Mutual Benefit Group

April 3, 2017Revdex.comServing Western PennsylvaniaAttn: [redacted]400 Holiday Drive, Suite 220Pittsburgh, PA 15220Re: ID #[redacted]Dear Ms. [redacted],I researched the problem outlined by the customer in the above complaint ID. The complaint regarded the increase in premium she...

sustained after having claims on her homeowner policy.In reviewing this matter, there were three separate and distinct losses. They were all water losses by different causes, none were related to another and the company paid on each. As a result, they are considered separate claims.As an insurance company, we are required to file our rates with the state insurance department. Included in our rates is a surcharge for claims. Since there were three claims, the policy was surcharged at renewal as required by our state filing. Unfortunately, we cannot do anything to revise this increase as we would then be in violation of our state filing.Please let me know if you have any additional questions.Regards,Marianne M[redacted]Vice President, Field Operations and Personal Lines

I am responding to your correspondence to [redacted] CEO of Mutual Benefit Group datedJanuary 23, 2015, since the complaint is in regards to the handling of(3) claims submitted by thecomplainant for lightning damage.Complainant reported (3) claims directly to our in house claim reporting unit on...

July 28, 2014 at9:26AM, indicating that lightning had struck an oak tree and damaged his home; shed; 2011 FordFiesta; 2012 Chevrolet Silverado 1(1500 and electrical items in his home. Since Mutual BenefitGroup claims are handled based on specialty, the homeowner claim [redacted] was immediatelyassigned to Sr. Field Claim Representative [redacted] while both the automobile losses[redacted] and [redacted] were immediately assigned to Fast Track Adjuster I [redacted].Both Ms. [redacted] and Ms. [redacted] made contact with the complainant the same day they wereaeci8ned tho~e chime. - -Regarding the homeowner claim assigned to Ms. [redacted], due to the location of complainant’shome a field assignment was made to Sr. Ficld Claim Representative Phil [redacted] who was in thearea of the complainant’s home to inspect and report back to Ms. [redacted] on the home damage.Mr. [redacted] did so reporting that the tree had not fell nor had it fell on any covered property.After receiving this information Ms. [redacted] advised complainant that the policy coverage islimited to $500 for damage to the tree itself, the tree had some limbs that fell but was stillstanding, there was also coverage for the personal property in the home, after the $250deductible of the policy was applied. Payment for the tree in the amount of $500 the policy limitwas issued to complainant on August 5, 2014 on the same day after receiving personal propertydamage inventory a payment of $3,205.00 which was for damage to the property less $250deductible and $1,000 of recoverable depreciation, was also issued. On August 7,2014 Ms.[redacted] did receive a phone call from Attorney Josh Bish to discuss coverage for complainant. Asof tins date, we have not received any ftrther communications on the homeowner claim frontAttorney Bish or complainant.Regarding the automobile claims assigned to Ms. [redacted], the 2012 Chevrolet Silverado Kl500had pieces of wood from the tree dent this vehicle Ms. [redacted] assigned a licensed independentappraiser of Grieco Appraisal Services LLC the same day July 28, 2014, with appraiser [redacted] Appraiser License fi 153344 inspecting on July 30, 2014. We received the appraisal onAugust 1, 2014 and called complainant as we either issue payment to our insured and the losspayee or the insured and the body shop of their choice. A call was placed to complainant thesame day and he indicated he was going on vacation, having two shops in mind and would letMs. [redacted] know which one when he returned from vacation. Ms. [redacted] called complainantAugust 7, 2014 at which time complainant indicated he would be taking the vehicle toMcPherson Auto Body and Ms. [redacted] issued payment to insured and McPherson Auto Body thesame day for the appraised amount $1,672.04 less the policies $500.00 comprehensivedeductible. On September 25, 2014 complainant called Ms. [redacted] indicating he was havingissues with both vehicles and wanted to take to a dealer, he was indicating it was the work doneby McPherson Auto Body, Ms. [redacted] told complainant that he really should take back toMcPherson and the independent appraiser would re-inspect. A supplement was issued afterreceiving a supplemental appraisal from Grieco Appraisal Services on December 1, 2014 in theamount of $186.59, however, there were a chip in tailgate and plastic piece underneath the frontbumper as not related to the pieces of wood hitting this vehicle after reviewing with the bodyshop and the indcpendent appraiser that visually inspected the vehicle.Regarding the 201 I Ford Fiesta, Ms. [redacted] assigned independent appraiser who inspected at thesame times as the 2012 Chevrolet Silverado. However, complainant was in need of a rentalwhich was afforded to him up to the coverage limit per day of his policy $30.00 while thevehicle was being repaired. The independent appraiser inspected this vehicle on July 30, 2014and Mutual Benefit Group received on August 1, 2014 along with the other appraisal. Theappraisal was for $1,853.53 less betterment and tax of$ 136.97 on alternator and less$500.00comprehensive deductible for a payment of$1,2l6.56. The appraiser indicated that the oilpressure light is on but appraiser could not relate this to lightning strike, that the vehicle wouldneed diagnostic testing to determine issue. The diagnostic testing results were received January13, 2015 from Clarion Ford, the report was immediately given to independent licensed appraiser[redacted] the same day. On January 28, 2015 Ms. [redacted] received diagnostics from Ad Autothis second diagnostic report was also given to independent appraiser. As of today we do nothave a final determination of the exact cause of the electric issue with this vehicle or if theycould be related to the lightning.Sincerely,[redacted]Assistant Vice President of Claims

Dear Ms. [redacted]:This letter is in response to your letter dated January 9, 2017 for a complaint made by complainant [redacted]. This complaint was received in the claim department January 13, 2017 having been mailed to Mutual Benefit Insurance Company.The complaint is made for Customer Services...

IssuesOur Insureds’ independent agency mailed this loss accord to Mutual Benefit Insurance Company, with our receipt on June 14, 2016. All facts regarding the claim, received from both the insured driver and complainant supported acceptance of liability on June 15, 2016. The complainant’s vehicle was determined to be a total loss by an independent appraiser on June 23, 2016. An offer of settlement was made to complainant June 23, 2016. On June 28, 2016 a demand letter was received in the mail from complainant, with a response to the letter the same day. On July 5, 2016, receipts for mechanical repairs to complainant’s vehicle were received in the mail. Complainant was advised the receipts were under review by letter dated July 11, 2016 and again on August 17, 2016. The August 17, 2016 letter was after receiving complainant’s letter looking for status of receipt review. A revised settlement offer, considering the receipts, was made to complainant by way of letter dated August 25, 2016. Follow up letters after this revised settlement offer, to complainant requested paper work to conclude the total loss settlement and were dated October 3, 2016; November 23, 2016 and January 3, 2017. On Friday January 13, 2017 your letter of complaint was received. Upon receipt of this letter a review was conducted. Mutual Benefit Insurance Company can only believe that the revised settlement letter of August 25, 2016, must not have been received by complainant. Contact with complainant was made after receipt of your letter with another revised offer given to complainant January 23, 2017. As of today there has been no response to the most recently revised settlement offer.It is our contention Mutual Benefit Insurance Company properly handled the complainant’s claim, not knowing the revised settlement offer letter established in August did not reach complainant. As to why complainant did not continue to complain or contact Mutual Benefit Insurance Company after his August letter until January 2017, we cannot answer. Mutual Benefits’ offer remains and once all paperwork is received payment will be issued.Sincerely,Susan A. L[redacted] CPCUAVP of ClaimsMutual Benefit Insurance Co.[redacted]

Review: Company refused to fix certain things on vehicle, but did fix other things. Used the excuse that damage was not related to the lighting strike. Then the company refused to reimburse me the cost of out of pocket expense that they promised they would.Desired Settlement: A refund and disiplinary action against the claims person and supervisor, plus time and interest that I have needlessly had to put into this matter.

Business

Response:

I am responding to your correspondence to [redacted] CEO of Mutual Benefit Group datedJanuary 23, 2015, since the complaint is in regards to the handling of(3) claims submitted by thecomplainant for lightning damage.Complainant reported (3) claims directly to our in house claim reporting unit on July 28, 2014 at9:26AM, indicating that lightning had struck an oak tree and damaged his home; shed; 2011 FordFiesta; 2012 Chevrolet Silverado 1(1500 and electrical items in his home. Since Mutual BenefitGroup claims are handled based on specialty, the homeowner claim [redacted] was immediatelyassigned to Sr. Field Claim Representative [redacted] while both the automobile losses[redacted] and [redacted] were immediately assigned to Fast Track Adjuster I [redacted].Both Ms. [redacted] and Ms. [redacted] made contact with the complainant the same day they wereaeci8ned tho~e chime. - -Regarding the homeowner claim assigned to Ms. [redacted], due to the location of complainant’shome a field assignment was made to Sr. Ficld Claim Representative Phil [redacted] who was in thearea of the complainant’s home to inspect and report back to Ms. [redacted] on the home damage.Mr. [redacted] did so reporting that the tree had not fell nor had it fell on any covered property.After receiving this information Ms. [redacted] advised complainant that the policy coverage islimited to $500 for damage to the tree itself, the tree had some limbs that fell but was stillstanding, there was also coverage for the personal property in the home, after the $250deductible of the policy was applied. Payment for the tree in the amount of $500 the policy limitwas issued to complainant on August 5, 2014 on the same day after receiving personal propertydamage inventory a payment of $3,205.00 which was for damage to the property less $250deductible and $1,000 of recoverable depreciation, was also issued. On August 7,2014 Ms.[redacted] did receive a phone call from Attorney Josh Bish to discuss coverage for complainant. Asof tins date, we have not received any ftrther communications on the homeowner claim frontAttorney Bish or complainant.Regarding the automobile claims assigned to Ms. [redacted], the 2012 Chevrolet Silverado Kl500had pieces of wood from the tree dent this vehicle Ms. [redacted] assigned a licensed independentappraiser of Grieco Appraisal Services LLC the same day July 28, 2014, with appraiser [redacted] Appraiser License fi 153344 inspecting on July 30, 2014. We received the appraisal onAugust 1, 2014 and called complainant as we either issue payment to our insured and the losspayee or the insured and the body shop of their choice. A call was placed to complainant thesame day and he indicated he was going on vacation, having two shops in mind and would letMs. [redacted] know which one when he returned from vacation. Ms. [redacted] called complainantAugust 7, 2014 at which time complainant indicated he would be taking the vehicle toMcPherson Auto Body and Ms. [redacted] issued payment to insured and McPherson Auto Body thesame day for the appraised amount $1,672.04 less the policies $500.00 comprehensivedeductible. On September 25, 2014 complainant called Ms. [redacted] indicating he was havingissues with both vehicles and wanted to take to a dealer, he was indicating it was the work doneby McPherson Auto Body, Ms. [redacted] told complainant that he really should take back toMcPherson and the independent appraiser would re-inspect. A supplement was issued afterreceiving a supplemental appraisal from Grieco Appraisal Services on December 1, 2014 in theamount of $186.59, however, there were a chip in tailgate and plastic piece underneath the frontbumper as not related to the pieces of wood hitting this vehicle after reviewing with the bodyshop and the indcpendent appraiser that visually inspected the vehicle.Regarding the 201 I Ford Fiesta, Ms. [redacted] assigned independent appraiser who inspected at thesame times as the 2012 Chevrolet Silverado. However, complainant was in need of a rentalwhich was afforded to him up to the coverage limit per day of his policy $30.00 while thevehicle was being repaired. The independent appraiser inspected this vehicle on July 30, 2014and Mutual Benefit Group received on August 1, 2014 along with the other appraisal. Theappraisal was for $1,853.53 less betterment and tax of$ 136.97 on alternator and less$500.00comprehensive deductible for a payment of$1,2l6.56. The appraiser indicated that the oilpressure light is on but appraiser could not relate this to lightning strike, that the vehicle wouldneed diagnostic testing to determine issue. The diagnostic testing results were received January13, 2015 from Clarion Ford, the report was immediately given to independent licensed appraiser[redacted] the same day. On January 28, 2015 Ms. [redacted] received diagnostics from Ad Autothis second diagnostic report was also given to independent appraiser. As of today we do nothave a final determination of the exact cause of the electric issue with this vehicle or if theycould be related to the lightning.Sincerely,[redacted]Assistant Vice President of Claims

Review: My vehicle and my fiance's vehicle were significantly damaged by hail on 5/22/2014. My vehicle was not driveable due to a cracked windshield. I called in both claims that day. My fiance's vehicle was seen by an adjuster the following Tuesday (5/27), which was very timely. I called the adjustor assigned for my vehicle on Wednesday, 5/28, and they had informed me that they had not recieved my claim. I called Mutual Benefit back and had them re-send the claim. The adjustor then told me they received the claim on 5/28. If I had not called them to resend, the adjustor would have never received it. At that point, I was on a 2 week waiting list to be seen by the adjustor. However, there was a week delay between when the claim should have been sent to the adjustor and when it was actually sent to the adjustor. Due to the 3 week delay total, my car was not able to be worked on at the shop until late June. At this point, my 30-day rental coverage expired, and I was left without at car.Desired Settlement: I called Mutual Benefit to see if they could extend my rental coverage for 7 days, to make up for their mistake. They declined, and stated the contract limited me to 30, which I agree. However, their mistake caused an unnecessary 7 day delay to the processing of my claim. A fair resolution would have been to extend the rental for 7 days. Unfortunately, the rental was returned at the end of the 30-day coverage.

Business

Response:

Dear Ms. Geiger: