As explained to our insured, we are experiencing an unexpected 20% increase in phone volume to ourca ll centerWe are doing everything we possibly can do at this time to address our service levels.Based on the reports pulled, we can see that our insured placed his first call with us on March at4:39pmHe hung up after approximately secondsHe ca lled again on March at 10:10amTherewas a wait of about minutes and he was ab le to speak with a Customer Service Representative at10:27am and have his question about his policy answered.As explained to our policyholder, we are active ly interviewing, hiring, and t raining new Customer ServiceRepresentativesRegrettably, this process does not happen overnightCall Center Leaders have beeninstructed to assist serving our Customer Service phone queue during th is time.Our insured has been advised of our hours of operation which are 7:30am- 7:30pm Monday throughFriday and 8:00am-4:30pm on SaturdayAs well, I have offered for him to contact me directly if needbe.We sincerely apologize for not being able to provide and meet expected customer service
Dear Mr***:I am in receipt of your complaint to the Revdex.com sent to us April regarding yourinability to contact us on April 11, 2015.First let me please offer my sincere apologies for our inability to answer and take your telephone call thefirst time you phoned usI am in complete agreement that this type of service is unacceptable andneeds to be improved immediatelyI have phoned and left several messages hoping to speak with youdirectly to apologize.Over that weekend, starting on Thursday afternoon, April 10, our local carrier, AT&T experienced a cutin a fiber line that provides service for our telephone and processing systemsThis turned out to be amajor incident and turned out to take much longer to repair than anyone expected.Once the problem line was identified, we were told that they had no access to the manhole where it waslocated until after [redacted] on Saturday morning, the day you calledOur phone report shows that youcalled us several times between 9:34am and 9:55am and the phone just rangNormally, our companymessaging would have been in place to route you to Customer Service for assistance.This turned out to be a larger problem than thought and took the weekend to repairWe did our bestwith the resources we had to advise our customers of the outageA message was placed on our websiteand, if or when the phone line service was restored, a message explaining the current system issues.I see in the complaint information that you have a different addressI will make that address change toyour policy and send you confirmation.As for your desired settlement to refund all monies paid, please contact me to discussRefunding allmonies paid requires a cancellation of the policy back to its inception date of July 16, You haveadvised us that you have a lienholder on your vehicle and proof of insurance has been provided to them.Again Mr***, I sincerely apologize for not being able to meet and provide expected customerserviceUnfortunately, the circumstances were out of our control that day.Sincerely, [redacted] Customer Service ManagerWawanesa General Insurance Company
Please be advised we have received an inquiry from the Revdex.com (Revdex.com) of San Diego,the California Department of Insurance and through Wawanesa General Insurance Company's website"feedback" page regarding the above-captioned lossAttached to all three pieces of correspondence wereceived your description of your concerns and your desired outcomePlease accept this letter toaddress your concerns as registered to the entities mentioned above.By way of background, this will confirm you carry an HHomeowners policy with WawanesaGeneral Insurance CompanyYou reported a water loss to our staff on November 4, 2014, indicatingyou noticed a leak at your kitchen ceiling, which is directly below an upstairs showerWe immediatelyestablished a claim and initiated an investigation.Determining the cause, origin, and duration of the water escape is a common and critical component inthe investigation of any presented water lossAs such, we provided referrals to you for plumbers whohave expertise in leak detectionAfter conducting your own research about plumbing vendors, youselected American Leak Detection to inspect the plumbing leak in questionThey visited your home onNovember 10, After performing a thorough inspection, they determined that the water leak wasfrom failed tile grouting and that re-grouting of the shower was a needed maintenance item.Importantly, the plumber opined the water escape from the failed grout was days old.We discussed the claim further with you on November 13, 2014, at which time you confirmed the tileshower enclosure was original to your home, which was built in We also reviewed yourhomeowner policy contract wording with you regarding an exclusion which appears to apply to thislossThe pertinent portion of the policy reads as follows:SECTION I- EXCLUSIONSAWe do not insure for loss caused directly or indirectly by any of the followingSuch loss isexcluded regardless of any other cause or event contributing concurrently or in any sequence tothe lossThese exclusions apply whether or not the loss event results in widespread damage oraffects a substantial areaWaterThis means:eContinuous or repeated seepage or leakage of water or the presence or condensationof humidity, moisture or vapor, over a period of time greater thanldays.The policy also outlines duties of policyholder, such as youIn particular, please refer to:SECTION I- CONDITIONSCDuties After LossIn case of a loss to covered property, we have no duty to provide coverage under this policyif the failure to comply with the following duties is prejudicial to usThese duties must bepe1jormed either by you, an "insured" seeking coverage, or a representative of either:Cooperate with us in the investigation of a claim;As often as we reasonably require:aShow the damaged property;We offered to inspect your damages and secure your statement, but you declined these offers and statedyou were expecting a denial letter from usInstead, we sent you a letter on November 21, 2014,confirming you were withdrawing your claim.We next heard from you on December 2, 2014, with a request that a different plumber inspect the loss.We agreed to this request and [redacted] inspected your residence anew on December 3, 2014.Not surprisingly, that plumber confirmed the findings of the first plumber; namely, that worn tile groutand caulking were the leak failure sources, and that the duration of the leak was "more than a monthprior to discovery on October 30, 2014." Wood rot at the subflooring was also observed, whichprovides further evidence of the long-term nature of the water leak event.We informed you of these further investigative results on December 4, 2014, and have been attemptingto obtain your recorded statement ever since, in order to conclude our investigationJanice [redacted] ofAdams Adjusting is assisting in this portion of the investigationYou may recall she completed aninspection at your homePlease contact her to provide your statementShe can be reached atIn the meantime, we have offered to pay for the kitchen ceiling drywall access cutmade by the [redacted] technician, as part of the inspection and diagnosis processWe willforward this payment to you under separate cover.In closing, we respectfully disagree with your various critiques surrounding our handling of yourreported claimIn fact, we have gone to great lengths to provide superior customer service whileconducting a thorough and accurate investigationPresent evidence leads us to advise you of thehomeowner's policy exclusionary language mentioned above, and we encourage you to mitigate yourdamages at this timePlease continue to cooperate with our investigation by providing your statementto Ms [redacted] , so we can reach a final conclusion in this matterIn the meantime, by copy of thisletter, I'm informing the San Diego Revdex.com and the California Department of Insurance of our positionthat while we have handled this matter in an appropriate manner we are attempting to conclude ourinvestigation and provide you with a resolution
January 7, 2014 [redacted] *** RE: Our Insured: [redacted] *** Date of Loss: September 15,... 2014 ClaimNo.: [redacted] Complaint: [redacted] Mr. ***: We are in receipt of an inquiry from theRevDex.com based on a complaint you submitted to their office on01/05/2015. In your complaint, you raised a few issuesthat appear to be based on your misunderstanding of the insurance policy. First, the Wawanesa Automobile Policy covers: LIMITOF LIABILITYA. Our limit of liability for any loss will be the lesser ofthe:2. Amount necessary to repair or replace theproperty with other property of like kind and quality, minus the deductible. Inaccordance with the policy contract, we obtained a confirmed price of $576.00from a local glass company to replace the damaged glass on your vehicle. This price was based on a like kind andquality part. In this situation, thatpart was a non-OEM replacement part. Secondand unfortunately, we believe you may be misunderstanding our customer servicerepresentatives when you quote them as stating, “ Wawanesa only uses OEMparts.” With certain types of partsthat statement may be true (ex: metal crash parts) based on a number of factors(vehicle age, availability of parts, etc). With other types of parts we may use industry available like kind andquality replacement parts (including glass). Again, this issue is covered in your Automobile Policy per the LIMIT OFLIABILITY stated above. Finally,you indicated to the Bureau that your “Desired Settlement” would be to, “Changethe lease insurance agreement”. As youmay be aware this request cannot be met. Our insurance policy and operations are regulated by the State ofCalifornia Department of Insurance. Ourpolicy was submitted to and approved for use by the State of CaliforniaDepartment of Insurance in accordance with all applicable law andregulations. Furthermore, our policyfollows generally accepted industry, market, and ISO guidelines. We regret that you had this experience andread or learned of your applicable insurance coverage for the first time aftera loss was incurred. You have beenprovided with a copy of your policy contract in the past as well as allapplicable policy renewal documentation. Nofurther coverage of payment for this loss will be offered at this time. If you have additional information that maychange the facts or value of the loss, please contact your adjuster, as weremain open to reviewing such information. Sincerely, WawanesaGeneral Insurance Company [redacted] *** [redacted] ClaimsManager
Dear Mr [redacted] :We are in receipt of your complaint from the San Diego Revdex.comIn response, Ireviewed the claim file.We inspected your Honda Civic on April 2, 2015, and estimated the damages to be$2,We issued a Collision payment of $1,on April 8, 2015, pursuant to yourrequest as Alliance United Insurance, who insured the other driver, had not yet agreed to payfor your damages.Alliance United Insurance verified their policyholder has valid coverage for this lossHowever,they are in the process of confirming the facts of the accident with their policyholder in order todetermine their position on liabilityWe advised them it is your desire to have your Collisiondeductible advanced to you immediately upon their acceptance of liability and we haveforwarded all the necessary documents for them to do so.We will continue to follow up with Alliance United Insurance for status on their investigationand possible recovery of your Collision deductibleWe apologize for any inconvenience thismatter has caused youHowever, per the terms of your policy contract with us, the Collisiondeductible is your self-insured portion of the claim and must be applied to the Collision claim.We are making every effort to see that you are reimbursed by the responsible party but cannotguarantee success.Please feel free to contact me should you have any questionsI can be reached at (858)522-My office hours are Monday through Friday, 7:30am to 4:00pm.Sincerely,WAWANESA GENERAL INSURANCE COMPANY
This letter is written in response to your complaint filed with the Revdex.comagainst Wa\vanesa Insurance.The New Business Unit received your application on March 30, New BusinessRepresentative, [redacted] spoke to you on April 1, to advise that since you updatedthe annual mileage on your application from 3,to 9,000, your premium would increase.During that conversation, it was decided that the annual mileage would remain at 3,asoriginally stated and the annual premium would remain at $as originally quoted.Your policy was issued on April 1, with an effective date of March 27, Ourpolicy notes show you called our Customer Service Department on April 2, andrequested to cancel your policyA full refund of $was mailed to you on April 7,2015.We apologize for any inconvenience or misunderstandingIf you are interested in a policywith Wawanesa now, or anytime in the future, we would welcome the opportunity to dobusiness with youIf you have any further concerns regarding this matter, please feel tocontact me.Sincerely, [redacted] MBA, AINSUnderwriting Manager
February 9, 2015The Revdex.comAttention: Ms*** ***Viewridge Avenue, Suite 200San Diego, CA 92123RE: Complaint ID Number: ***Dear Ms***:Enclosed is our response to the above referenced complaint number.As explained to our insured, we are experiencing a very unexpected
17% increase in phone volume toour call centerWe are doing everything we possibly can do at this time to address our service levels.I have placed several calls to our insured hoping to speak with him directly about his concernsI havehad no reply.Our insured did speak with a representative on February rd to change vehiclesThat change was placedon hold per his request pending his approval.In seeing that this complaint was made after he spoke with us and his desired settlement is to cancel hispolicy, we will do as he has requested and cancel his policy.As explained to our policyholder, we are actively interviewing, hiring, and training new Customer ServiceRepresentativesRegrettably, this process does not happen overnightCall Center Leaders have beeninstructed to assist serving the Customer Service queue during this time.We sincerely apologize for not being able to provide and meet expected customer service.Sincerely,*** * *** _Vice President, U.SOperationsWawanesa General Insurance Company*** *** ***
We are in receipt of the February 23, correspondence from Mr*** regarding the abovecaptioned matterIn review of his further correspondence Mr*** did not offer any new informationthat would lead to a change in our positionIn addition to the letter dated February 13, 2015, from ouroffice to Mr*** (which you received a copy of) a second letter was directed to Mr*** on or aboutFebruary 20, This letter denied the claim presented by Mr*** and provided an explanation forthe basis of the denialOur file remains closed
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
I do not ask Wawanesa to change MY policyI ask them to change THEIR policy for all future leasesThey state that they cannot, because they are regulatedI am currently purchasing new insurance that is also regulated by the state and it DOES cover my lease and official OEM PartsIt seems that Wawanesa doesn't know that they can become a better company.I DO ask them to teach their salespeople to not fraudulently state that they will use ONLY OEM parts for any and all repairsI did not "misunderstand" the customer service repsI pointedly asked them numerous timesThe salespeople and the supervisors I spoke with all admitted they were incorrect to try to sell me something they never had to sell.I wish Wawanesa had admitted any failure on their partThe supervisors admitted it over the phone, but the company will notI have paid well over $12,to Wawanesa in insurance payments over the yearsFor their lack of truth and integrity, I am now going to pay that amount to someone else for all future insurance needs
Regards,
*** ***
We are in receipt of your October 8, email where our insured, *** *** has lodged
a complaint with your officeIn your correspondence you state that you "recognize that there
are two sides to every dispute." In this particular auto accident there are actually three separate
versions
of the incident being presented
This loss occurred at 7:p.mon July 30, All vehicles involved in the loss were
travelling on Interstate westbound also known as the Santa Monica freewayTraffic was
heavy and described as "stop and go" trafficMr*** was alone operating his Chevy
Malibu and travelling in lane number threeHe is described as the front most vehicle in this
loss and *** *** was travelling directly behind him in her Mazda Ms***
had five passengers in the Mazda vanTravelling directly behind the Mazda van was ***
*** in a Pontiac Grand-AmPlease note; Ms*** is also insured with Wawanesa
General Insurance Company
California Highway Patrol responded to the accident sceneThe investigating officers took
statements from all parties and concluded that the cause of the loss was Mr*** in
violation of California Vehicle Code Section which states: no person shall drive a vehicle
upon a highway at a speed greater than is reasonable or prudent having due regard for weather,
visibility, the traffic on, and the surface and width of, the highway, and in no event that a speed
which endangers the safety of persons or propertyIn essence the investigating officer found
that Mr*** drove his Pontiac into the rear of the Mazda van driven by Ms*** and
pushed the van into Mr***'s vehicleIt should also be noted that Mr*** was cited
for being an un-licensed driverThe Pontiac being driven by Mr*** had just been
purchasedPart of the difficulty in resolution of this claim is the fact that *** Insurance,
for Mr***, has yet to reach a coverage determination regarding the Pontiac
Grand-Am
The occupants of Ms***'s Mazda van all of which are between the ages of and have a
slightly different version of the accidentThe two recorded statements we have obtained
indicate that the Chevy Malibu driven by Mr*** came to a very abrupt stop and Ms
*** braked hard and almost avoided rear ending the Chevy; however, made slight contact
seconds before being rear ended by Mr***'s vehicleThey state they were pushed back
into Mr***'s vehicle a second time, much harderIn the second impact the airbags of the
Mazda van deployedIn their version they felt three impacts two to the front of the vehicle and
one from the rearIn this second scenario Mr*** should have felt two impacts
The Complainant, *** *** has yet a third version of the auto accidentHe states he
was slowing for traffic when he was rear-ended by the Mazda van travelling directly behind
himHe denies there being a second impact and upon being struck in the rear had to swerve to
avoid striking the vehicle in front of him
We have kept Mr*** informed of our progress and why we've required additional time to
conclude our investigationWe obtained the statement of our driver, *** ***, on
October 16, 2014, which allowed us to reach a liability determinationMr*** was
informed this date that we will be able to honor his claim
The sorting out of the three separate versions created some difficulty in final resolution of this
claimWhile Wawanesa General Insurance Company would have liked to have completed it's
investigation into this matter sooner, it took some time to arrange for statements with the
minors involved, including Ms***
Should you require further information regarding this claim, please contact the undersigned
between the hours of 8:30a.mand 5:00p.m., Monday through Friday, at ###-###-####
Respectfully,
** *** ***
Claims Manager
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***
January 22, 2015*** ***Revdex.comVIEWRIDGE AVE, STE 200SAN DIEGO CA 92123Re: Complaint ID: ***Insured: *** ***Cancelled Policy Number: ** ***Quotation Number: ** ***Dear Ms***:We have received and reviewed the complaint filed with your
organization by our priorpolicyholder, Mr*** ***The following is a summary of the policy transactionsand an explanation of the handling of Mr***'s cancelled policy and quotation issued.Mr***'s original policy, ** ***, was effective March 22, and has renewedeach consecutive yearPrior to the cancellation, the below transactions occurred on thepolicy:February 27, - An "Offer to Renew" effective March 22, 2014-March 22,2015was mailedTotal policy premium $Down payment of$due before March 22, 2014; Payments to be billed:$due June 22, and September 22, 2014.March 26, - Mr*** contacted our Customer Service Department to makethe renewal paymentA renewal payment of $was madeand the policy was reinstated effective March 27, 2014.April16, - Mr*** contacted our Customer Service Department to add avehicle to his policyThe policy changes were made effectiveMarch 27, 2014; and an amended declarations policy was mailedshowing new payments to be billed in the amounts of $dueJune 22, and September 22, 2014.Mr*** also requested to delete a vehicle from his policyeffective April17, 2014; and a subsequent amended declarationspage was mailed with payments to be billed in the amount of$due June 22, and September 22, 2014.May 19,- Mr*** requested to add another vehicle to his policyThispolicy request was effective May 8, and the total policypremium with all the policy changes was $(includingservice charge)After subtracting the payment of$312.00previously received, the account balance was $Anamended policy declarations page was mailed showing newpayments to be billed in the amount of$due June 22, 2014and September 22, 2014.June 25, - A payment of $was made on the policy leaving a balancedue of$478.50.No additional payments were made on the account although billing notices were mailed.On October 25, 2014, a Notice of Cancellation effective November 14, 2014, was mailed.Since no payment was received by October 25, 2014, the policy cancelled.On November 22, 2014, a Notice of Premium Due was mailed requesting payment forearned premium due of$Finally, on December 6, 2014, a Delinquent Notice wasmailed requesting the outstanding amount due of$17.50.Mr*** contacted our Customer Service Department on January 6, to discussreinstatement of his policyHe was advised that due to the length of time the policy hadbeen cancelled; he would need to reapply; and prior to reapplication, the outstandingamount of $would have to be paid.A representative in our Inquiry/Quoting Department spoke to Mr*** on January 6,and the information was taken for the new quotation (Quote #** ***).However, prior to clearing and releasing the quote, Mr*** was again advised the priorbalance must be paidOn January 7, 2015, Mrs*** *** spoke with arepresentative and she, too, was advised the prior balance needed to be paid before thequote could be releasedMrs*** then contacted our Customer Service Department toobtain assistance in making the payment on our EZ-Pay online service and the paymentof$ was made on January 8, Mr*** then contacted our New BusinessDepartment; and after receiving confirmation of the payment, Mr*** was advised thequote would be sentQuote #** * * * *** * was emailed at 3: the same day to***Mr*** requested a call back from a supervisor; and theunderwriter gave the message to a supervisor for the call back.An underwriting supervisor contacted Mr*** that same day and Mr*** expressedhis frustrations regarding the service and the reapplication requirementAfter explainingthe process, the supervisor asked Mr*** how he could provide additional assistance toobtain his businessMr*** advised there was nothing the supervisor could do as hehad already obtained insurance elsewhereMr*** thanked the supervisor for the callback and the call was ended.Mr*** states in his complaint that he is uninsured although he advised the supervisorhe had obtained coverageResearch into our quoting database shows the quoteprepared for Mr*** has not been returnedAs qualified applicants, Mrand Mrs.*** are welcome to return their application for insurance coverageHowever, due tothe length of time, the prior policy has been cancelled, we would be unable to apply theLoyalty Discount as this discount applies to policies that have been continuously in forcefor more than one yearBecause there was an interruption in Mr***'s prior policy inexcess of days, he no longer qualifies for the Loyalty Discount.Based on the information explained, I ask that this complaint be classified as invalidIfyou need further assistance regarding this matter, please feel free to contact me.Sincerely,Underwriting ManagerWawanesa General Insurance Company*** *** ***
January 12, 2014 *** *** *** *** *** ** *** RE: Our Insured: *** *** Date of Loss: September 15, 2014 ClaimNo.: *** Complaint: *** Mr***: Please be advised that the Better BusinessBureau supplied us with a copy of your most recent communication to themWefurther assessed your concerns and I want to clarify that your communication tous has created an opportunity for us to revisit with our personnel the propermanner of messaging to our customers how the Automobile Policy accounts for OEMpart usageI appreciate that you’ve given us an opportunity to improve Please understand that should you be facedwith the need to file a claim for glass replacement in the future, the WawanesaGeneral Insurance Company Automobile Policy remains unchanged and maintains alimit of liability for the amount necessary to repair or replace the propertywith other property of like kind and qualityVery few automobile manufacturersactually manufacture their own glass and we will again be in a position thatleaves us with no option but to authorize a settlement amount that comportswith this policy provision by considering the availability of aftermarket glass. In light of our possible miscommunication,and to emphasize your value as a customer, I’ve enclosed with this letter acheck in the amount of $which should serve to reimburse you for the outof pocket expense you incurred to install the OEM glass on your vehicle Thank you for the opportunity to assist withyour insurance needs. Sincerely, WawanesaGeneral Insurance Company * *** ***ClaimsManager
Dear Ms. [redacted]:
I am in receipt of your complaint to the Revdex.com regarding the billing of the above
referenced automobile policy.
Enclosed you will find a copy of your Automobile Insurance Application (#1). The total premium, for
your policy effective March 25, 2014, was...
$1468.00. You selected the 9-pay plan. Based on that
payment plan, 20% of the total premium was due to start the policy; you would then be billed 10% of
the total the 1st through 8th months after the policy started. There is a $4.00 service charge for each
payment. I have highlighted this section of the application.
Also enclosed is a copy of your Auto Policy New Declaration (#2). That declaration confirms receipt of
$300.00 and the subsequent payments to be billed. As you can see, your payments were scheduled
April through November.
In May, a Notice of Cancellation (#3) was mailed to you because of non-payment of premium. That was
for the April and-May payments. We received $300.00 via an online payment on June 13,2014. We
mailed you a confirmation (#4) that payment was received and your new payment schedule.
In August, another Notice of Cancellation (#5) was mailed. This was for the June and July payments. We
received $148.00, the amount billed on notice (#4), on September 8. This only took care of your June
outstanding payment.
We mailed you confirmation (#6) that payment was received and your new payment schedule.
In October, a Notice of Cancellation (#7) was mailed. This was for July, August, and September. I can
confirm that an online payment of $540.00 was submitted November 4 (#8).
You stated in your complaint that you had not received any reminder notices that a payment was due.
However, you did receive the notices of pending cancellation and the declarations confirming payment
had been received and the new payment schedule. I can see that the reminder notices were generated
and it is curious that you did not receive them. We have no record of any returned mail.
You stated in your complaint, and you told one of our Customer Service Representatives, that your
husband had made a payment over the phone. As our Representative advised, we have never taken any
payments over the phone. You can make a payment online via our website, but not by phone.
I am uncertain where the confusion has come from regarding your payment schedule. The terms of the
9-pay plan were clearly stated on you application for insurance. And why you haven't received payment
reminder notices yet you have other correspondence sent from us.
I hope this information has clarified the issues you raised to the Revdex.com. If you have any
further questions, please do not hesitate in contacting me directly.
Sincerely,
[redacted], Customer Service Manager
Dear Mr. [redacted]:I am in receipt of your complaint to the Revdex.com sent to us April 14 regarding yourinability to contact us on April 11, 2015.First let me please offer my sincere apologies for our inability to answer and take your telephone call thefirst time you phoned us. I am in...
complete agreement that this type of service is unacceptable andneeds to be improved immediately. I have phoned and left several messages hoping to speak with youdirectly to apologize.Over that weekend, starting on Thursday afternoon, April 10, our local carrier, AT&T experienced a cutin a fiber line that provides service for our telephone and processing systems. This turned out to be amajor incident and turned out to take much longer to repair than anyone expected.Once the problem line was identified, we were told that they had no access to the manhole where it waslocated until after [redacted] on Saturday morning, the day you called. Our phone report shows that youcalled us several times between 9:34am and 9:55am and the phone just rang. Normally, our companymessaging would have been in place to route you to Customer Service for assistance.This turned out to be a larger problem than thought and took the weekend to repair. We did our bestwith the resources we had to advise our customers of the outage. A message was placed on our websiteand, if or when the phone line service was restored, a message explaining the current system issues.I see in the complaint information that you have a different address. I will make that address change toyour policy and send you confirmation.As for your desired settlement to refund all monies paid, please contact me to discuss. Refunding allmonies paid requires a cancellation of the policy back to its inception date of July 16, 2014. You haveadvised us that you have a lienholder on your vehicle and proof of insurance has been provided to them.Again Mr. [redacted], I sincerely apologize for not being able to meet and provide expected customerservice. Unfortunately, the circumstances were out of our control that day.Sincerely,[redacted] Customer Service ManagerWawanesa General Insurance Company
Please see attached, thank you.Dear Ms. [redacted]:This office is in receipt of a letter from the Revdex.com, dated October 2, 2016, advising us you lodged a complaint on October 1, 2016.The loss occurred September 6, 2016, and the claim was reported to us by your insurance company, [redacted]...
Insurance, on that same date. The claim was assigned to Adjuster, [redacted], who immediately initiated the investigation. Based on the information available to us, liability was accepted and we made arrangements to appraise the damage to your vehicle.The initial inspection of your 2011 [redacted] revealed it sustained damage to the right corner of the front bumper in the amount of $1,087.44. We issued payment to you in this amount on September 16, 2016. We subsequently received a supplement repair invoice in the amount of $498.99 and issued payment in this amount to your shop, [redacted].When I reviewed the claim file, I found the appraiser who inspected your vehicle inadvertently used a hyphen instead of an underscore after your first name when emailing the damage estimate to you. I suspect this is the reason you did not immediately receive the estimate from him.On September 21, 2016, you contacted Ms. [redacted] to notify her you did not receive the initial damage estimate and the estimate was emailed to you that date.With respect to the rental car portion of your claim, I found that on September 23, 2016, you notified Ms. [redacted] you had an appointment with [redacted]. As such, she made a reservation for you with [redacted], and authorized $53.34 per day for a comparable vehicle. Ms. [redacted] does not select the [redacted], location when making the reservation, as the [redacted], computer system automatically selects the branch closest to the customer’s residence. The reservation is valid at any [redacted], location. [redacted], can access the reservation by the reservation number and/or the customer’s name and address, if the customer does not have a reservation number available. Ms. [redacted] sent you an email with the reservation number; unfortunately, there was a typo in her email. The [redacted], was able to look up your reservation under your name and home address. Ms. [redacted] sent you an email on September 29, 2016, apologizing for any inconvenience she may have caused you.October 4, 2016, the repairs to your vehicle were completed and you returned the rental vehicle. We issued payment to [redacted], in the amount of $535.78, which effectively resolved your property damage and rental claims.Please be advised it is our position that your claim for lost wages from this property damage claim is not legally compensable. Please understand that as an insurance company we do not pay all claims, but only those claims for which our insured is legally liable. In this particular case, you are not owed compensation for missed time from work due to the property damage.I apologize for the mistakes made by us when emailing you during the course of your claim and for the rude manner of your adjuster. It is our goal to provide the best possible service to all our customers and I agree the service you received was below our company standards.If you feel your claim has been wrongfully denied or rejected, please contact the undersigned at [redacted], extension [redacted]. If we are unable to resolve this matter amicably, you may elect to have the entire matter reviewed by the California Department of Insurance, Claims Services Bureau, [redacted], telephone number [redacted].Sincerely,Wawanesa General Insurance Company
Dear Mr. [redacted]:We are in receipt of letters from both the California Department of Insurance and the Revdex.com wherein you request their assistance. You provided them with a lengthy description of your version of how the claim was handled. Specifically you are not happy with the...
offer to resolve your bodily injury claim.As you are well aware Wawanesa General Insurance Company immediately accepted liability on behalf of our insured, Mr. [redacted]. Upon receiving the appraisal for your 2011 [redacted] a payment for your property damage was sent to you, five days after the date of loss. Wawanesa General Insurance Company arranged for a rental vehicle, for your convenience, and paid that bill in full immediately upon receipt.The only item remaining in this matter is to resolve your bodily injury claim. In your description of the problem to the Department of Insurance there appears to be a great issue with regard to the bruising to your back. In review of your [redacted] records, a copy of page 4 is included with this letter, we noted that Dr. [redacted] was very clear in his findings with regard to your complaints of any bruising or hematoma. In fact, Dr. [redacted] placed those comments in bold that there was a lack of bruising noted. You provided us with a photograph to demonstrate a bruise in your left shoulder area of your back. We took this into consideration as we evaluated your claim for injury.Please be advised that our offer of $1350 includes compensation for all medical bills, to include your co-payments, and any and all bruising you may have sustained in the accident. This evaluation is reasonable given all medical records we have regarding this minor accident.Please be advised that your claim has been thoroughly reviewed by additional Wawanesa General Insurance Company staff since your Department of Insurance and Revdex.com complaints and all reviewers find the offer of $1350 to be a reasonable amount.Furthermore, in my review of your file I do not find any justification for your complaints that you were not fairly treated by any of our staff. You claim was timely and fairly adjusted.Finally, you state to the Revdex.com of San Diego that you would like a refund from Wawanesa. We can find no records where you have paid any money to Wawanesa General Insurance Company that would require a refund. Therefore, I am unable to address this concern with you.At this time we are requesting you return the signed release in the amount of $1,350 if you wish to resolve your claim.Should you require any further information with regard to this claim, please feel free to contact [redacted] at [redacted] between the hours of 7:00 a.m. and 3:30 p.m., Mondaythrough Friday.Sincerely,WAWANESA GENERAL INSURANCE COMPANY
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
We did contact [redacted] who is an extremely rude individual and tried to pit my wife and me against each other by lying. We have a letter sent to us by her denying our claim and did send a letter to them letting them know of [redacted]'s lack of decency. We pay you the insurance company to deal with these incidents and you have failed. You have stressed my wife and I beyond belief by your laziness and lack of decency.
Regards,
[redacted]
Dear Mr. [redacted]:Please be advised we have reviewed your renewed inquiry with the Revdex.com (Revdex.com)of San Diego regarding the above-mentioned claim. For reasons described below, we respectfullydisagree with your various critiques and stand on our denial of your claim. A copy of ourApril 13, 2017 denial letter is enclosed for your review.Despite your contentions to the contrary, our office did undertake a thorough and reasonableinvestigation into the facts and circumstances surrounding this loss. This included confirmingthe facts of the loss with our insured, inspecting our insured’s vehicle and yours, and securing acopy of the police report filed by our insured. The results of this investigation lead us to concludethat an unidentified hit and run vehicle collided with our insured’s vehicle, subsequently causingour insured’s vehicle to collide with your parked and unoccupied vehicle. Indeed, our insured’svehicle has damage to its’ drivers side, which provides physical evidence supporting our insured’scontention that a hit and run vehicle was involved.The fact that our insured left a note on your vehicle does not equate to an admission of liabilityon the part of our insured, but it does provide evidence that this was not a hit and run automobileaccident as you suggest.While it is true that the police were not immediately called to the scene of the loss, the lack ofimmediate police involvement is not an uncommon occurrence for a traffic accident of this nature.Your suggestions that our insured was a hit and run driver in this matter, was unreliable in herreport to the police regarding this event, or that she actually created the hit and run damage toher own vehicle, are potentially libelous statements which are completely unfounded.In actuality, both you and our insured are victims of the same hit and run vehicle which initiallycollided into our insured’s vehicle and caused the subsequent loss with your vehicle. While weempathize and regret that you too were an innocent victim in this event, we are not in a positionto pay for your damages and stand on our prior liability denial as outlined above.
Ms. [redacted] contacted our office on December 15, 2016 to inquire about her renewal amount anddue date. We sent an offer to renew, so if a payment is not received by the due date we send a lapsenotice that lets the customer know the policy has expired, but we would reinstate the policy...
withoutinterruption if the payment is received within a certain time frame. If a payment is never made, thepolicy remains cancelled and there is no fee or premium associated with it. Ms. [redacted] contactedour office on January 04, 2017 when she received the lapse notice. Ms. [redacted] advised therepresentative that she had thought she cancelled the policy already as she had purchased insuranceelsewhere. The representative she spoke to cancelled the policy effective January 5, 2017 instead ofbackdating it to the renewal date, which generated a bill for $34.71. Ms. [redacted] sent an emailthrough our website on January 11, 2017 explaining that our agent had made an error. Afterreviewing the policy and listening to the phone calls, I replied to her email and provided anexplanation of what had happened. I apologized and assured her I would make the appropriatecorrections. After making the corrections in the system, I emailed Ms. [redacted] and sent her a copyof the corrected cancellation notice that reflected no premium was due. Ms. [redacted] respondedthanking me for a prompt response to her email and that she appreciated the help.If you need further assistance regarding this matter, please feel free to contact me.Sincerely,[redacted]Customer Service Division SupervisorWawanesa General Insurance Company
As explained to our insured, we are experiencing an unexpected 20% increase in phone volume to ourca ll centerWe are doing everything we possibly can do at this time to address our service levels.Based on the reports pulled, we can see that our insured placed his first call with us on March at4:39pmHe hung up after approximately secondsHe ca lled again on March at 10:10amTherewas a wait of about minutes and he was ab le to speak with a Customer Service Representative at10:27am and have his question about his policy answered.As explained to our policyholder, we are active ly interviewing, hiring, and t raining new Customer ServiceRepresentativesRegrettably, this process does not happen overnightCall Center Leaders have beeninstructed to assist serving our Customer Service phone queue during th is time.Our insured has been advised of our hours of operation which are 7:30am- 7:30pm Monday throughFriday and 8:00am-4:30pm on SaturdayAs well, I have offered for him to contact me directly if needbe.We sincerely apologize for not being able to provide and meet expected customer service
Dear Mr***:I am in receipt of your complaint to the Revdex.com sent to us April regarding yourinability to contact us on April 11, 2015.First let me please offer my sincere apologies for our inability to answer and take your telephone call thefirst time you phoned usI am in complete agreement that this type of service is unacceptable andneeds to be improved immediatelyI have phoned and left several messages hoping to speak with youdirectly to apologize.Over that weekend, starting on Thursday afternoon, April 10, our local carrier, AT&T experienced a cutin a fiber line that provides service for our telephone and processing systemsThis turned out to be amajor incident and turned out to take much longer to repair than anyone expected.Once the problem line was identified, we were told that they had no access to the manhole where it waslocated until after [redacted] on Saturday morning, the day you calledOur phone report shows that youcalled us several times between 9:34am and 9:55am and the phone just rangNormally, our companymessaging would have been in place to route you to Customer Service for assistance.This turned out to be a larger problem than thought and took the weekend to repairWe did our bestwith the resources we had to advise our customers of the outageA message was placed on our websiteand, if or when the phone line service was restored, a message explaining the current system issues.I see in the complaint information that you have a different addressI will make that address change toyour policy and send you confirmation.As for your desired settlement to refund all monies paid, please contact me to discussRefunding allmonies paid requires a cancellation of the policy back to its inception date of July 16, You haveadvised us that you have a lienholder on your vehicle and proof of insurance has been provided to them.Again Mr***, I sincerely apologize for not being able to meet and provide expected customerserviceUnfortunately, the circumstances were out of our control that day.Sincerely, [redacted] Customer Service ManagerWawanesa General Insurance Company
Please be advised we have received an inquiry from the Revdex.com (Revdex.com) of San Diego,the California Department of Insurance and through Wawanesa General Insurance Company's website"feedback" page regarding the above-captioned lossAttached to all three pieces of correspondence wereceived your description of your concerns and your desired outcomePlease accept this letter toaddress your concerns as registered to the entities mentioned above.By way of background, this will confirm you carry an HHomeowners policy with WawanesaGeneral Insurance CompanyYou reported a water loss to our staff on November 4, 2014, indicatingyou noticed a leak at your kitchen ceiling, which is directly below an upstairs showerWe immediatelyestablished a claim and initiated an investigation.Determining the cause, origin, and duration of the water escape is a common and critical component inthe investigation of any presented water lossAs such, we provided referrals to you for plumbers whohave expertise in leak detectionAfter conducting your own research about plumbing vendors, youselected American Leak Detection to inspect the plumbing leak in questionThey visited your home onNovember 10, After performing a thorough inspection, they determined that the water leak wasfrom failed tile grouting and that re-grouting of the shower was a needed maintenance item.Importantly, the plumber opined the water escape from the failed grout was days old.We discussed the claim further with you on November 13, 2014, at which time you confirmed the tileshower enclosure was original to your home, which was built in We also reviewed yourhomeowner policy contract wording with you regarding an exclusion which appears to apply to thislossThe pertinent portion of the policy reads as follows:SECTION I- EXCLUSIONSAWe do not insure for loss caused directly or indirectly by any of the followingSuch loss isexcluded regardless of any other cause or event contributing concurrently or in any sequence tothe lossThese exclusions apply whether or not the loss event results in widespread damage oraffects a substantial areaWaterThis means:eContinuous or repeated seepage or leakage of water or the presence or condensationof humidity, moisture or vapor, over a period of time greater thanldays.The policy also outlines duties of policyholder, such as youIn particular, please refer to:SECTION I- CONDITIONSCDuties After LossIn case of a loss to covered property, we have no duty to provide coverage under this policyif the failure to comply with the following duties is prejudicial to usThese duties must bepe1jormed either by you, an "insured" seeking coverage, or a representative of either:Cooperate with us in the investigation of a claim;As often as we reasonably require:aShow the damaged property;We offered to inspect your damages and secure your statement, but you declined these offers and statedyou were expecting a denial letter from usInstead, we sent you a letter on November 21, 2014,confirming you were withdrawing your claim.We next heard from you on December 2, 2014, with a request that a different plumber inspect the loss.We agreed to this request and [redacted] inspected your residence anew on December 3, 2014.Not surprisingly, that plumber confirmed the findings of the first plumber; namely, that worn tile groutand caulking were the leak failure sources, and that the duration of the leak was "more than a monthprior to discovery on October 30, 2014." Wood rot at the subflooring was also observed, whichprovides further evidence of the long-term nature of the water leak event.We informed you of these further investigative results on December 4, 2014, and have been attemptingto obtain your recorded statement ever since, in order to conclude our investigationJanice [redacted] ofAdams Adjusting is assisting in this portion of the investigationYou may recall she completed aninspection at your homePlease contact her to provide your statementShe can be reached atIn the meantime, we have offered to pay for the kitchen ceiling drywall access cutmade by the [redacted] technician, as part of the inspection and diagnosis processWe willforward this payment to you under separate cover.In closing, we respectfully disagree with your various critiques surrounding our handling of yourreported claimIn fact, we have gone to great lengths to provide superior customer service whileconducting a thorough and accurate investigationPresent evidence leads us to advise you of thehomeowner's policy exclusionary language mentioned above, and we encourage you to mitigate yourdamages at this timePlease continue to cooperate with our investigation by providing your statementto Ms [redacted] , so we can reach a final conclusion in this matterIn the meantime, by copy of thisletter, I'm informing the San Diego Revdex.com and the California Department of Insurance of our positionthat while we have handled this matter in an appropriate manner we are attempting to conclude ourinvestigation and provide you with a resolution
January 7, 2014 [redacted] *** RE: Our Insured: [redacted] *** Date of Loss: September 15,... 2014 ClaimNo.: [redacted] Complaint: [redacted] Mr. ***: We are in receipt of an inquiry from theRevDex.com based on a complaint you submitted to their office on01/05/2015. In your complaint, you raised a few issuesthat appear to be based on your misunderstanding of the insurance policy. First, the Wawanesa Automobile Policy covers: LIMITOF LIABILITYA. Our limit of liability for any loss will be the lesser ofthe:2. Amount necessary to repair or replace theproperty with other property of like kind and quality, minus the deductible. Inaccordance with the policy contract, we obtained a confirmed price of $576.00from a local glass company to replace the damaged glass on your vehicle. This price was based on a like kind andquality part. In this situation, thatpart was a non-OEM replacement part. Secondand unfortunately, we believe you may be misunderstanding our customer servicerepresentatives when you quote them as stating, “ Wawanesa only uses OEMparts.” With certain types of partsthat statement may be true (ex: metal crash parts) based on a number of factors(vehicle age, availability of parts, etc). With other types of parts we may use industry available like kind andquality replacement parts (including glass). Again, this issue is covered in your Automobile Policy per the LIMIT OFLIABILITY stated above. Finally,you indicated to the Bureau that your “Desired Settlement” would be to, “Changethe lease insurance agreement”. As youmay be aware this request cannot be met. Our insurance policy and operations are regulated by the State ofCalifornia Department of Insurance. Ourpolicy was submitted to and approved for use by the State of CaliforniaDepartment of Insurance in accordance with all applicable law andregulations. Furthermore, our policyfollows generally accepted industry, market, and ISO guidelines. We regret that you had this experience andread or learned of your applicable insurance coverage for the first time aftera loss was incurred. You have beenprovided with a copy of your policy contract in the past as well as allapplicable policy renewal documentation. Nofurther coverage of payment for this loss will be offered at this time. If you have additional information that maychange the facts or value of the loss, please contact your adjuster, as weremain open to reviewing such information. Sincerely, WawanesaGeneral Insurance Company [redacted] *** [redacted] ClaimsManager
Dear Mr [redacted] :We are in receipt of your complaint from the San Diego Revdex.comIn response, Ireviewed the claim file.We inspected your Honda Civic on April 2, 2015, and estimated the damages to be$2,We issued a Collision payment of $1,on April 8, 2015, pursuant to yourrequest as Alliance United Insurance, who insured the other driver, had not yet agreed to payfor your damages.Alliance United Insurance verified their policyholder has valid coverage for this lossHowever,they are in the process of confirming the facts of the accident with their policyholder in order todetermine their position on liabilityWe advised them it is your desire to have your Collisiondeductible advanced to you immediately upon their acceptance of liability and we haveforwarded all the necessary documents for them to do so.We will continue to follow up with Alliance United Insurance for status on their investigationand possible recovery of your Collision deductibleWe apologize for any inconvenience thismatter has caused youHowever, per the terms of your policy contract with us, the Collisiondeductible is your self-insured portion of the claim and must be applied to the Collision claim.We are making every effort to see that you are reimbursed by the responsible party but cannotguarantee success.Please feel free to contact me should you have any questionsI can be reached at (858)522-My office hours are Monday through Friday, 7:30am to 4:00pm.Sincerely,WAWANESA GENERAL INSURANCE COMPANY
This letter is written in response to your complaint filed with the Revdex.comagainst Wa\vanesa Insurance.The New Business Unit received your application on March 30, New BusinessRepresentative, [redacted] spoke to you on April 1, to advise that since you updatedthe annual mileage on your application from 3,to 9,000, your premium would increase.During that conversation, it was decided that the annual mileage would remain at 3,asoriginally stated and the annual premium would remain at $as originally quoted.Your policy was issued on April 1, with an effective date of March 27, Ourpolicy notes show you called our Customer Service Department on April 2, andrequested to cancel your policyA full refund of $was mailed to you on April 7,2015.We apologize for any inconvenience or misunderstandingIf you are interested in a policywith Wawanesa now, or anytime in the future, we would welcome the opportunity to dobusiness with youIf you have any further concerns regarding this matter, please feel tocontact me.Sincerely, [redacted] MBA, AINSUnderwriting Manager
February 9, 2015The Revdex.comAttention: Ms*** ***Viewridge Avenue, Suite 200San Diego, CA 92123RE: Complaint ID Number: ***Dear Ms***:Enclosed is our response to the above referenced complaint number.As explained to our insured, we are experiencing a very unexpected
17% increase in phone volume toour call centerWe are doing everything we possibly can do at this time to address our service levels.I have placed several calls to our insured hoping to speak with him directly about his concernsI havehad no reply.Our insured did speak with a representative on February rd to change vehiclesThat change was placedon hold per his request pending his approval.In seeing that this complaint was made after he spoke with us and his desired settlement is to cancel hispolicy, we will do as he has requested and cancel his policy.As explained to our policyholder, we are actively interviewing, hiring, and training new Customer ServiceRepresentativesRegrettably, this process does not happen overnightCall Center Leaders have beeninstructed to assist serving the Customer Service queue during this time.We sincerely apologize for not being able to provide and meet expected customer service.Sincerely,*** * *** _Vice President, U.SOperationsWawanesa General Insurance Company*** *** ***
We are in receipt of the February 23, correspondence from Mr*** regarding the abovecaptioned matterIn review of his further correspondence Mr*** did not offer any new informationthat would lead to a change in our positionIn addition to the letter dated February 13, 2015, from ouroffice to Mr*** (which you received a copy of) a second letter was directed to Mr*** on or aboutFebruary 20, This letter denied the claim presented by Mr*** and provided an explanation forthe basis of the denialOur file remains closed
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
I do not ask Wawanesa to change MY policyI ask them to change THEIR policy for all future leasesThey state that they cannot, because they are regulatedI am currently purchasing new insurance that is also regulated by the state and it DOES cover my lease and official OEM PartsIt seems that Wawanesa doesn't know that they can become a better company.I DO ask them to teach their salespeople to not fraudulently state that they will use ONLY OEM parts for any and all repairsI did not "misunderstand" the customer service repsI pointedly asked them numerous timesThe salespeople and the supervisors I spoke with all admitted they were incorrect to try to sell me something they never had to sell.I wish Wawanesa had admitted any failure on their partThe supervisors admitted it over the phone, but the company will notI have paid well over $12,to Wawanesa in insurance payments over the yearsFor their lack of truth and integrity, I am now going to pay that amount to someone else for all future insurance needs
Regards,
*** ***
We are in receipt of your October 8, email where our insured, *** *** has lodged
a complaint with your officeIn your correspondence you state that you "recognize that there
are two sides to every dispute." In this particular auto accident there are actually three separate
versions
of the incident being presented
This loss occurred at 7:p.mon July 30, All vehicles involved in the loss were
travelling on Interstate westbound also known as the Santa Monica freewayTraffic was
heavy and described as "stop and go" trafficMr*** was alone operating his Chevy
Malibu and travelling in lane number threeHe is described as the front most vehicle in this
loss and *** *** was travelling directly behind him in her Mazda Ms***
had five passengers in the Mazda vanTravelling directly behind the Mazda van was ***
*** in a Pontiac Grand-AmPlease note; Ms*** is also insured with Wawanesa
General Insurance Company
California Highway Patrol responded to the accident sceneThe investigating officers took
statements from all parties and concluded that the cause of the loss was Mr*** in
violation of California Vehicle Code Section which states: no person shall drive a vehicle
upon a highway at a speed greater than is reasonable or prudent having due regard for weather,
visibility, the traffic on, and the surface and width of, the highway, and in no event that a speed
which endangers the safety of persons or propertyIn essence the investigating officer found
that Mr*** drove his Pontiac into the rear of the Mazda van driven by Ms*** and
pushed the van into Mr***'s vehicleIt should also be noted that Mr*** was cited
for being an un-licensed driverThe Pontiac being driven by Mr*** had just been
purchasedPart of the difficulty in resolution of this claim is the fact that *** Insurance,
for Mr***, has yet to reach a coverage determination regarding the Pontiac
Grand-Am
The occupants of Ms***'s Mazda van all of which are between the ages of and have a
slightly different version of the accidentThe two recorded statements we have obtained
indicate that the Chevy Malibu driven by Mr*** came to a very abrupt stop and Ms
*** braked hard and almost avoided rear ending the Chevy; however, made slight contact
seconds before being rear ended by Mr***'s vehicleThey state they were pushed back
into Mr***'s vehicle a second time, much harderIn the second impact the airbags of the
Mazda van deployedIn their version they felt three impacts two to the front of the vehicle and
one from the rearIn this second scenario Mr*** should have felt two impacts
The Complainant, *** *** has yet a third version of the auto accidentHe states he
was slowing for traffic when he was rear-ended by the Mazda van travelling directly behind
himHe denies there being a second impact and upon being struck in the rear had to swerve to
avoid striking the vehicle in front of him
We have kept Mr*** informed of our progress and why we've required additional time to
conclude our investigationWe obtained the statement of our driver, *** ***, on
October 16, 2014, which allowed us to reach a liability determinationMr*** was
informed this date that we will be able to honor his claim
The sorting out of the three separate versions created some difficulty in final resolution of this
claimWhile Wawanesa General Insurance Company would have liked to have completed it's
investigation into this matter sooner, it took some time to arrange for statements with the
minors involved, including Ms***
Should you require further information regarding this claim, please contact the undersigned
between the hours of 8:30a.mand 5:00p.m., Monday through Friday, at ###-###-####
Respectfully,
** *** ***
Claims Manager
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***
January 22, 2015*** ***Revdex.comVIEWRIDGE AVE, STE 200SAN DIEGO CA 92123Re: Complaint ID: ***Insured: *** ***Cancelled Policy Number: ** ***Quotation Number: ** ***Dear Ms***:We have received and reviewed the complaint filed with your
organization by our priorpolicyholder, Mr*** ***The following is a summary of the policy transactionsand an explanation of the handling of Mr***'s cancelled policy and quotation issued.Mr***'s original policy, ** ***, was effective March 22, and has renewedeach consecutive yearPrior to the cancellation, the below transactions occurred on thepolicy:February 27, - An "Offer to Renew" effective March 22, 2014-March 22,2015was mailedTotal policy premium $Down payment of$due before March 22, 2014; Payments to be billed:$due June 22, and September 22, 2014.March 26, - Mr*** contacted our Customer Service Department to makethe renewal paymentA renewal payment of $was madeand the policy was reinstated effective March 27, 2014.April16, - Mr*** contacted our Customer Service Department to add avehicle to his policyThe policy changes were made effectiveMarch 27, 2014; and an amended declarations policy was mailedshowing new payments to be billed in the amounts of $dueJune 22, and September 22, 2014.Mr*** also requested to delete a vehicle from his policyeffective April17, 2014; and a subsequent amended declarationspage was mailed with payments to be billed in the amount of$due June 22, and September 22, 2014.May 19,- Mr*** requested to add another vehicle to his policyThispolicy request was effective May 8, and the total policypremium with all the policy changes was $(includingservice charge)After subtracting the payment of$312.00previously received, the account balance was $Anamended policy declarations page was mailed showing newpayments to be billed in the amount of$due June 22, 2014and September 22, 2014.June 25, - A payment of $was made on the policy leaving a balancedue of$478.50.No additional payments were made on the account although billing notices were mailed.On October 25, 2014, a Notice of Cancellation effective November 14, 2014, was mailed.Since no payment was received by October 25, 2014, the policy cancelled.On November 22, 2014, a Notice of Premium Due was mailed requesting payment forearned premium due of$Finally, on December 6, 2014, a Delinquent Notice wasmailed requesting the outstanding amount due of$17.50.Mr*** contacted our Customer Service Department on January 6, to discussreinstatement of his policyHe was advised that due to the length of time the policy hadbeen cancelled; he would need to reapply; and prior to reapplication, the outstandingamount of $would have to be paid.A representative in our Inquiry/Quoting Department spoke to Mr*** on January 6,and the information was taken for the new quotation (Quote #** ***).However, prior to clearing and releasing the quote, Mr*** was again advised the priorbalance must be paidOn January 7, 2015, Mrs*** *** spoke with arepresentative and she, too, was advised the prior balance needed to be paid before thequote could be releasedMrs*** then contacted our Customer Service Department toobtain assistance in making the payment on our EZ-Pay online service and the paymentof$ was made on January 8, Mr*** then contacted our New BusinessDepartment; and after receiving confirmation of the payment, Mr*** was advised thequote would be sentQuote #** * * * *** * was emailed at 3: the same day to***Mr*** requested a call back from a supervisor; and theunderwriter gave the message to a supervisor for the call back.An underwriting supervisor contacted Mr*** that same day and Mr*** expressedhis frustrations regarding the service and the reapplication requirementAfter explainingthe process, the supervisor asked Mr*** how he could provide additional assistance toobtain his businessMr*** advised there was nothing the supervisor could do as hehad already obtained insurance elsewhereMr*** thanked the supervisor for the callback and the call was ended.Mr*** states in his complaint that he is uninsured although he advised the supervisorhe had obtained coverageResearch into our quoting database shows the quoteprepared for Mr*** has not been returnedAs qualified applicants, Mrand Mrs.*** are welcome to return their application for insurance coverageHowever, due tothe length of time, the prior policy has been cancelled, we would be unable to apply theLoyalty Discount as this discount applies to policies that have been continuously in forcefor more than one yearBecause there was an interruption in Mr***'s prior policy inexcess of days, he no longer qualifies for the Loyalty Discount.Based on the information explained, I ask that this complaint be classified as invalidIfyou need further assistance regarding this matter, please feel free to contact me.Sincerely,Underwriting ManagerWawanesa General Insurance Company*** *** ***
January 12, 2014 *** *** *** *** *** ** *** RE: Our Insured: *** *** Date of Loss: September 15, 2014 ClaimNo.: *** Complaint: *** Mr***: Please be advised that the Better BusinessBureau supplied us with a copy of your most recent communication to themWefurther assessed your concerns and I want to clarify that your communication tous has created an opportunity for us to revisit with our personnel the propermanner of messaging to our customers how the Automobile Policy accounts for OEMpart usageI appreciate that you’ve given us an opportunity to improve Please understand that should you be facedwith the need to file a claim for glass replacement in the future, the WawanesaGeneral Insurance Company Automobile Policy remains unchanged and maintains alimit of liability for the amount necessary to repair or replace the propertywith other property of like kind and qualityVery few automobile manufacturersactually manufacture their own glass and we will again be in a position thatleaves us with no option but to authorize a settlement amount that comportswith this policy provision by considering the availability of aftermarket glass. In light of our possible miscommunication,and to emphasize your value as a customer, I’ve enclosed with this letter acheck in the amount of $which should serve to reimburse you for the outof pocket expense you incurred to install the OEM glass on your vehicle Thank you for the opportunity to assist withyour insurance needs. Sincerely, WawanesaGeneral Insurance Company * *** ***ClaimsManager
Dear Ms. [redacted]:
I am in receipt of your complaint to the Revdex.com regarding the billing of the above
referenced automobile policy.
Enclosed you will find a copy of your Automobile Insurance Application (#1). The total premium, for
your policy effective March 25, 2014, was...
$1468.00. You selected the 9-pay plan. Based on that
payment plan, 20% of the total premium was due to start the policy; you would then be billed 10% of
the total the 1st through 8th months after the policy started. There is a $4.00 service charge for each
payment. I have highlighted this section of the application.
Also enclosed is a copy of your Auto Policy New Declaration (#2). That declaration confirms receipt of
$300.00 and the subsequent payments to be billed. As you can see, your payments were scheduled
April through November.
In May, a Notice of Cancellation (#3) was mailed to you because of non-payment of premium. That was
for the April and-May payments. We received $300.00 via an online payment on June 13,2014. We
mailed you a confirmation (#4) that payment was received and your new payment schedule.
In August, another Notice of Cancellation (#5) was mailed. This was for the June and July payments. We
received $148.00, the amount billed on notice (#4), on September 8. This only took care of your June
outstanding payment.
We mailed you confirmation (#6) that payment was received and your new payment schedule.
In October, a Notice of Cancellation (#7) was mailed. This was for July, August, and September. I can
confirm that an online payment of $540.00 was submitted November 4 (#8).
You stated in your complaint that you had not received any reminder notices that a payment was due.
However, you did receive the notices of pending cancellation and the declarations confirming payment
had been received and the new payment schedule. I can see that the reminder notices were generated
and it is curious that you did not receive them. We have no record of any returned mail.
You stated in your complaint, and you told one of our Customer Service Representatives, that your
husband had made a payment over the phone. As our Representative advised, we have never taken any
payments over the phone. You can make a payment online via our website, but not by phone.
I am uncertain where the confusion has come from regarding your payment schedule. The terms of the
9-pay plan were clearly stated on you application for insurance. And why you haven't received payment
reminder notices yet you have other correspondence sent from us.
I hope this information has clarified the issues you raised to the Revdex.com. If you have any
further questions, please do not hesitate in contacting me directly.
Sincerely,
[redacted], Customer Service Manager
Dear Mr. [redacted]:I am in receipt of your complaint to the Revdex.com sent to us April 14 regarding yourinability to contact us on April 11, 2015.First let me please offer my sincere apologies for our inability to answer and take your telephone call thefirst time you phoned us. I am in...
complete agreement that this type of service is unacceptable andneeds to be improved immediately. I have phoned and left several messages hoping to speak with youdirectly to apologize.Over that weekend, starting on Thursday afternoon, April 10, our local carrier, AT&T experienced a cutin a fiber line that provides service for our telephone and processing systems. This turned out to be amajor incident and turned out to take much longer to repair than anyone expected.Once the problem line was identified, we were told that they had no access to the manhole where it waslocated until after [redacted] on Saturday morning, the day you called. Our phone report shows that youcalled us several times between 9:34am and 9:55am and the phone just rang. Normally, our companymessaging would have been in place to route you to Customer Service for assistance.This turned out to be a larger problem than thought and took the weekend to repair. We did our bestwith the resources we had to advise our customers of the outage. A message was placed on our websiteand, if or when the phone line service was restored, a message explaining the current system issues.I see in the complaint information that you have a different address. I will make that address change toyour policy and send you confirmation.As for your desired settlement to refund all monies paid, please contact me to discuss. Refunding allmonies paid requires a cancellation of the policy back to its inception date of July 16, 2014. You haveadvised us that you have a lienholder on your vehicle and proof of insurance has been provided to them.Again Mr. [redacted], I sincerely apologize for not being able to meet and provide expected customerservice. Unfortunately, the circumstances were out of our control that day.Sincerely,[redacted] Customer Service ManagerWawanesa General Insurance Company
Please see attached, thank you.Dear Ms. [redacted]:This office is in receipt of a letter from the Revdex.com, dated October 2, 2016, advising us you lodged a complaint on October 1, 2016.The loss occurred September 6, 2016, and the claim was reported to us by your insurance company, [redacted]...
Insurance, on that same date. The claim was assigned to Adjuster, [redacted], who immediately initiated the investigation. Based on the information available to us, liability was accepted and we made arrangements to appraise the damage to your vehicle.The initial inspection of your 2011 [redacted] revealed it sustained damage to the right corner of the front bumper in the amount of $1,087.44. We issued payment to you in this amount on September 16, 2016. We subsequently received a supplement repair invoice in the amount of $498.99 and issued payment in this amount to your shop, [redacted].When I reviewed the claim file, I found the appraiser who inspected your vehicle inadvertently used a hyphen instead of an underscore after your first name when emailing the damage estimate to you. I suspect this is the reason you did not immediately receive the estimate from him.On September 21, 2016, you contacted Ms. [redacted] to notify her you did not receive the initial damage estimate and the estimate was emailed to you that date.With respect to the rental car portion of your claim, I found that on September 23, 2016, you notified Ms. [redacted] you had an appointment with [redacted]. As such, she made a reservation for you with [redacted], and authorized $53.34 per day for a comparable vehicle. Ms. [redacted] does not select the [redacted], location when making the reservation, as the [redacted], computer system automatically selects the branch closest to the customer’s residence. The reservation is valid at any [redacted], location. [redacted], can access the reservation by the reservation number and/or the customer’s name and address, if the customer does not have a reservation number available. Ms. [redacted] sent you an email with the reservation number; unfortunately, there was a typo in her email. The [redacted], was able to look up your reservation under your name and home address. Ms. [redacted] sent you an email on September 29, 2016, apologizing for any inconvenience she may have caused you.October 4, 2016, the repairs to your vehicle were completed and you returned the rental vehicle. We issued payment to [redacted], in the amount of $535.78, which effectively resolved your property damage and rental claims.Please be advised it is our position that your claim for lost wages from this property damage claim is not legally compensable. Please understand that as an insurance company we do not pay all claims, but only those claims for which our insured is legally liable. In this particular case, you are not owed compensation for missed time from work due to the property damage.I apologize for the mistakes made by us when emailing you during the course of your claim and for the rude manner of your adjuster. It is our goal to provide the best possible service to all our customers and I agree the service you received was below our company standards.If you feel your claim has been wrongfully denied or rejected, please contact the undersigned at [redacted], extension [redacted]. If we are unable to resolve this matter amicably, you may elect to have the entire matter reviewed by the California Department of Insurance, Claims Services Bureau, [redacted], telephone number [redacted].Sincerely,Wawanesa General Insurance Company
Dear Mr. [redacted]:We are in receipt of letters from both the California Department of Insurance and the Revdex.com wherein you request their assistance. You provided them with a lengthy description of your version of how the claim was handled. Specifically you are not happy with the...
offer to resolve your bodily injury claim.As you are well aware Wawanesa General Insurance Company immediately accepted liability on behalf of our insured, Mr. [redacted]. Upon receiving the appraisal for your 2011 [redacted] a payment for your property damage was sent to you, five days after the date of loss. Wawanesa General Insurance Company arranged for a rental vehicle, for your convenience, and paid that bill in full immediately upon receipt.The only item remaining in this matter is to resolve your bodily injury claim. In your description of the problem to the Department of Insurance there appears to be a great issue with regard to the bruising to your back. In review of your [redacted] records, a copy of page 4 is included with this letter, we noted that Dr. [redacted] was very clear in his findings with regard to your complaints of any bruising or hematoma. In fact, Dr. [redacted] placed those comments in bold that there was a lack of bruising noted. You provided us with a photograph to demonstrate a bruise in your left shoulder area of your back. We took this into consideration as we evaluated your claim for injury.Please be advised that our offer of $1350 includes compensation for all medical bills, to include your co-payments, and any and all bruising you may have sustained in the accident. This evaluation is reasonable given all medical records we have regarding this minor accident.Please be advised that your claim has been thoroughly reviewed by additional Wawanesa General Insurance Company staff since your Department of Insurance and Revdex.com complaints and all reviewers find the offer of $1350 to be a reasonable amount.Furthermore, in my review of your file I do not find any justification for your complaints that you were not fairly treated by any of our staff. You claim was timely and fairly adjusted.Finally, you state to the Revdex.com of San Diego that you would like a refund from Wawanesa. We can find no records where you have paid any money to Wawanesa General Insurance Company that would require a refund. Therefore, I am unable to address this concern with you.At this time we are requesting you return the signed release in the amount of $1,350 if you wish to resolve your claim.Should you require any further information with regard to this claim, please feel free to contact [redacted] at [redacted] between the hours of 7:00 a.m. and 3:30 p.m., Mondaythrough Friday.Sincerely,WAWANESA GENERAL INSURANCE COMPANY
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
We did contact [redacted] who is an extremely rude individual and tried to pit my wife and me against each other by lying. We have a letter sent to us by her denying our claim and did send a letter to them letting them know of [redacted]'s lack of decency. We pay you the insurance company to deal with these incidents and you have failed. You have stressed my wife and I beyond belief by your laziness and lack of decency.
Regards,
[redacted]
Dear Mr. [redacted]:Please be advised we have reviewed your renewed inquiry with the Revdex.com (Revdex.com)of San Diego regarding the above-mentioned claim. For reasons described below, we respectfullydisagree with your various critiques and stand on our denial of your claim. A copy of ourApril 13, 2017 denial letter is enclosed for your review.Despite your contentions to the contrary, our office did undertake a thorough and reasonableinvestigation into the facts and circumstances surrounding this loss. This included confirmingthe facts of the loss with our insured, inspecting our insured’s vehicle and yours, and securing acopy of the police report filed by our insured. The results of this investigation lead us to concludethat an unidentified hit and run vehicle collided with our insured’s vehicle, subsequently causingour insured’s vehicle to collide with your parked and unoccupied vehicle. Indeed, our insured’svehicle has damage to its’ drivers side, which provides physical evidence supporting our insured’scontention that a hit and run vehicle was involved.The fact that our insured left a note on your vehicle does not equate to an admission of liabilityon the part of our insured, but it does provide evidence that this was not a hit and run automobileaccident as you suggest.While it is true that the police were not immediately called to the scene of the loss, the lack ofimmediate police involvement is not an uncommon occurrence for a traffic accident of this nature.Your suggestions that our insured was a hit and run driver in this matter, was unreliable in herreport to the police regarding this event, or that she actually created the hit and run damage toher own vehicle, are potentially libelous statements which are completely unfounded.In actuality, both you and our insured are victims of the same hit and run vehicle which initiallycollided into our insured’s vehicle and caused the subsequent loss with your vehicle. While weempathize and regret that you too were an innocent victim in this event, we are not in a positionto pay for your damages and stand on our prior liability denial as outlined above.
Ms. [redacted] contacted our office on December 15, 2016 to inquire about her renewal amount anddue date. We sent an offer to renew, so if a payment is not received by the due date we send a lapsenotice that lets the customer know the policy has expired, but we would reinstate the policy...
withoutinterruption if the payment is received within a certain time frame. If a payment is never made, thepolicy remains cancelled and there is no fee or premium associated with it. Ms. [redacted] contactedour office on January 04, 2017 when she received the lapse notice. Ms. [redacted] advised therepresentative that she had thought she cancelled the policy already as she had purchased insuranceelsewhere. The representative she spoke to cancelled the policy effective January 5, 2017 instead ofbackdating it to the renewal date, which generated a bill for $34.71. Ms. [redacted] sent an emailthrough our website on January 11, 2017 explaining that our agent had made an error. Afterreviewing the policy and listening to the phone calls, I replied to her email and provided anexplanation of what had happened. I apologized and assured her I would make the appropriatecorrections. After making the corrections in the system, I emailed Ms. [redacted] and sent her a copyof the corrected cancellation notice that reflected no premium was due. Ms. [redacted] respondedthanking me for a prompt response to her email and that she appreciated the help.If you need further assistance regarding this matter, please feel free to contact me.Sincerely,[redacted]Customer Service Division SupervisorWawanesa General Insurance Company