Custom Eyes

Initial Business Response /* (1000, 6, 2016/02/11) */
Revdex.com of Central Oklahoma February 10,
*** *** Dispute Counselor
South Dewey
Oklahoma City, OK XXXXX
(Online Response: note customer personal information intentionally omitted per request of Revdex.com of
Central Oklahoma)
RE: Case# XXXXXXXX,
Contract# XXXXXXXX
Claim# XXXXXXX
Dear Mr***
Please reference your case number XXXXXXXX regarding the contract holder's claim number XXXXXXXThe contract holder purchased a vehicle service contract under which Mercury Select Management Company, Inc(MSMC) agrees to remedy the Mechanical Breakdown of certain components according to the terms and conditions of the contractPlease note that MSMC is insured by American Mercury Insurance Company (AMIC)
On November 19, 2015, Zack at Northside Ford Truck contacted our claims office and reported several mechanical problems with the contract holder's Ford ExcursionThe concern reported by the repair facility was the transmission slipping and a popping noise from the front end, vehicle blowing a lot of white smoke and the temperature guage going to hotThis same day our claims office assigned a 3rd party inspector to confirm the cause and extent of reported mechanical failures
The inspection was performed on November 23, and confirmed mechanical failure to the EGR cooler (is a non covered item), oil cooler, all ball joints, left front hub, and oil pressure switch and some other non covered componentsNo failure to the head gasket was confirmed but the report did state 'may need head gasket'Claim authorization was provided by our office on November 25, for the covered components, less egr cooler and the head gaskets since the head gasket was not requested by the repair facility or confirmed as failed by the repair facility or the inspector
On December 1, 2015, the repair facility reported to us that during the repair process they noticed the turbocharger was also failed
The turbocharger was added to the claim coverageThe total amount paid for the above listed components including the turbocharger, also including the fuel pressure regulator and filter, an engine thermostat and radiator cap & oil filler cap which were also recommended by the repair facility, (less the EGR cooler which is not a covered component, & head gasket) was $
Note there were other additional components recommended by the repair facility that are specifically excluded from coverage by this service contract and therefore were not coveredThese components were intentionally not named in this response since they are not associated with the complaint regarding the denial of the head gasket coverage, and also to prevent this response from being excessively lengthyHowever we can provide the names of these components upon request
The repair facility emailed the invoice to us for payment on December 28, Payment was issued to the repair facility on the same day via our corporate MasterCardNote, the dates on the invoice show that the repair order was opened on November 18, 2015, and 'ready' on December 24, In addition, the repair facility notated on the invoice that they 'tested for head gasket failureTests passed *** both pressure build & combustion gasses in cooling systemTest drove, steam cleaned & checked for leaksOK at this time.'
On January 27, the contract holder called our claim office and reported that the vehicle needs a head gasketCoverage was declined for the head gasket because the service contract expired on January 10, 2016, the failure was reported after the expiration date of the service contract
Please note according to the terms and conditions of the service contract, all mechanical failures must occur and be reported to us within the terms of the contractSee excerpts from the service contract belowUnderlining added
SECTION IIWHAT THIS CONTRACT COVERS
COVERAGE AMECHANICAL BREAKDOWN REIMBURSEMENT
During the term of this Contract, We will reimburse You, or an authorized repair facility, the Repair Cost to repair or replace any Covered Component of Your Vehicle that has experienced a Mechanical Breakdown, less the applicable DeductibleUnder all Coverages the Mechanical Breakdown must occur and be reported during the term of this Contract
SECTION IIIWHAT IS NOT COVERED
ANY MECHANICAL BREAKDOWN OR DAMAGE:
Fthat may reasonably be assumed to have existed 1) prior to the effective date of this
contract, 2) during any existing claim exclusion period, 3) that occurs or is reported after
the expiration of this contract,
Unfortunately the head gasket failure was not reported to us within the term of the service contract and according to the test results conducted by the repair facility, the failure did not exist when the vehicle was at the repair facility during the time the fore mentioned repairs were being completedFor these reasons, coverage for the head gasket repair must remain denied
I regret that our decision could not have been more favorable but I believe we have adhered to the terms and conditions of the service contractPlease contact me if you have any questions
Sincerely,
*** ***
MBP Claim Supervisor
Mercury Select Management Company, Inc
XXX XXX XXXX ext XXXXX

The contract purchased provides 12 months/15,000 miles of Silver
level coverage.  Silver is considered component level coverage, and does NOT include
every component for a vehicle, but only those components listed in the contract.  All claim payments and correspondence have
been...

handled in strict compliance with the terms and conditions of the contract.  To provide the best customer service
possible, we are willing to cancel the contract and refund the full purchase price,
less any claims paid.  If this is
agreeable, please respond affirmatively and we shall proceed with the
cancellation, and begin the refund process.