Society Insurance

Society Insurance is in receipt of Ms*** complaint and your letter dated Wednesday, August 17, 2016. The letter was received by our CEO on Friday, August 19, 2016. This matter has been forwarded to my attention for review and response to your office. Society Insurance
is the commercial general liability insurance carrier for NJB Ops LLC, which does business as Taco Bell, located at the above captioned location in Crystal Lake, Illinois. Our policyholder reported the above captioned claim/matter to us on July 1, 2016. The incident was assigned to *** *** in our claims department for further investigation. On July 1st, MsFrailing spoke to the complainant, *** *** and obtained a recorded statement over the telephone. The facts of the alleged incident were reviewed during that recorded interview. Ms*** could not identify any foreign object or product contained in the Mexican pizza she ordered, only that it tasted “funny” and tasted like “plastic” or a “chemical”. Ms*** alleged to have suffered from stomach cramping and diarrhea which began two hours after ingestion of the food purchased at our insured’s Taco Bell location. Ms*** did not seek any medical treatment (that we have been informed of) to support her claim of a food related illness caused by any product purchased at the Taco Bell location in question. Although she still admits to having the Mexican pizza at issue in her possession, she has not had the alleged food product tested to support her claim that there was a foreign object on the food product which caused her to become ill. In these types of situations, the burden of proof is on the person making the complaint. Absent that evidence of proof, Society Insurance is unable to take any further action on this matter. Based on the lack of proof and no other complaints by Ms***, the other parties she dined with off premises, or any other of the numerous customers on the date in question, our claim representative, *** ***, issued a denial of liability letter to Ms*** very promptly after her investigation was complete. We had no evidence to support a claim for illness caused by the food product purchased and no other complaints. Since that time, Ms*** has not provided any additional evidence to support her claim(s). The final issue I would like to address is Ms*** allegations that *** *** was “very rude and cheated me with disrespect”. For the sake of my reply, I am presuming “cheated” is a typographical error and Ms*** meant “treated”. Although I was not privy to any of the direct telephone contacts between Ms*** and MsFrailing, I can assure you that our claims staff is held to very high standards with regards to customer service and etiquette. To help management gauge and measure the satisfaction of our customers and policyholders, surveys are sent out after closure of a claim file. *** *** has been employed with Society Insurance for several years. She has in the past and continues to receive excellent customer service responses on her claims. For example, her rating in the category ofCourteous/Professional is 94.86% and 96.59% of the policyholders she has interacted with in her position have stated they would Recommend Society Insurance as an insurance carrier to their peers. In sum, there is always “two sides to each story” and your letter dated August 17thasked for Society Insurance’s version of the events. I can understand that Ms*** is upset with the outcome of her claim, but we have absolutely no evidence to support that she became ill from a food product made and purchased from our insured’s location. She has provided no medical or scientific evidence to support her allegations. Absent that, we are unable to take any further action on her claim. Please let me know if you have any further questions or require further documentation. Thank you, *** *** AIC AISClaims Manager Property, Auto and Liability Claimsext

See Attached

On January 30th, 2015 I received your letter in regards to a complaint filed by Ms. [redacted] At Society Insurance we pride ourselves on providing prompt, professional and personalservice. Upon reading Ms. [redacted] narrative I immediately gave her a call. She explained...

her experience in detail. I was able to identify areas of miscommunication between our organization andMs. [redacted]. The Wisconsin Compensation Rating Bureau (WCRB) requires a 30 day waiting period before a cancellation request becomes effective. That does not take away from the fact that uponcancelling our internal processes could have been expedited. That option should have been extended toMs. [redacted]. Within the complaint Ms. [redacted]'s desired settlement was to have the return premium mailed immediately. I confirmed that a check was mailed on the 1/26/15 to the address and named insured onthe policy. On 1/28/15 Ms. [redacted] contacted the billing department and requested the check be made in her name and mailed to her new address. We promptly stopped payment on the check that wasmailed on 1/26/15 and reissued another. I told Ms. [redacted] I will personally follow-up with her on Tuesday, 2/3/15 to verify the check had arrived.[redacted]Audit Manager[redacted]
[redacted]

Review: On July 8, 2013 I sent an email directly to Society Insurance, Mr. [redacted], property claims specialist, requesting him to email as an Attachment my entire loss claim adjustment report along with all of the pictures, forms, written reports my adjuster made when coming out to my Restaurant location and taking/handling my loss of claim. The issue is at a dead end, I am also entitled to a pay out for my claim, however society insurance refuses to pay me my claim loss check. This is a substandard insurance company and I pay a lump sum premium to have coverage in my establishment. I want society to send to your office all of my loss of claim paperwork along with my pictures taken by my adjuster and all of the paperwork my adjuster sent to them. [redacted] was also sent a written Authorization form from me personally granting full authorization for my nephew [redacted] to handle this matter. [redacted] stated he mailed out the originals on July 10th. it is now July 21st and nothing has ever happened.Desired Settlement: I want society to send to your office all of my loss of claim paperwork along with my pictures taken by my adjuster and all of the paperwork my adjuster sent to them.

Consumer

Response:

Review: Last year (In June) I got food poisoning from [redacted] in which I want sent to the hospital. While at [redacted] after filling out a statement and incident report, I was told that for any reason I may have to seek medical attention that their insurance (SOCIETY INSURANCE) would take care of the hospital costs, which equal too $1,204.25.

Last year after talking with blessing hospital I was told that blessing was billing society and that it was taken care of. Apparently society insurance tried to "contact" me for further information in which I didn't receive anything. I just found out in January of this year 2014, that society never paid the bill. So jumping through hoops, I finally got a hold of [redacted], who was taking care of my claim. She has been unprofessional. The first time I called her I waited 72 hours for her to return my phone call and she didn't. I called back, I figured she wasn't going to call me back. When I called the second time, she answered and told me she got my message! just didn't return it. She pulled up my file and proceeded to tell me that she was busy that day and scheduled to speak to me the next day at 9:00 am because I work over nights. I called her at 9 and she didn't answer. She didn't get back to me until 1:00 pm. We talked, and she said that she saw no problem with putting my claim through and told me that it would be taken care of. I called the hospital today and she still has not contacted them or put that claim through. I'm very frustrated, and at my wits end with this whole situation, this has now affected my credit and I need answers and help from someone who will actually give me the time of day.Desired Settlement: I want that bill paid that was promised to me.

and would like to discuss options for the stress I have been going through because of this representative.

Business

Response:

On 2/12/2014 Society Insurance received a complaint of [redacted] regarding an incident at Society's insured location. The policy in force at the date of loss has medical expense coverage that applied to this incident.

I slipped and fell at work and now I'm battling with Society Insurance. The Workers Comp doctor took me off work until a "specialist" can look at me. However, Society Insurance called me and told me that the doctor made a mistake and ordered me to return to work ASAP. I didn't get a call from the doctor or from his office telling me this, so I went to him.
Come to find out, the doctor said to me that he NEVER spoke to anybody and that he NEVER said such a thing.
Society Insurance lied to me and when I confronted the case worker about this, she wouldn't back down and insisted that I return to work ASAP.
Well, I didn't. In fact, I waited to see the "specialist" to see what he had to say. Come to find out I tore 1/3 of my right rotator cuff and was told NOT to use that arm at all.
I've since got a lawyer.
Avoid Society Insurance if you can.

Review: I sold my business on Oct. 24th, 2014. In August of 2014 I renewed my Workmans Comp Ins., with Society Insurance, in full. I contacted them when I sold the business, and was told I would be issued a refund since I only operated the business for 3 months after paying for a full year. I never received anything, so continued to contact them until I finally got a response that 30 days after the sale I would receive an audit that I would need to fill out, pertaining to those 3 months. I had to continue to contact them about "not" getting the audit. I finally received the audit on Dec. 22nd, and it was dated Dec. 19th. I filled it out and emailed it back to them that day. Still, I heard nothing back from them.

I then emailed them on January 13th, regarding again "no response" regarding my refund. This is the reply I received: Dear Mickey, I am truly sorry for any inconvenience this may have caused you. We did receive you audit back on 1/12/14 and it will be processed today, and the moneys owed to you will be sent.

Thank you, [redacted] Audit Department [redacted] Ext. 5666

I had understood that this money owed me would be sent out on the day I got the email from the Audit Dept, according to the wording in the above email.

I have stressed to them, time and again, that because the check will be made out to my former business name, that I have to continue to keep open an account that I can no longer use, for the sake of being able to cash this check. This account requires me to keep $500 to avoid a monthly service fee.

As of yesterday, Jan. 20th, I still had not received a check. I am in Wisconsin, Society Ins. is in Wisconsin...this shouldn't take forever to get mailed out.

I then emailed again yesterday, and received this response: The billing department says the refund check will go out on 1/26. Which is your billing date.

Thank you,

Tamara Simon

Audit Department [redacted] Ext. 5666

I, however, do not believe what is stated in the above email, because I have been misled for so many months now. Also, the billing date for this insurance, when I was renewing it annually for the business, Waggin' Tails Training Company, LLC, was actually in August.Desired Settlement: I would like this refund sent to me immediately, as I have been told too many times that "someone will be taking care of this" , or it will be only so many more days, or months. This is not a good business practice, and I, as the customer, truly has absolutely no faith that I will ever see what is owed to me.

Business

Response:

On January 30th, 2015 I received your letter in regards to a complaint filed by Ms. [redacted] At Society Insurance we pride ourselves on providing prompt, professional and personal