Pekin Insurance

Revdex.com Complaint # 12079659Consumer -[redacted]Claim # [redacted]Date of Loss - 03-01-17I am responding on behalf of F.A.I.A., of 2505 Court Street, Pekin, Illinois, 61558,to the above captioned complaint.We insure [redacted] under Homeowners policy [redacted]4.Insured turned in...

the claim at 9 AM on Wednesday, 3/1. Our adjuster called andleft a message with the insured at noon on 3/1. On Monday, 3/6, Adjusterinspected the dwelling and found one shingle and one piece of the ridge capmissing. Adjuster noticed evidence of shingle damage from either installation orimproper ventilation. However, this was not storm related and there were cracksin some shingles on all the slopes due to this problem.Adjuster denies the allegations that he has not returned the insured's phonemessages. This adjuster has been the only adjuster working this claim and thesecond adjuster (P.E.) he refers to in his complaint is the engineer we hired,Unified., to inspect the damages for a second opinion.On Tuesday, 3/7, our adjuster wrote an estimate for the storm related damagesand that estimate was less than the insured's $2,000 deductible.Adjuster sent the insured a denial letter on this same date.Our adjuster spoke to the insured on 3/20 concerning his letter and the insured didnot agree with Dave's assessment. The insured requested a second opinion andafter discussing with his supervisor he contacted an engineering firm on 3/21/17 toinspect and get their opinion to the damages of the roof. Adjuster received a phonecall from the engineer who inspected the home on 3/24/17 and he verbally toldadjuster there were issues to the roof. The roof has a seal strip problem and didnot seal properly prior to the storm and he saw hail damage on the vents on theroof. However, nothing on the shingles. He did notice some wind damage to theroof and told us he would send him a written report with his findings.Revdex.com of Central IllinoisPage 2Our adjuster spoke with the insured's agent, Morty on 4/3/17 and indicated thestatus of the claim and that we were awaiting the written report from the engineer.The written report was received 4/7/17 and placed in the file after 12:15 PM, and aportion of the report is attached. The summary of the report indicates that theshingle damage is expansion/contraction and not wind damage. The engineer wenton to indicate this could be because of shingle material makeup, (possiblyassociated with a 2002 class action law suit) construction deficiencies ormanufacturing defects.Formal denial letter was sent to insured on 04/09/17.If you should have any further questions or need additional information pleasecontact us.[redacted] CPCU, AICDirector of Claims1-800-322-0160, [redacted] pekininsurance.com

Initial Business Response /* (1000, 5, 2016/03/03) */
I have reviewed complaint and will address those issues that Pekin Insurance had direct involvement in. Unfortunately, most of her complaint centered around communication or activities that involved her Independant Agent. Pekin Insurnace was not...

a party to those discussions or actives therefore, I can not address them directly. Our underwritng file does not contain any communication from the insured or the agent concerning the request for inspection of her property.
In her complaint she indicated that Pekin Insurance refused to inspect her property as required by our contract. That is incorrect. The policy language gives Pekin Insurance the right to inspect any property that we insure. It does not mandate or require that an inspection be performed. Pekin Insurance did inspect her property in 2010 and we attempted to inspect it again in 2015 as part of our routine underwriting process. Unfortunately, she did not arrange access to her building. We attempted 8 times between 5-12-15 and 6-2-15 to arrange an inspection date with no success. For the record, insurance inspections are not designed to be a comprehensive inspection of a property. The intent is to provide underwriting information to determine if the property is of a quality to meet the companies underwriting guidelines. In fact, there is verbiage on the inspection and any recommendations that clearly indicate it is for insurance purposes only and cannot be considered a comprehensive inspection .
Lastly, a representation was made that Pekin Insurance canceled the policy under"false"
pretense as a cover-up for our negligence. Nothing could be further from the truth. As discussed above we attempted to inspect her property but could not gain access. The policy cancelled because the insurd did not pay her premium when due. Appropriate notices were mailed to her indicating the reason for cancelation was non-payment of premium. The insured also received a second notice as an additonal insured. The notice was mailed on 1-21-15 with a termination date of 1-31-15.
Unfortunately, Pekin Insurance did not have any communication with the insured until 3 weeks after the termination date. Upon receiving an e-mail from the insured, Pekin Insurance offered to consider rewriting her policy and asked her to contact an Independant Agent who represented Pekin Isurance. The next communication we had with her was via this complaint.
Based on our underwriting file, it is felt that we upheld our contractual agreement and due to the non-payment of premium, terminated coverage with legal notice.
Pekin Insurance understands Mrs. [redacted]'s concerns but in no way contributed to the situation she is now in.

Initial Business Response /* (1000, 5, 2016/01/25) */
The policy renewed effective 1-16-15 with an annual premium of $396.00. The change made effective 10-29-15 reduced the annual premium to $372.00. That is a difference of $24.00 annually. Since the change was not made until 10-29-15, the...

insured is not owed the full $24.00. The return premium for the remaining period of the policy of 10-29-15 to 1-16-16 is $5.18. This amount was subject to the rule for our minimum refunds or charges being waived. The company's policy however, is to refund the amount if it is requested by the insured. We will be sending a refund check of $5.18 to the insured.
Initial Consumer Rebuttal /* (3000, 7, 2016/01/26) */
(The consumer indicated he/she DID NOT accept the response from the business.)
At what point does the policy start the amended rate of $372? If I made monthly payments, I would've paid $372, when this amended policy came in Oct, but since I paid 1 check for the total $396, I only get back $5.18? Why wasn't the amended return in the amount of $390.82 (that's $5.18 difference)? When does the remainder $18.82 get refunded? 18.82 + 5.18= 24.00