QBE Insurance

face="Arial, sans-serif">This will serve to acknowledge that we received your above referenced complaint ln our office on January 23rd, QBE is committed to providing its customers with high quality products and servicesYour comments are important to us in this processYour inquiry has been forwarded to an authorized person for a response to your request Direct [redacted] Fax: [redacted] Thank you – and have a nice weekend Sincerely, [redacted] [redacted] [redacted] [redacted] [redacted] ** [redacted]

My house got damaged by hail May 21,2014, I send my statement for QBE one for for the stucco,5,for the roofing, and I have damage in my garage windows and around the house and this insurance only gave me 6,to pay everything and still I have damage and they won't give me anymore money and closed my case so I don't have enough money to cover the damages that were made in my house, I do not recommend this insurance to anybody because my problem wasn't solvedThey sent me one last check for $1,and the rest I had to put from my own pocket! I to put over $3,out of my own pocket to fix my house because this insurance couldn't pay anything!

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.] RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me. Regards, [redacted]

This is the worst service of company I've ever experienced in my entire life. There is an exception to this as after the people started ignoring my calls and I could not get to a person and that whole department, I called and a random lady in an IT health department did her best to contact someone that could help. I still have yet to have my claim finished I cannot reach anyone. It is been almost 2 months since the incident happens and the first thing company people try to give me not even an 1/8th of the Lost property, and when I disagreed they became very rude and evasive. Before iI researched the company as a whole I was convinced there was some shady dealings happening internally and I'm still not convinced that there is not. I technically didn't didn't even sign up with QBE! I have progressive and I was unaware Iwas bale to choose the underwriter. I contacted progressive for help and was basically told it's not their problem after they still did t respond. finally about 3 weeks later they send a guy to meet me in person from enservio and he was very helpful;l but now its been weeks since that and I still can't reach anyone but answering machines and agents that send me into limbo. I am am feeling more violated then the actual armed robbery! never get involved because not knowing that one little detail with progressive has caused me hours upon days of turmoil. Im s student so am working with little as it is so when a 4.7 billion dollar company treats you like garbage because they want to keep the equivalency of pennies fr them they will ruin another's life without a second thought.

Thank you for the opportunity to address the complaint which has been filed on behalf of Ms. *** ***
Please note that *** is the third party claim administrator for QBE Insurance Corporation and its insured Unity Health Care, Inc*** is not an
insurance carrierIn a good faith effort to resolve this complaint, *** provides the following information for your fileThis claim is being handled as a District of Columbia jurisdiction workers compensation claimThe claim was received on 11/18/with a date of injury of 11/05/The description of injury was "illness"The loss description was that she was found unresponsive and disorientedThrough our investigation we have discovered additional information surrounding this claimThe claimant stated that she developed symptoms due to construction being done in the officeThe claims examiner had several conversations with the insured regarding the details of this claim as well as the state of the office areaNo other employees reported any problems with dust or moldNo other employees have reported seeing moldThe construction that was done was done over a month prior to the date of loss and a hole less than one inch in diameter was drilled in the wall at floor level so a wire could be passed from one office to anotherThere is no ongoing construction
The building in which Ms*** works for the insured is not owed by United Health Care, IncThe building owner has not mentioned any issues to the insuredWe have been informed Ms*** went to the ER on the date of loss and then to another ER at some other pointShe has not presented any of this documentation to the insured or *** CMS She was seen by Advanced Pulmonary Critical Care on 11/12/She presents with asthma for an initial evaluationHer symptoms have persisted and are aggravated by dust and dust mitesThere is no mention in the History of Present Illness of anything happening at workHer chronic problems are listed as allergic rhinitis, asthma exacerbation, and refluxThe diagnosis is Asthma exacerbation with fair controlShe is to continue with her inhaler as neededShe is to schedule a chest CT and follow up in month.
She was seen at Patient First on 11/17/Her chief complaint is trouble breathingShe states that on the 6th she inhaled a powdery substance at work and since then she has had trouble breathingIt has been getting worsePatient First sent her to a pulmonologist already
who has scheduled her for a CT Scan but she has not scheduled thisChest pain and shortness of breath have continuedShe was also seen in the Emergency Room for thisShe was given inhalers by the pulmonologistShe is given a prescription for a cough syrup with codeine and a cough medication without codeineDiagnosis is Dyspnea (shortness of breath)
We have not received any medical documentation from the emergency rooms that she visited On 11/21/she filed a claim for FMLAHer symptoms are shortness of breath, severe chest pains, migraines, headaches and dizzinessThe examiner filed the Notice of Controversion on 12/03/stating there was no accident or disability arising out of employment and no prima facia medical related to this claimThe Notice comes with a set of instructions for the employee to contact the Office of Worker's Compensation (OWC) to file a request for an informal hearing or to obtain guidance on her rightsIt is our understanding that she has not done this.
We have no prima facia medical evidence to support a worker's compensation claimThere is no mention of a work injury at the first pulmonologist visitThere is no supporting evidence that there is abdust or mold in the work place In an effort to resolve this dispute, *** has attempted to explain the rationale for the Notice of Controversion in this letter as well as directly to Ms***.
Again, thank you for the opportunity to respond to the complaint filed by MsRenicka ***Should you require additional information, please me at (***
Sincerely,
*** ***

RE: Company Name: Regent Insurance Company Company Address: General Drive, Sun Prarie, WI Insured: Tom’s Backhoe Service, Inc Complainant: *** *** Date of Loss: 07/13/ Policy Number: *** Claim Number: *** Your File Number: WI Revdex.com *** NAIC Number: *** Adjuster Name: *** *** Policy Issue Date: 07/01/Dear Ms***: Please accept this as a response to the complaint you sent dated May 4, Per review of the documentation provided, it appears *** *** was not satisfied with the handling of her claim or with the communication received from the assigned adjuster concerning the status of her claimUpon review of the claim, I understand Ms***’s concerns and offer a full apology to her concerning the delays in responding to her and in handling her claim payment in a timely manner. On May 9, 2016, the adjuster made contact with Ms***, who is listed as MsHartin in our records, and made an offer to settle her claim in the amount of $40,Ms*** accepted the offer via email confirmation and the adjuster emailed her a full and final property damage release on the same dateOn May 10, 2016, the properly executed release was received and the check was issued in the agreed amountThis settlement should resolve Ms***’s concerns and this inquiryPlease advise if there are any further questions or concernsSincerely, *** *** Assistant Vice President-Casualty QBE North America Direct: 608-834-| Mobile: 815-238-Email: ***

On December 5, 2016, our office received the above referenced complaint submitted by the Wisconsin Revdex.com on behalf of *** ***Please accept this response to the inquiry pertaining to claim number ***We attempted to contact Ms*** on December 5, to discuss her
concerns regarding communications on the claim but had to leave a messageOn December 6, 2016, we spoke with Ms*** and at that time, reassigned the file to a new adjusterAdditional Living Expense coverage was reviewed and the insured will provide incurred expenses for reviewWe also discussed the repairs to the kitchen and have located a local contractor to address the damagesOn a follow up with Ms*** on December 8, 2016, we confirmed that all her concerns had been addressed and she was satisfied with the current handling of the lossShould you have any additional concerns, please contact usSincerely, Susan MChamberlin Assistant Claims Manager Sedgwick Claims Management Services, Inc., a Business Partner of QBE Americas, Inc(QBEAI) E-mail: [email protected] Phone: 770-901-

This letter will serve to acknowledge that we received your above referenced complaint in our office on February 28, QBE is committed to providing its customers with high quality products and servicesYour comments are important to us in this processYour inquiry has been forwarded to an
authorized person for a response to your requestSincerely, *** ***

Please accept this as a follow up response to the additional concerns expressed by our insured *** ***
We have notified our inspector from PT&C Forensic Consulting Services to contact Mrs *** and her contractor of choice to schedule a joint inspection of the roof.
Upon completion of this inspection, we will notify all involved of the findings and any change to our positionIf you have any further questions concerning this matter, please contact us at ***
Very truly yours,
*** M ***

Complainant: *** ***
Company QBE Insurance Corporation
This letter will serve to acknowledge that we received your above referenced complaint in our office on March 23, QBE is committed to providing its customers with high
quality products and services, Your comments are important to us in this processYour inquiry has been forwarded to an authorized person for a response to your requestSincerely,
*** ***

Please
accept this response to the above referenced inquiry which was received in our
office on March 23,
A
review of our records indicates that on February 18, 2015, we received a new
claim for fire and water damage to the insured’s apartment. The claim was assigned to *** *** with
our office on February 18, and he left a voicemail for the ***’s on the
18th requesting a return call.
During a conversation with Mrs*** *** on February 20, 2015,
Mr*** explained the claims process and he asked Mrs*** to complete
a contents list to document any/all damage to her unscheduled personal
property. Mrs*** advised that
her son has asthma and that they would be moving to a new apartmentOn
March 9, 2015, we received an invoice from All My Sons Moving and Storage of
Jacksonville Incin the amount of $738.09.
Mr*** reviewed the invoice and he submitted a request to have the
mailing address updated in our claim system on March 13, 2015. The mailing address was updated on March 13,
by *** ***, who is Mr***’s immediate supervisor. A check in the amount of $was sent to
Mrand Mr*** on March 13, 2015, and Mr*** left a voicemail for Mr
*** *** letting him know that the payment had been sent. Mr*** spoke with a member of our
customer service team on March 16, and he was advised that the check was
sent on March 13, 2015. *** *** spoke with Mr*** on March 17, and he again confirmed that the
check was sent to the new address on March 13, and that the check had been
mailed out of Irvine, California
The
amount of our payment is equal to the disputed amount noted in the complaint;
therefore, we believe this issue to be resolved. If you have any further questions concerning
this matter, please contact us at ***
Very
truly yours,
*** ** ***
Claims Assistant Manager
Phone: ***
E-mail:
***

A review of our records reflects that Ms*** has made inquiries to both the Wisconsin Revdex.com as well as the Ohio Department of Insurance regarding the claim of August 12, 2017. We attach a copy of our response to the Ohio Department of Insurance as our response to the Revdex.com. Should you require any additional information, please let us know. Thanks,***
*** *** Claims SupervisorClaims Technical Property QBE North AmericaMrBrent GuessAnalyst, Property & Casualty UnitConsumer Services DivisionOhio Department of InsuranceWest Town StreetThird Floor- Suite 300Columbus, OH 43215-4186Re: Consumer Services Division File #: CSD-0053208Complainant: Cynthia ***Insured: Cynthia ***Insurance Carrier: QBE Insurance CorporationNAIC Number: 39217Policy Number: QHP 4130630Policy type: Homeowners PolicyClaim Number: 513151NDate of Loss: 08/12/2017Dear MrGuess:On behalf of QBE Insurance Corporation, we are responding to the correspondence received from the Ohio Department of Insurance regarding the above referenced matterPlease accept this reply to the concerns pertaining to policy QHP 4130630.A review of our records reflects a loss was reported on Saturday, August 12, for dwelling damage from a bedroom ceiling that collapsed/fellOur after-hours adjuster immediately contacted Ms*** and set up temporary housingWe spoke with our insured on August 14, 2017, regarding the facts of loss and assigned an independent appraiser from Fourseventy Claim Management to complete a scope and estimate of damagesFourseventy inspected the residence on August 15, but was unable to opine a cause of loss other than a “...proper bond of the glue between the rafter and drywall panel may not have beenachieved.” We retained Envista Forensics to inspect the residence and determine the cause of lossThe inspection was completed on September 25, with Ms*** presentIt was the engineer’s opinion that the drywall ceiling fell due to inadequate attic ventilation coupled with improper nail spacing which led to withdrawal of the drywall nails from the truss bottom chord supporting theCLMS (2013)ceilingBased upon the engineer’s opinion, there would be no affordable coverage for the loss and the insured was advised of the sameThe insured was provided temporary housing during our investigation, starting August 12, 2017, and it was ended on October 13, given the coverage decision.We trust our response addresses the concerns raised in the inquiry to the DepartmentPlease do not hesitate to contact us if additional assistance is required.Very truly yours,Susan MChamberlinClaims SupervisorQBE Americas, Inc(QBEAI)E-mail: [email protected]: 770-850-

Re: Your File # ***
Consumer: *** ***
Company QBE Insurance Corporation, NAIC This letter will serve to acknowledge that we received your above referenced complaint in our office on January 5,
QBE is committed to providing its customers with high quality products and services Your comments are important to us in this process
Sincerely*** ***
Complaint Coordinator
Corporate legal
QBE
Direct: ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
*** ***
I have not received a call form PT&C Forensic Consulting ServicesI will be contacting my insurance and PT&C Forensic Consulting Services to scheduled an appointment

A review of our records indicates that on December 16, 2014, Ms*** reported a claim for a theft from the insured residenceA payment was issued to the insured for the Actual Cash Value of the stolen items less the policy deductible and recoverable depreciationUnder
the terms and conditions of the policy, the insured has plus one day from the date of loss to submit receipts to recover the initially withheld depreciationIn this case, the receipts were received from Ms*** on December 23, some seven days after the recovery period had runAs this was within a week of the expiration, we will go ahead and honor the submitted receipts and send payment to our insured for the depreciation.Should you require any further information on this claim, please contact us directly at ***Very truly yours,
*** ** ***Assistant Claims Manager

Dear *** ***,Re: Policy number *** Agent code ***This letter is in regards to your recent request for a listing of your loss history for your homeowner insurance policyYour original policy effective date was 4/24/Your policy is currently active as of 2/28/Your five year claim history is as follows:Date 4/26/14Claim number ***Loss BurglaryAmount $3,693.33Closed N/AIf you have any further questions, feel free to contact us at the address or phone number provided above.Thank you.Sincerely,UnderwritingCustomer service: 866.318.2016Fax: 855.268.9567E-mail: [email protected]: Your Case ID: ***NAIC Number: ***Insured: *** ***Policy Number: ***Claim Number: ***Date of Loss: 04/26/14On February 28, 2017, our office received the above referenced complaint submitted by the Wisconsin Revdex.com on behalf of *** ***Please accept this response to theconcerns pertaining to claim number ***.A review of our records for policy ***, issued to *** ***, reflects one reported loss for a theft from an automobileThe claim was reported on May 9, and closed on July 18,The total indemnity paid to the insured was $3,Attached is a letter of claims experience reflecting the same.We have notified *** *** that our account reflects only one loss, not three, and request that they correct their data.We trust our response addresses the concerns raised in the inquiry to the BureauPlease do not hesitate to contact us if additional assistance is required.Very truly yours,*** ** ***Claims SupervisorQBE Americas, Inc(QBEAI)E-mail: [email protected]: 770-850-

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

This letter is in response to the recent inquiry dated June 17,sent from the Revdex.com of Wisconsin received in our office on June 22, on behalf of *** *** and her concerns regarding the cancellation of her voluntary Renters Insurance Policy, number ***QBEFIRST
Insurance Agency ("QBE FIRST") is the Program Manager for this insurance company and is responding on behalf of Praetorian Insurance Company ("Praetorian") and its designated third party QBE Americas.According to records, MsG*** was advised on May 12, during a telephone conversation with a customer service representative, that per company policy we are unable to back date the cancellation of the policy in question back to 2014.The customer service representative further advised, that because MsG*** policy had renewed effective March 26, for the following tenTI, the cancellation could only be retroactive back to that dateHowever, to process the cancellation, documentation was needed to verify the date in which MsG*** moved out of the covered residenceThis process is part of Praetoriatl'S cancellation policy which states for Renters whom have Reason for Cancellation: Moved to New Property: Insured Billed: Start of current term onlyDocuments Required: " Move in/move out statementNew policy Dec pageLease Agreement or Release From LeasePost Office Change of Address formUtility Bill*Must include insured's name and property address.Future renewals are not considered current term MsG*** was provided with the fax number to fax in the requested documentation. Records reflect that MsG*** contacted customer service again on May 19, regarding the same issue and was again advised of the company cancellation policyOn May 20, 2015, the requested documentation was received and the policy was cancelled effective March 26,At this time the policy is cancelled. We trust that this response addresses the concerns expressed in the Bureau's inquiryIf any additional questions should arise, please feel free to contact me directly at (*** extension 7325.Sincerely,*** ***Senior Compliance Analyst

The claim adjuster *** *** working on our office claim, was rude, insulting, condescending and unreasonable!!!
Our office had water damage in the kitchen/conference room affecting the cabinets and flooring*** suggested that our contractor check into USED cabinets or stores such as "Habitat" to find replacement cabinets!! *** has very poor customer service skillsSubsequent dealings with her was very difficult!!!
I left messages to address our concerns to the *** ** *** *** but unfortunately, I never heard back from ***This is the FIRST claim our office had in over years of having been insured by this company

This letter will serve to acknowledge that we received your above referenced complaint in our Office on April 12, QBE is committed to providing its customers with high quality products and servicesYour comments are important to us in this processYour inquiry has been forwarded to an
authorized person for a response to your requestSincerely, *** ***
Senior Complaint Analyst Corporate Legal QBE