Kettle Moraine Agency

In response to the complaint K. [redacted] filed against the Kettle Moraine Agency I can only address the part of the complaint that our agency was involved in.   Our agency receive this particular client and Dwelling Fire policy as a result of a transfer of business from the [redacted]co Agency...

.  We have no knowledge of the prior policy coverage or what might have been said to Ms. [redacted] by [redacted] the previous agent.  The policy that Ms.  [redacted] received effective 8/1/2011 from Erie Insurance was a Dwelling Fire form 1 policy which provides  basic coverages on a one or two family dwelling that is rented to others.   The Dwelling Fire form 1 provides coverage for Fire, Lightning, Internal Explosion, Windstorm, Hail, Riot or Civil Commotion, damage by Aircraft or Vehicles and  damage by Smoke.   Vandalism and Malicious Mischief are optional coverages  and Ms. [redacted]’s policy  included both coverages.  In additional an additional endorsement was added for  water damage caused by the backing up of the city sewer or the overflow of water directly from the sump crock. (Sewer and Drain Backup coverage)  Personal Liability of $300,000 was included and still remains on the policy regardless of Ms. [redacted]’s claim that the coverage was removed.     Excluded from the Dwelling Fire form 1 is coverage for the Accidental discharge or overflow of water from a broken pipe.  It is this exclusion that prompted the denial of Ms. [redacted]’s claim by Erie Insurance.   In Ms. [redacted]’s complaint she indicates on January 12, 2014 she experienced  a “Sewer and Drain back up” when in fact she did not. The water problem in her dwelling came from the Water Meter malfunction and had nothing to do with the City Sewer backing up or water coming from a Sump pump failure.  When Ms. [redacted] called our office on 2/11/2004 to advise us of the problem I asked for a phone number to give Erie so the adjuster could call her.  She gave me her landline but   indicated she had no answering machine.  I asked her for a work or cell phone and she had another number but indicated it was not her phone.  She gave me the number but I made the decision not to pass it onto Erie because it was not her phone.    It seems that decision on my part caused Ms. [redacted] further issues and I apologize for that.  The majority of Ms. [redacted]’s complaint is with Erie Insurance and their adjuster [redacted].  As an agent for the company our job is to report the claim to the company so an adjuster can be assigned to handle the loss.    [redacted]Kettle Moraine AgencyPO Box 474Kewaskum, WI 53040

Review: Around August 1, 2011 I had taken a Insurance Policy out with [redacted]co Independent Insurance ([redacted]) - my policies were to cover both my residence and this rental property which Ms [redacted] advised me I had "excellent" coverage for BOTH. -After [redacted] sent my renewal to the wrong address- causing Cancelation- she advised me that she was going to have me go thru her "affiliated"company Kettle Moraine Agency , and receive a non renewal letter(10/15/11) but would have the same excellent policies via Erie Insurance Group. I received a policy period 8/1/11 to 8/01/12 with a bunch of endorsements and added Liablity coverage $300,000 personal liability and $1000, each person medical payments($97.00) along with Water back up /sump discharge or overflow($50.00). On Jan. 12 , 2014 I experience the latter but advised "[redacted]" on/around Feb 10 - that I'd be filing a claim with the city of Milwaukee for the issues of them not acknowledging , repairing, or replacing defective meter, fixing back hoe tear up to my yard, and over billed me $313.86 charges for services not properly rendered. AT NO TIME WAS I TOLD I MAY NOT BE COVERED or I had "crappy" insurance as the Adjuster of Erie insurance [redacted] described the coverage when I described the series of events regarding the negligent response by the city for almost 7 months when I finally filed a claim on or around August 05, 2014. "[redacted]" failed to supply the adjuster with my cell phone number I insisted I be called at - so my claim was delayed as well. When [redacted] (Erie Insurance adjuster) finally was reached by me - I gave him the cell number, emailed requested info regarding the city claims (I filed two claims with the city of Milwaukee- Feb 11 - and then another May 12th complaining they first completely IGNORED my first claim and added LOSS OF RENT as well to the new claim.[redacted] stated he couldn't talk "because he was out in the field" , never reviewed the emails I sent him, but went on with the taped interview anyway. I gave him the step by step happening , the negligence in response by the city and advised [redacted] that the sump pump/drain was overwhelmed and even the fire dept couldn't immediately clear either- but, I had little or NO water damage because over night I had a team that cleared the drain , rendered 20 bottles of Clorox and 5 fans to make sure there was NO WATER DAMAGE- and insisted his 'suggestion' of that claim was NOT valid- At NO TIME did [redacted] suggest my claim would NOT be paid- received the DENIAL from the city notice I emailed him to answer within the 21 days as specified in the letter dated July 30, (but not mailed until August 6 - received by me August 9 th and emailed to [redacted] for response immediately on August 11, 2014.Desired Settlement: [redacted] of ERIE INSURANCE GROUP used his OWN term he 'suggested' which I denied in assessing my claim. AT NO TIME DID I REFER TO THE CLAIM AS "water damage'. At NO TIME did "I change my mind" of the claim he suggested so he could deny my claim without payment. If I claimed anything with water I would of clearly stated the COVERED term of Sump Pump/drain discharge or overflow! [redacted] DID NOT respond to the denial letter by the city mailed from the ERIE office of Brookfield, never advised me in the FIRST contact he made with me since the phone interview (Aug. 19th ) that my claim was NOT covered - just that he needed 'more information' - then and only after the 21 day limit of the appeal to the city - did [redacted] advise me in a letter dated Aug. 21 that I was denied because they didn't cover water damage (WHICH I NEVER CLAIMED !!) Failing to respond to the appeal - caused my appeal Sept 5 to be denied as well (being late) which was advised to me Sept 15th by the city THE SAME EXACT DATE another letter came from ERIE - see enclosed. I want my LOSS OF RENT, Damage to my yard from the city vandalism of a back hoe paid, The overcharged bill the city sent me of $313.86 for two trucks with two women with NO TOOLS sent by Martin Wahl of the Utility Dept paid with late charges as well , and the little damage listed from the result of water backup and sump discharge and overflow - that IS covered PAID - I also want to know what happened to the Liablity coverage on my policy which apparently was at some time deleted without my knowledge or permission after Kettle Moraine took over [redacted]co's policy.

Business

Response:

In response to the complaint K. [redacted] filed against the Kettle Moraine Agency I can only address the part of the complaint that our agency was involved in. Our agency receive this particular client and Dwelling Fire policy as a result of a transfer of business from the [redacted]co Agency . We have no knowledge of the prior policy coverage or what might have been said to Ms. [redacted] by [redacted] the previous agent. The policy that Ms. [redacted] received effective 8/1/2011 from Erie Insurance was a Dwelling Fire form 1 policy which provides basic coverages on a one or two family dwelling that is rented to others. The Dwelling Fire form 1 provides coverage for Fire, Lightning, Internal Explosion, Windstorm, Hail, Riot or Civil Commotion, damage by Aircraft or Vehicles and damage by Smoke. Vandalism and Malicious Mischief are optional coverages and Ms. [redacted]’s policy included both coverages. In additional an additional endorsement was added for water damage caused by the backing up of the city sewer or the overflow of water directly from the sump crock. (Sewer and Drain Backup coverage) Personal Liability of $300,000 was included and still remains on the policy regardless of Ms. [redacted]’s claim that the coverage was removed. Excluded from the Dwelling Fire form 1 is coverage for the Accidental discharge or overflow of water from a broken pipe. It is this exclusion that prompted the denial of Ms. [redacted]’s claim by Erie Insurance. In Ms. [redacted]’s complaint she indicates on January 12, 2014 she experienced a “Sewer and Drain back up” when in fact she did not. The water problem in her dwelling came from the Water Meter malfunction and had nothing to do with the City Sewer backing up or water coming from a Sump pump failure.