Spice Restaurant

This homeowner filed a claim under a policy add-on he had not purchased with his base one-year policy. While the claim was, as the homeowner indicated, initially approved for a set amount should the add-on have been purchased with his base policy, a final review revealed the homeowner did not...

purchase the add-on and so his policy did not cover for the claim. Giving approval for a homeowner to contact their own contractor does not equal a blanket approval of any associated costs; it was made very clear that the contractor would have to contact us with a written estimate and diagnosis before the claim could be processed. While no written estimate or diagnosis was provided, the homeowner did submit a receipt for reimbursement after the repair was completed. Upon review of the invoice, it was clear that this claim was not covered under the homeowner’s policy due to the lack of the add-on. We here at RWS greatly value customer satisfaction and try to ensure the homeowner’s awareness of all covered and non-covered items in their warranty with us – we also try to cater to our customer’s needs by offering base policies with standard coverage and allowing each homeowner to build a custom policy with our add-on services, so that their final warranty covers only what they need covers and fits in their budget. If a customer chooses not to purchase an add-on for something they have in their home, RWS cannot be faulted for denying a claim for non-coverage.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this response/resolution is satisfactory to me. 
Regards,
[redacted]

It should be noted that this homeowner filed a claim on 1-27-2017 (a Friday), and filed this Revdex.com complaint 1-31-2017, not even two business days after the claim was submitted. As a result, the homeowner has not provided documentation, as required pursuant to his policy, that would allow RWS to...

continue processing his claim - the homeowner’s Platinum Roof Protection Plan covers “repairs for leaks only” and “consequential damage is not covered”. Therefore, to determine exactly what is covered, we require a breakdown of the estimate. Additionally, there is no “written diagnosis’ provided. Furthermore, this policy clearly states “any defect noted in your home inspection or any consequential leak resulting from a defect noted in your inspection is not covered. If your inspector noted damage, leaks, improper installation, or worn materials, it is the responsibility of the homeowner to remedy these conditions.” The homeowner’s inspection report clearly states. “open seams on the roof were observed. This could lead to a leak. Contact a roofer to further inspect the roof and make necessary repairs” in numerous locations. Furthermore, the inspection report states “patches were observed on the roofing. Patches are a temporary fix and need to be monitored. Budget to make permanent repairs” along with “no counter flashing over step flashing. Counter flashing is needed to prevent water from getting behind step flashing. Recommend roofing contractor make needed repair”. Therefore, as the home inspection report clearly lists multiple defects with regards to the roof, and specifically leaks - with just the information provided the homeowner's claim is clearly precluded from coverage, and his claim will be marked as such. If the homeowner has any additional information, such as an itemized repair estimate or written diagnosis to counter any of the above information, please submit it prior to your policy’s expiration date and we here at RWS will be happy to review.

Thank you for your 14 July 2015 letter to Residential Warranty Services, Inc. ("RWS"). I've reviewed the letter and it appears the policyholder violated the terms of his warranty, which negates this claim's coverage under the warranty and, as a result of this violation, detailed below, the claim...

continues to be denied.
The homeowner called RWS 19 June 2015 to ask about reimbursement for his air conditioning claim as detailed in the complaint. Unfortunately, the homeowner broke RWS protocol, which he should have been abundantly aware of as he's had a policy with RWS for over seven (7) years, which negated this particular claim. Specifically, the policy clearly states, in bolded, capitalized font, "DO NOT CALL A CONTRACTOR BEFORE YOU CALL RWS". It goes on to state, "RWS will not be liable for any costs associated with a contractor selected by the policyholder without prior authorization. Policyholder's contractors contacted prior to making a claim with RWS and without prior authorization will not be considered for servicing any claim, nor will any bill be reimbursed."
In the case at hand, the homeowner contacted a contractor, had the unit REPLACED, and then called RWS after the fact, in direct violation of the policy, for reimbursement. The claim was denied and, on 13 July 2015, when the claims representative tried to again explain the policy denial to the homeowner, which the homeowner should have been familiar with due to his years of contracting with RWS, he began yelling at her and not allowing her to speak.
RWS would like to note here that customer service is one of their highest priorities and any complaint is taken very seriously. However, unfortunately there are customers who feel the right, or the need, to verbally abuse the representatives or receptionists who answer the phones, who are only trying to fix the situation. In these cases, our representatives are informed to bring over a manager or director to witness the abuse. If the manager/director agrees that the abuse has reached a level that the representative is simply being held on the line by the policyholder to be continually abused, with the policyholder refusing to allow the claims representative to explain or gather information to possibly remedy the perceived problem, our representatives are allowed to politely warn of the pending disconnection and, if the abuse continues, to disconnect the call. We do this to protect our representatives who have no other remedy by which to protect themselves from the abuse some policyholders feel they are entitled to dole upon them.
In the case at hand, the claims representative followed protocol completely and, in full view and with the support of her director, informed the homeowner that, should he continue to yell and abuse her verbally, she would be forced to disconnect the call. He continued the abuse and the phone call was subsequently ended.
Notwithstanding the abuse and disconnected telephone call, RWS followed the verbiage of our carefully constructed warranty and, though we deeply sympathize with the Customer's situation, proper RWS protocols were followed at all times, as were policy terms and conditions. The policyholder blatantly violated the terms of the warranty and, per the terms of the warranty, RWS is not responsible for paying for a repair for which no prior authorization was given. The claim will continue to be denied.
Sincerely,
 
Alix L. [redacted] Esq.
Corporate Counsel — Residential Warranty Services, Inc.
[redacted]
(317) 573-[redacted] (tel.)
(317) 218[redacted] (fax)
[redacted].com

The homeowner has stated she has a year-long home warranty in place with ANOTHER warranty company (not RWS). As a result, per the terms of her warranty with us, “the coverage under this policy shall come after any and all other warranties in place [emp. added].” Therefore, the homeowner, must file...

the entirety of her claim with her other warranty company. However, as a goodwill gesture from RWS to this homeowner, she may keep the check RWS has already mailed to her as we strive to go above and beyond our obligations to our customers, every time.

It is clear this homeowner does not wish to honor the terms of the warranty and that he would rather resort to extorting a company for more money, evident not only by his responses to the Revdex.com but by his contacting a reporter, providing that reporter false information, and then insinuating that, unless RWS pays his ransom price, our name will be dragged through the mud. This is unacceptable and abhorrent. At this point, the homeowner has clearly declined the previous offer set forth and so the owner of the Company has asked me to offer the homeowner, one final time, the initial offer of $375, no review required. Of course this final offer is dependent upon this payment settling the issue for good. If the homeowner accepts this amount, he must respond to the Revdex.com accordingly by noon tomorrow in order for a check to be both processed and mailed tomorrow as any further delay in an acceptance will result in a delay in receiving a check. Otherwise, if the homeowner continues to push for more money or otherwise threaten or extort RWS, the original buyout amount of $225 will be processed and this issue will be litigated elsewhere with the homeowner keeping in mind that he will be held both legally and financially responsible for any damages that occur due to any defamatory statements that are published about our company due to his statements.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
This is a company who holds customer satisfaction at a high level but yet we’ve filed a claim April 28th 2016 and they didn’t send anyone out to follow up on the claim and we were put into a position to go to Hiller Plumbing to find out why we have a leak coming from the shower areas, under sink and toilet. RWS Warranty had an opportunity to send someone that was contracted with them to get whatever information they desired without having to depend on Hiller Plumbing for a break down. We shouldn’t have to talk to OUR contractor which we don’t have one to fix our leak issue. RWS Warranty should be talking to their vendor who they’ve sent out to fix the issue (they NEVER sent one). Also RWS Warranty alluded to a buyout which we don’t have any knowledge of or paper work to confirm any buyout. They allegedly claim they have paperwork but won’t send them because my wife and I contacted Revdex.com. It’s been 20 days and still RWS Warranty has not sent their own contractor out to follow up on our claim nor did we receive any funds from them to take care of this issue. We have voice recordings from telephone conversations we’ve had with RWS Warranty trying to get this issue taken care of. I don’t know how you fix a leak problem when RWS Warranty are stating we’re not covered under Hiller Plumbing break down but yet we’re covered to fix the leak. Very confusing but RWS holds customer satisfaction at a high level. 
Regards,
[redacted]

The homeowner’s termite protection plan covers “new infestations” after the home inspection. The homeowner filed a claim stating they witnessed termites but, in the estimate they submitted, the contractor only confirmed the home inspection’s previously disclosed findings and there was no indication...

in the bid that new termite activity had been found. As a result, the damage appeared to be pre-existing, which precluded coverage and so the claim was denied.After the denial was mailed, the homeowner’s home inspector called in and explained to the Director of the Warranty Department that the homeowner had seen new termite activity and he argued their case. The Director exercised his discretion and had the homeowners’ claim representative call the contractor directly to find out what was going on. The contractor stated that he was unaware the bid was going to a warranty company and so he wrote the bid for the homeowners, leaving out the new infestation signs and the price breakdown required. After speaking with him, it was apparent that the homeowner’s claim was covered. The contractor told RWS that they would charge $910.00 to chemically treat the infected areas, which is what the homeowner's plan covers, and the Director approved the amount. As a result, a check in the amount of $660 ($910 – the homeowner’s $250 deductible) was submitted earlier this month and mailed 12 July 2016.If the homeowner would like to decline the buyout check, RWS is happy to re-review the claim a second time (with no guarantee that the review will result in a higher buyout amount). To re-open their claim, the homeowner simply needs to VOID and return the buyout check and provide an estimate for chemical treatment of the infected areas only, which is the treatment covered by their warranty, and the claim will be re-opened immediately.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID[redacted], and find that this resolution would be satisfactory to me.  I want to also inform you and RWS, that I placed this complaint in the morning and spoke with Mr.[redacted] in the afternoon.  It took this situation 5 months to be resolved.  I have been working very hard and at my day job and I am currently out of town on business. I had not had a chance to write back to the Revdex.com to update them on our conversation. I do apologize for that.  I am so glad Mr. [redacted] decided to help us 5 months later and blame us for their mistake.  Our Family of 6 mouths to feed are very much appreciatiative. Thanks to the Revdex.com for your prompt action in this situation.
Regards,
[redacted]

All of the homeowner’s raised questions have been addressed, including by quoting the policy itself, in RWS’s previous responses. We here at RWS urge Mr. [redacted] to review his policy, and our previous answers, thoroughly. As stated earlier, Mr. [redacted]’s policy is still marked for cancellation without refund due to his refusal to pay the clearly delineated fees associated with this warranty. Once RWS receives confirmation of the payment, we will be able to work with Mr. [redacted] with regards to his air conditioners. If there was no work done, as Mr. [redacted] alleges, the contractor should have no problem giving RWS written confirmation of the same, along with an explanation detailing the reason for the discrepancies in the invoice given to the homeowner (per Mr. [redacted]'s claims) versus the invoice submitted to RWS. Otherwise, as stated earlier, Mr. [redacted]'s policy will be canceled in accordance with the cancellation provision included therein.