us a copy of the police report on 4/22/15. Once we had the police report, we were able to confirm that the driver of our insured's vehicle was not listed on our insured's policy. Also on 4/22/15, we spoke with Ms. [redacted] and obtained her version of the facts of loss. Ms. [redacted] advised us that her 3 year old was taken to the emergency room and diagnosed with a minor concussion. The adjuster advised Ms. [redacted] to send the medical records to our office once she received them.
The adjuster handling this claim left the company and the claim was reassigned on 5/5/15. On 5/8/15, an email was received from Ms. [redacted]. We responded by advising her that her file had been reassigned. The new adjuster spoke with Ms. [redacted] on 5/8/15 and advised her that there was a coverage issue. Based on our inability to reach the named insured by phone, an ROR was mailed out to the insured and the unlisted driver on 5/8/15. The agent for the insured was contacted to see if they had any additional telephone numbers for the our insured. According to the agent, we had the only phone number they had on file. The number we had (and the agent had) was disconnected when we called it.
On 5/13/15, we were able to get in touch with the unlisted driver, [redacted]. He confirmed his date of birth and resident address. He confirmed that he lived with the named insured, his father, at the time of the loss and has lived with the named insured for the past 10 years.
[redacted] gave us an updated phone number for his father. We were able to reach Mr. [redacted] on 5/13/15 and he confirmed that his son was driving the insured vehicle and that his son lives with him at the policy address. On 5/18/15, coverage was reviewed by the carrier and a coverage denial was granted based on the fact that the unlisted driver, who resides in the insured's home, was driving our insured's vehicle but was not listed on the insured's policy. A coverage denial letter was sent to the named insured and to Ms. [redacted] on 5/20/15.

Initial Business Response /* (1000, 5, 2015/06/02) */
Respectfully, Ms. [redacted]'s allegations are mostly unfounded and unwarranted. She was not involved in the accident and as with most accidents and disputes there are two sides to every story. The accident is only a week old and she is requesting a...

liability decision to be made and payment of her claim without a thorough and warranted investigation to be completed. To date, she has refused to permit us to interview her daughter to assist in the investigation.
All insurance companies are regulated to conduct a thorough and reasonable investigation of an accident. This is the process before accepting, compromising, or denying claims to a "third party". If claimants are anxious to have their vehicle repaired before the liability investigation is completed, most third party claimants utilize their collision coverage under their own auto policy and sign over their right of subrogation to their insurance company to collect from the "responsible carrier".
In this case the facts are disputed as our policyholder is adamant he lawfully entered the intersection on a green arrow and had control of the intersection when Ms. [redacted]'s daughter entered the intersection.
Our driver was not cited for "running a red light" as Ms. [redacted] alleges. The citation, which is being disputed, is for "failure to yield". Our insured's vehicle did not broadside Ms. [redacted]'s vehicle as she alleges. Her daughter, broadsided our insured's vehicle when she allegedly entered the intersection from a stopped position, while talking on her cell phone, and without allowing the intersection to clear. Prior to the arrival of the Houston Police, the Harris County Sheriff sided with our policyholder.
This is why the statements from the witness and Ms. [redacted]s daughter are important to help clarify the facts of loss.
Blackhawk Claims will continue to investigate this loss to conclusion and provide Ms. [redacted] with our timely liability decision.
Sincerely,
[redacted]