Mutual of Enumclaw Insurance Company

Complaint: [redacted] I am rejecting this response because:to put it frankly this is inaccurate at best and some flat out lies For examples at first they state that our original estimate lacked details as to what would be worked on, yet later states some of the items in the estimate were excessive and not covered under my policyObviously there must have been a detailed estimated or them to state items are not covered next they state they suggested I seek other estimates and I refused, also not true as I eventually did have to seek other contractors and spoke with my adjuster [redacted] about these estimates that was when he sent the letter about having to seek a second party adjuster I diddnt understand the process and left messages trying to get further explanation after I was told by the places I contacted they diddnt know what I was looking for, I have since found a third party adjuster and scheduling appointments one thing to note as well my policy states I have the right to choose my own contractor, but apon speaking to my adjuster about the multiple quotes I was finally able to receive, his suggestion was to use a contractor off their list and stated if we do and they call and say more money is required it mont be a problem also the reason my original contractor had issues with their first adjuster and engineer was that they spoke to him about doing lesser quality work to fit the budget and stated they work for the ins company and are trying to save them money also as I previously wrote they did try and say the damages only equaled appx 3k wouldn't take our contractors big and only after their hired engineer came did they change to over 20k this is a show of how rediculous this process is they actually tried to convince me 3k would cover damages then miraculously changed to 20plus during that time I also was given a new adjuster, is this the ins version of good cop bad cop and now I should feel lucky to get the higher offer .....which is still less than half of any estimates I have received from contractors I should also add the engineer came out twice and changed what he was saying each time he said one thing to my fiancé, who has experienced in the construction industry being a former construction company owner herselfBasically stating she was lying also yes he tried to find pre existing damage but then stated no it was just heavy paint layerAnd yes I was told by my original adjuster that mold wasn't covered except when caused by water damage which this was this is not even a complaint as to what work needs to be done it's about getting actual market price for a respectable contractor of my choice as allowed by my coverage We used the print out of work to be done sent by the ins company after the engineer to get estimates from the last couple companiesThis is where we received estimates for appx 50k by multiple companiesAgain well above the we were offeredAlso my house is now sitting another almost year getting more damaged do to not being able to fix itOne of the issues was the ins company wanted to do the demo first then have a contractor finish the job Which my contractors stated they then couldn't guarantee the work as someone else would have started the job and they couldn't assure proper proceduresAnd it's a good thing I diddnt for my exterior wall would have been removed and my house exposed this whole time in closing again this is not a dispute as to what work is covered or needs to be done but we are trying to get the money to fairly pay a respectable contractor of our choosing as stated we are not only allowed but encouraged to do as per my policy Sincerely, [redacted] ***

Dear Ms [redacted] : Thank you for sending me the response from our customer [redacted] dated 1/20/It is certainly the intention of our company to honor all provisions within the insurance policy we hold with Ms [redacted] Since January 20, our company claim professional, [redacted] , has paid the full roof replacement amount based on the contract the customer submitttedIn addition, [redacted] has written an estimate for the interior damages and paid that amount [redacted] has requested electrical and AV/TV/Security invoices, and business income information, from Ms [redacted] Once received, [redacted] will review and hopefully resolve those issues as well Hopefully, this matter will be resolved, very soon, to Ms [redacted] 's satisfaction Sincerely, [redacted] Claims Field Operations Manager Mutual of Enumclaw Insurance

April 25, Thank you for the opportunity to respond to this complaint The accident occurred on September 3, 2012, and was reported to us on October 26, On January 17, 2013, we sent a letter to [redacted] that contained, in part, the following statement: “This letter is not a substitute for legal advicePlease be aware that the opportunity to conclude your injury claim is limited by time which is known as the Statute of Limitations I understand the Statute of Limitations for your claim in the state of Washington would require you to bring formal legal action by September 3, It is my hope that we will reach an agreement to settle your injury claim before the Statute of Limitations approaches.” Between January and June 2015, we sent eight (8) individual letters to [redacted] extending monetary offers to settle her injury claim The June 18, 2015, certified letter sent to [redacted] , and received on June 22, 2015, also contained notification of the impending Statute of Limitations set to expire on September 3, We had no further communications with [redacted] until she contacted us, via e-mail, on April 15, We advised her that the Statute of Limitations had expired on her injury claim as of September 3, Please let me know if there is any additional information that we can provide

Complaint: [redacted] I am rejecting this response because: While I do acknowledge that Mutual of Enumclaw sent me letters addressing the statue of limitations for legal action, however as I previously stated “legal” action to me meant a lawyer and I had stated over and over to Maria, Claims manager, I did not intend to get a lawyer and wanted to settle but felt it was not going to be sufficient because of the dental work I had to haveI had to have a new dental bridge implanted and have had trouble with my teeth since, my teeth hurt and it didn’t feel stableI wanted to make sure I wasn’t going to have additional issues with the bridge, which I communicated to Maria the claims managerWhen I went to the dentist he did tell me it was going to take time for my teeth to adjust to the new bridgeThis is the reason I waited so long Also, at no time was it explained to me that that I would not have any opportunity to settle “at all” once September passedI did not understand that until it Maria replied to my email in April At that time she was clear and I fail to understand why she did not tell me this prior to September I do not feel this statute of limitations was explained fully and had it been I would have just settled because it would have been better than nothingEnumclaw needs to understand they are not dealing with people with legal backgrounds and need to use plain English instead of language that is confusing and misleading to people who do not work in the insurance environment they do I feel they did this on purpose in order to get out of their obligation

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received, your complaint will be closed Administratively Resolved] Revdex.com, I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below I am still waiting for an invoice on AV/Electrical etc Once received I will send to my claims adjuster and attempt to settle this Ms [redacted] is the only person that has been helpful at Mutual of EnumclawIt's too bad Mutual of Enumclaw doesn't have more adjusters like her that actually try to help customers I will close this case when we have resolved the final invoices Regards, [redacted]

Thank you for the opportunity to address Ms***’s concerns
regarding the collection of her deductible from the responsible partyEnumclaw Property and Casualty Insurance Company provides a
Personal Automobile policy on behalf of Ms***Ms*** was driving a
rented vehicle at the time of
the automobile accident. Ms***’s policy provides coverage subject
to the policy conditions, the deductible and other benefits if the at-fault
party is uninsuredThe claim was reported to Enumclaw Property and Casualty
Insurance Company. During our
investigation it was determined that the other party was driving a borrowed
vehicle at the time of the accident. It
was unclear if the other driver or owner had insurance coverage on their vehicle. We advised Ms*** that we could assist her with the
damages to the rental vehicle under her coverage, subject to her
deductible. Furthermore, we advised Ms
*** that we would investigate the availability of insurance coverage for the
vehicle driven by the other party and pursue the responsible party for
damages. At no time does it appear that
it was suggested that there would be no out-of-pocket expense for Ms*** as
her insurance coverage is subject to all applicable deductibles. We attempted to file a claim under the other driver’s policy
without success. In addition, we were
unsuccessful in pursuing the owner of the vehicle. The rental car company submitted a damage estimate for
repairs on the rental car, driven by Ms***.
Payment was issued for the submitted amount less her collision
deductible. Enumclaw Property and Casualty Insurance Company
exhausted all efforts to determine if there was applicable insurance coverage
for the at-fault driver as of May 2, 2017.
At that time, we should have extended benefits under the policy that
provide for a lower deductible. We
apologize for the oversight and have issued payment to Ms*** for the
difference between the two deductibles. Enumclaw Property and Casualty is continuing to work to
recover the damages paid out, including Ms***’s deductible from the
responsible partyBrett *J*** Senior Claims Material Damage Manager Enumclaw Property and Casualty Insurance Company

This will acknowledge receipt of your inquiry dated September 23, 2015.Enumclaw Property and Casualty Insurance Company provides a personal auto policy and Mutual ofEnumclaw Insurance Company provides a personal excess liability policy on behalf of Ms***.Ms***’s letter indicates
that her concern is that she is being charged a $fee each time shechooses to make an installment payment toward her policy premiumsThe $fee is charged tocustomers who choose to, in essence, finance their policy premiums through the company by makingmonthly installment payments rather than pay in full at the onset of each policy termThe fee is waivedfor those customers who choose to have their insurance premiums automatically deducted from theirbank accounts via electronic funds transfer (“EFT”) or who pay their policy premium in full at the onsetof each policy termThis fee, both the amount and the rules governing when it is applied, has been filedand approved with the Office of the Insurance Commissioner in the State of Washington.Ms*** also expressed concern that EFT payments would be for amounts for which she would notbe previously awareInstallment payments are, unless policy changes are made at the request of thecustomer which result in additional premium (such as adding additional coverages or another vehicle,etc.), determined at the onset of a policy term regardless of how a customer chooses to makepaymentsCustomers are notified in advance of any additional or return premium charges made to theirpolicies when changes have been requestedEFT payments would therefore never be for an amountmore than what was indicated on the noticeFor your convenience, a copy of Ms***’s most recentaccount statement has been attached.We appreciate the trust Ms*** has placed in Mutual of Enumclaw in providing for her insuranceneeds and we hope that this explanation satisfies your inquiry.Please do not hesitate to let me know if you have any further questions.Sincerely,Keri O***, CIC, MCMCompliance ManagerMutual of Enumclaw Insurance Company*** *** *** ***@mutualofenumclaw.com
***SUPPORTING DOCUMENTS REDACTED BY Revdex.com***

Complaint: ***I am rejecting this response because:
The explanation given states the $fee is essentially my choice, because I am "financing" my bill, in lieu of paying the entire balanceHowever, they do not charge the $fee to members with the automatic payment, who are also paying only the monthly minimum payment and not the entire balanceIt appears that Mutual of Enumclaw is giving preferential treatment to electronic paying members, or penalty to the non electronic paying membersEither way you look at it, it is an unfair practiceIf your next concern is printing and mailing the statements each month, than why can't I receive mine by email, and avoid the printing/mailing issueGoing forward I'm sure my insurance bill will now be increased as additional penalty for simply by bringing this issue to Revdex.com
Sincerely,*** ***

Thank you for sending us the correspondence from *** ***The policy limit , for contents (Coverage C), has been paidPrior to any final pricing of the contents the insured & Mr*** had let Mutual of Enumclaw Insurance Company know that the property could not be cleaned to their
satisfaction and the contents were then handled as non cleanableAt that point any salvage would have been the property of Mutual of Enumclaw Insurance Company if they chose to take itPrior to that time, our insured could have told us they were interested in retaining the salvage and we could have attempted to reach an agreement on any valueOur insured did not do that
The full value of the contents claim was in excess of the full amount contents policy limit so no depreciation was applied and the policy deductible was absorbed in a claim in excess of the policy limitThe full amount was paid
At no time, prior to learning that the damage exceeded policy limits, did our insured advise anyone that they were interested in the salvage, even after the vendor who attempted to clean them, Frsteam, put the insured on notice that they were going to dispose of the contents
Mutual of Enumclaw Insurance has fulfilled our obligations to our policyholder
Ken R***
Claims Field Operations Manager
Spokane, WA

Dear *** ***:Thank you for your 1/12/letter and the customer statement from *** ** ***We apologize for causing concernOur company claim professional, *** ***, has met with the customer and addressed her concernsWe believe the claim is now progressing properly. If you
or Ms*** have any further concerns please feel free to contact me at the address or phone number provided below. Sincerely, *** ***Claims Field Operations ManagerMutual of Enumclaw Insurance Company

May 16,
Revdex.com
POBox
DuPont, WA
Attention: *** ***
Company Involved: Enumclaw Property and Casualty Insurance
Company
Complainant: *** ***
Policyholder: *** ***
Claim Number: ***
Assigned ID: ***
Dear *** ***:
Thank you for the opportunity to address *** ***’s concerns. Mr*** reported on July 22, 2015, that wood was separating on the siding of the home near the bathroom window. Mr*** was contacted by a claims adjuster that day and Mr*** said that he had no idea what was causing this condition, but he was having a contractor inspect the home and would get back to us. We agreed to wait to hear back from his contractor before continuing with the claim investigation
On August 21, 2015, we received an estimate from Mr***’s contractor, Rainier View Construction, for $114,without details concerning the charges or scope of workThe contractor advised there was a long term leak inside the walls of the shower. Within a few days we advised Mr*** that his insurance policy limited coverage due to mold and wet or dry rot. We also advised the insured we would only pay the reasonable cost to repair damages that were covered under his insurance policy
After several attempts to reach Mr*** to schedule our claim representative to see the home, we were able to inspect the exterior damage on September 15, 2015. After viewing the home our adjuster concluded the scope of damage and the repair estimate completed by Rainier View Construction was excessive and appeared to include items that were not covered under the policy. Our preliminary repair estimate was completed for known damages (without being able to look behind the siding) of $3,098.41. We suggested that another contractor of Mr***’s choice inspect the damage and provide a second opinion, however Mr*** refused this request
On September 23, 2015, we hired Case Forensics Engineering to inspect the loss and coordinate with the contractor chosen by Mr*** for removal of the siding to identify the cause and full extent of the damage. Mr***’s contractor did not want to work with the Case engineer so on October 10, 2015, we hired an alternative engineering firm, BC Investigative Engineers (BCIE), to determine the extent and cause of the damage. BCIE found there was a grout issue at the window sill in the basement bathroom that had caused damage to the walls and the T1-siding in the area below the window over a period of years. BCIE also concluded there was preexisting damage to the structure. We received BCIE’s final report in November addressing the scope and cause of damage.
After receiving the final engineering report, a revised estimate for the repair of the covered damages in the amount of $21,was sent to Mr*** to provide to his chosen contractor. On February 19, 2016, after being unable to reach an agreed price with Mr***’s contractor, a final payment was issued in the amount of $20,959.61. On several occasions during our handling of his claim we advised Mr*** of the appraisal section of his policy which describes the dispute resolution process available to him.
Thank you for bringing this complaint to our attention. While we believe we have paid Mr*** the reasonable costs to repair all damages covered under the terms of his insurance policy, we will continue to work with Mr*** to resolve his claim.
Please let me know if there is any additional information that we can provide
Thomas *U***
Director of Litigation
Enumclaw Property & Casualty Insurance Company
1-360-825-ext***
***@mutualofenumclaw.com
Thomas *U***, JD, CPCU, CLU, ChFC
Director of Litigation
Mutual of Enumclaw Insurance Company
Phone: 800-366-Ext***Mobile: 253-797-1925***mutualofenumclaw.com

Complaint: [redacted]I am rejecting this response because:to put it frankly this is inaccurate at best and some flat out lies ...... For examples at first they state that our original estimate lacked details as to what would be worked on, yet later states some of the items in the estimate were excessive and not covered under my policy. Obviously there must have been a detailed estimated or them to state items are not covered..
next they state they suggested I seek other estimates and I refused, also not true as I eventually did have to seek other contractors and spoke with my adjuster [redacted] about these estimates that was when he sent the letter about having to seek a second party adjuster
I diddnt understand the process and left messages trying to get further explanation after I was told by the places I contacted they diddnt know what I was looking for, I have since found a third party adjuster and scheduling appointments 
one thing to note as well my policy states I have the right to choose my own contractor, but apon speaking to my adjuster about the multiple quotes I was finally able to receive, his suggestion was to use a contractor off their list and stated if we do and they call and say more money is required it mont be a problem...
also the reason my original contractor had issues with their first adjuster and engineer was that they spoke to him about doing lesser quality work to fit the budget and stated they work for the ins company and are trying to save them money
also as I previously wrote they did try and say the damages only equaled appx 3k wouldn't take our contractors big and only after their hired engineer came did they change to over 20k this is a show of how rediculous this process is they actually tried to convince me 3k would cover damages then miraculously changed to 20plus during that time I also was given a new adjuster, is this the ins version of good cop bad cop and now I should feel lucky to get the higher offer .....which is still less than half of any estimates I have received from contractors .....
I should also add the engineer came out twice and changed what he was saying each time he said one thing to my fiancé, who has experienced in the construction industry being a former construction company owner herself. Basically stating she was lying also yes he tried to find pre existing damage but then stated no it was just heavy paint layer... And yes I was told by my original adjuster that mold wasn't covered except when caused by water damage which this was 
this is not even a complaint as to what work needs to be done it's about getting actual market price for a respectable contractor of my choice as allowed by my coverage ... We used the print out of work to be done sent by the ins company after the engineer to get estimates from the last couple companies... This is where we received estimates for appx 50k by multiple companies.. Again well above the 20 we were offered. Also my house is now sitting another almost year getting more damaged do to not being able to fix it.. One of the issues was the ins company wanted to do the demo first then have a contractor finish the job ... Which my contractors stated they then couldn't guarantee the work as someone else would have started the job and they couldn't assure proper procedures.... And it's a good thing I diddnt for my exterior wall would have been removed and my house exposed this whole time .....
in closing again this is not a dispute as to what work is covered or needs to be done but we are trying to get the money to fairly pay a respectable contractor of our choosing as stated we are not only allowed but encouraged to do as per my policy
Sincerely,[redacted]

May 25, 2016
 
Revdex.com
P. O. Box 1000
DuPont, WA 98327
Attention: [redacted]
 
Company Involved:      Enumclaw Property and Casualty Insurance Company
Complainant:               [redacted]
Policyholder:               [redacted]
Claim Number:             [redacted]
Assigned ID:                [redacted]
 
Dear [redacted]:
 
Thank you for the opportunity to address [redacted]’s additional concerns.  The original estimate provided by Mr. [redacted] from Rainier Construction for $114,532.00 had six line amounts that did not list areas of the home that were damaged, dimensions of rooms, material to be used, or labor costs.  The six items that were included appeared to be excessive or not covered.  There were many areas where the estimate lacked detail.  Our final repair estimate of $21,959.61 had 59 line items.
 
Mutual of Enumclaw did not agree with the Rainier Construction estimate because the description of work lacked detail and did not match the scope of covered damages caused by this water event.  The second estimate we suggested to Mr. [redacted] was from one of our program contractors, and he was advised he was under no obligation to use this contractor.  Mr. [redacted] declined our offer.
 
We hired an engineer firm to provide a professional opinion as to the origin and cause of the damage.  The engineer’s job does not include determining if damage is covered or estimating the costs to repair.  Mr. [redacted] chose not to be present during the engineer’s inspections.   When we received the engineer’s opinion, we then prepared an estimate based on the engineer’s final report, policy coverage and applicable limits. 
 
Mr. [redacted] references other estimates.  On May 6, 2016, we received for the first time two additional estimates, one from Valley Construction for approximately $43,500 dated January 25, 2016, and one from Advance Construction LLC for approximately $52,700 dated February, 25, 2016.  As with the original Rainier Construction estimate, both these estimates lack basic detail including dimensions, material costs and labor costs. The scope of repairs being estimated is unclear.  Detailed information is needed to confirm if coverage is applicable or if policy limits apply to the work being estimated.
 
In an attempt to address the differences in repair estimates and the inadequacy of the estimates provided by Mr. [redacted], we have again offered to meet with Mr. [redacted] and his contractor to reach an agreement as to the scope of damages that are covered under Mr. [redacted]’s insurance policy.  Once we have an agreed scope of covered damages, it is our intention to hire a third party construction consultant, at our cost, to review the agreed scope, and updated estimates consistent with this scope to be prepared by Mutual of Enumclaw and by the insured’s contractor.  The consultant will verify the estimates fully and completely address damage within the agreed scope and are consistent with standard construction business practices.  Any additions to the cost of covered repairs will immediately be paid to Mr. [redacted].
 
Based on the information provided by Mr. [redacted], the opinions of the engineer regarding the cause of the damage, our inspections of the home and analysis of the coverage terms in Mr. [redacted]’s policy, we believe we have paid the amount reasonable and necessary to repair all covered damages.  Nevertheless, we will continue to work with Mr. [redacted] to resolve his claim. 
 
Please let me know if there is any additional information that we can provide.
 
 
Thomas *. U[redacted]
Director of Litigation
Enumclaw Property & Casualty Insurance Company
1-360-825-2591 ext. [redacted]@mutualofenumclaw.com

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received, your complaint will be closed Administratively Resolved]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
My claim has not been settled.  I just am on my 3rd adjuster in 60 days.  She is reviewing everything and has apologized, but I really am no better off than I was last month other than I elected to have a new roof put on because water was pouring in my business.  The amount of additional damage caused by the delays of my insurance and their failure to respond/act is exponential.  I will not close this complaint until my claim has been settle to my satisfaction.  The service I have received thus far from Mutual of Enumclaw has been abhorrent.  [redacted] is the first person to actually call me back and act in a timely manner.  I just hope the company will not stop her from helping us.
Regards,
[redacted]

Dear Ms. [redacted]:
Thank you for sending me the response from our customer [redacted] dated 1/20/16. It is certainly the intention of our company to honor all provisions within the insurance policy we hold with Ms. [redacted]. Since January 20, 2016 our company claim professional, [redacted], has paid the full roof replacement amount based on the contract the customer submittted. In addition, [redacted] has written an estimate for the interior damages and paid that amount.
[redacted] has requested electrical and AV/TV/Security invoices, and business income information, from Ms. [redacted]. Once received, [redacted] will review and hopefully resolve those issues as well.
Hopefully, this matter will be resolved, very soon, to Ms. [redacted]'s satisfaction.
Sincerely,
[redacted]
Claims Field Operations Manager
Mutual of Enumclaw Insurance

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received, your complaint will be closed Administratively Resolved]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
I am still waiting for an invoice on AV/Electrical etc.  Once received I will send to my claims adjuster and attempt to settle this.  Ms. [redacted] is the only person that has been helpful at Mutual of Enumclaw. It's too bad Mutual of Enumclaw doesn't have more adjusters like her that actually try to help customers.  I will close this case when we have resolved the final invoices.
Regards,
[redacted]

Complaint: [redacted]I am rejecting this response because:
 While I do acknowledge that Mutual of Enumclaw sent me letters addressing the statue of limitations for legal action, however as I previously stated “legal” action to me meant a lawyer and I had stated over and over to Maria, Claims manager,  I did not intend to get a lawyer and wanted to settle but felt it was not going to be sufficient because of the dental work I had to have. I had to have a new dental bridge implanted and have had trouble with my teeth since, my teeth hurt and it didn’t feel stable. I wanted to make sure I wasn’t going to have additional issues with the bridge, which I communicated to Maria the claims manager. When I went to the dentist he did tell me it was going to take time for my teeth to adjust to the new bridge. This is the reason I waited so long.
Also, at no time was it explained to me that that I would not have any opportunity to settle “at all” once September 2015 passed. I did not understand that until it Maria replied to my email in April 2016. At that time she was clear and I fail to understand why she did not tell me this prior to September 2015.
I do not feel this statute of limitations was explained fully and had it been I would have just settled because it would have been better than nothing. Enumclaw needs to understand they are not dealing with people with legal backgrounds and need to use plain English instead of language that is confusing and misleading to people who do not work in the insurance environment they do.
I feel they did this on purpose in order to get out of their obligation.

April 25, 2016
Thank you for the opportunity to respond to this complaint.  The accident occurred on September 3, 2012, and was reported to us on October 26, 2012.  On January 17, 2013, we sent a letter to [redacted] that contained, in part, the following...

statement:
 
“This letter is not a substitute for legal advice. Please be aware that the opportunity to conclude your injury claim is limited by time which is known as the Statute of Limitations.  I understand the Statute of Limitations for your claim in the state of Washington would require you to bring formal legal action by September 3, 2015.  It is my hope that we will reach an agreement to settle your injury claim before the Statute of Limitations approaches.”
 
Between January 2014 and June 2015, we sent eight (8) individual letters to [redacted] extending monetary offers to settle her injury claim.  The June 18, 2015, certified letter sent to [redacted], and received on June 22, 2015, also contained notification of the impending Statute of Limitations set to expire on September 3, 2015. 
 
We had no further communications with [redacted] until she contacted us, via e-mail, on April 15, 2016.  We advised her that the Statute of Limitations had expired on her injury claim as of September 3, 2015.
 
Please let me know if there is any additional information that we can provide.