Please be advised we have received an inquiry from the Revdex.com (Revdex.com) of San Diego,the California Department of Insurance and through Wawanesa General Insurance Company's website"feedback" page regarding the above-captioned lossAttached to all three pieces of
correspondence wereceived your description of your concerns and your desired outcomePlease accept this letter toaddress your concerns as registered to the entities mentioned above.By way of background, this will confirm you carry an HHomeowners policy with WawanesaGeneral Insurance CompanyYou reported a water loss to our staff on November 4, 2014, indicatingyou noticed a leak at your kitchen ceiling, which is directly below an upstairs showerWe immediatelyestablished a claim and initiated an investigationDetermining the cause, origin, and duration of the water escape is a common and critical component inthe investigation of any presented water lossAs such, we provided referrals to you for plumbers whohave expertise in leak detectionAfter conducting your own research about plumbing vendors, youselected American Leak Detection to inspect the plumbing leak in questionThey visited your home onNovember 10, After performing a thorough inspection, they determined that the water leak wasfrom failed tile grouting and that re-grouting of the shower was a needed maintenance item.Importantly, the plumber opined the water escape from the failed grout was days oldWe discussed the claim further with you on November 13, 2014, at which time you confirmed the tileshower enclosure was original to your home, which was built in We also reviewed yourhomeowner policy contract wording with you regarding an exclusion which appears to apply to thislossThe pertinent portion of the policy reads as follows:
SECTION I- EXCLUSIONSAWe do not insure for loss caused directly or indirectly by any of the followingSuch loss isexcluded regardless of any other cause or event contributing concurrently or in any sequence tothe lossThese exclusions apply whether or not the loss event results in widespread damage oraffects a substantial areaWaterThis means:eContinuous or repeated seepage or leakage of water or the presence or condensationof humidity, moisture or vapor, over a period of time greater thanldays.The policy also outlines duties of policyholder, such as youIn particular, please refer to:SECTION I- CONDITIONSCDuties After LossIn case of a loss to covered property, we have no duty to provide coverage under this policyif the failure to comply with the following duties is prejudicial to usThese duties must bepe1jormed either by you, an "insured" seeking coverage, or a representative of either:Cooperate with us in the investigation of a claim;As often as we reasonably require:aShow the damaged property;
We offered to inspect your damages and secure your statement, but you declined these offers and statedyou were expecting a denial letter from usInstead, we sent you a letter on November 21, 2014,confirming you were withdrawing your claimWe next heard from you on December 2, 2014, with a request that a different plumber inspect the loss.We agreed to this request and *** *** inspected your residence anew on December 3, 2014.Not surprisingly, that plumber confirmed the findings of the first plumber; namely, that worn tile groutand caulking were the leak failure sources, and that the duration of the leak was "more than a monthprior to discovery on October 30, 2014." Wood rot at the subflooring was also observed, whichprovides further evidence of the long-term nature of the water leak eventWe informed you of these further investigative results on December 4, 2014, and have been attemptingto obtain your recorded statement ever since, in order to conclude our investigationJanice *** ofAdams Adjusting is assisting in this portion of the investigationYou may recall she completed aninspection at your homePlease contact her to provide your statementShe can be reached atIn the meantime, we have offered to pay for the kitchen ceiling drywall access cutmade by the *** *** technician, as part of the inspection and diagnosis processWe willforward this payment to you under separate coverIn closing, we respectfully disagree with your various critiques surrounding our handling of yourreported claimIn fact, we have gone to great lengths to provide superior customer service whileconducting a thorough and accurate investigationPresent evidence leads us to advise you of thehomeowner's policy exclusionary language mentioned above, and we encourage you to mitigate yourdamages at this timePlease continue to cooperate with our investigation by providing your statementto Ms***, so we can reach a final conclusion in this matterIn the meantime, by copy of thisletter, I'm informing the San Diego Revdex.com and the California Department of Insurance of our positionthat while we have handled this matter in an appropriate manner we are attempting to conclude ourinvestigation and provide you with a resolution
February 9, The Revdex.comAttention: Ms*** ***Viewridge Avenue, Suite 200San Diego, CA RE: Complaint ID Number: ***
Dear Ms***:
Enclosed is our response to the above referenced complaint numberAs explained to
our insured, we are experiencing a very unexpected 17% increase in phone volume toour call centerWe are doing everything we possibly can do at this time to address our service levels.I have placed several calls to our insured hoping to speak with him directly about his concernsI havehad no replyOur insured did speak with a representative on February rd to change vehiclesThat change was placedon hold per his request pending his approvalIn seeing that this complaint was made after he spoke with us and his desired settlement is to cancel hispolicy, we will do as he has requested and cancel his policyAs explained to our policyholder, we are actively interviewing, hiring, and training new Customer ServiceRepresentativesRegrettably, this process does not happen overnightCall Center Leaders have beeninstructed to assist serving the Customer Service queue during this timeWe sincerely apologize for not being able to provide and meet expected customer serviceSincerely,*** * *** _Vice President, U.SOperationsWawanesa General Insurance Company*** *** ***
What has happened to Wawanesa? They no longer answer their phones, nor do they call customers back as they say they will This leads me to worry that my prepayment for insurance through April is money thrown out the window I took the day off from work to ask a question regarding dropping a car and driver from my insurance, but it looks as though it was a day wasted They used to be a good company years ago, but now it's rate increases and customer service decreases I am posting this to warn off new, unsuspecting customers I believe your A+ rating does not reflect the current picture
We are in receipt of your complaint filed with the Revdex.com on March 19,
In response, I have reviewed the claim file
I understand you spoke to supervisor, *** ***, on March 19, 2014, regarding the payment of
your rental car expenseSince you
feel your vehicle is not safe to drive as a result of the
damaged mirror, *** *** agreed to pay your rental expense, per the terms of your policy
The Rental Expense coverage pays up to $per day for a maximum of days
In addition, you spoke to supervisor *** *** on March 20, 2014, and he explained the use of
like kind and quality parts in the damage estimate we wroteI hope the two supervisors
answered you questions adequatelyIf they did not, please feel free to contact me directly
I would like to apologize for the misinformation you received from our office regarding
payment of your rental car expenseIt is our desire to provide the best possible service to our
policyholdersHowever, the service you received on this claim was below this standard, and
certainly below your expectation
Again, should you have any additional questions or concerns, please don't hesitate to contact
me directlyMy office hours are Monday through Friday, 7:30am to 4:00pm at (858)522-
Sincerely,
Wawanesa General Insurance
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
It was said in the response letter that *** *** has been trying to contact me and that is an outright fabricationI have left several messages at 858-522-*** after we received a letter from Wawanesa and have received nothing back in turnThis is the typical treatment we have been getting from Wawanesa in regards to this problemThey are an insurance company that we have been with for close to yearsWe have a letter dated in January from *** *** saying that they denied our claim and we had months to get a lawyerNo lawyer will touch this because its not worth their time money wise*** *** and the Risk management Division of San Bernardino are outright Liars and should be released of their positions
If *** *** or Wawanesa needs to get a hold of me all they have to do is call my number ***I have good coverage and do not miss callsThe last message left for this individual was 05/25/at 3:34pm so please do not lower yourself and state you tried to get a hold of me when its obvious you have not
Regards,
*** ***
Telephone support still plagues customer supportAs a policy holder, I required some information on my policyI called the number on Saturday Octand waited on hold for over minutesThe automated system gave me the choice of pressing "*" for a return call (not loosing my place in order)Pressing "*", on the third attempt, I was finally successful in getting a response to leave a message for a return callCome Monday morning I still had not received a return callCalling again on Monday morning resulted in a minute hold before connection with a representative where I registered my complaint and received the same excuses they have been expounding for the past seven months (at least)Not a good situation for a company in business
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
We did contact *** *** who is an extremely rude individual and tried to pit my wife and me against each other by lyingWe have a letter sent to us by her denying our claim and did send a letter to them letting them know of ***'s lack of decencyWe pay you the insurance company to deal with these incidents and you have failedYou have stressed my wife and I beyond belief by your laziness and lack of decency
Regards,
*** ***
January 22, *** ***Revdex.comVIEWRIDGE AVE, STE 200SAN DIEGO CA Re: Complaint ID: ***Insured: *** ***Cancelled Policy Number: ** ***Quotation Number: ** ***
Dear Ms***:
We have
received and reviewed the complaint filed with your organization by our priorpolicyholder, Mr*** ***The following is a summary of the policy transactionsand an explanation of the handling of Mr***'s cancelled policy and quotation issued.Mr***'s original policy, ** ***, was effective March 22, and has renewedeach consecutive yearPrior to the cancellation, the below transactions occurred on thepolicy:
February 27, - An "Offer to Renew" effective March 22, 2014-March 22,2015was mailedTotal policy premium $Down payment of$due before March 22, 2014; Payments to be billed:$due June 22, and September 22, March 26, - Mr*** contacted our Customer Service Department to makethe renewal paymentA renewal payment of $was madeand the policy was reinstated effective March 27, April16, - Mr*** contacted our Customer Service Department to add avehicle to his policyThe policy changes were made effectiveMarch 27, 2014; and an amended declarations policy was mailedshowing new payments to be billed in the amounts of $dueJune 22, and September 22, 2014.Mr*** also requested to delete a vehicle from his policyeffective April17, 2014; and a subsequent amended declarationspage was mailed with payments to be billed in the amount of$due June 22, and September 22, May 19,- Mr*** requested to add another vehicle to his policyThispolicy request was effective May 8, and the total policypremium with all the policy changes was $(includingservice charge)After subtracting the payment of$312.00previously received, the account balance was $Anamended policy declarations page was mailed showing newpayments to be billed in the amount of$due June 22, 2014and September 22, June 25, - A payment of $was made on the policy leaving a balancedue of$No additional payments were made on the account although billing notices were mailedOn October 25, 2014, a Notice of Cancellation effective November 14, 2014, was mailed.Since no payment was received by October 25, 2014, the policy cancelledOn November 22, 2014, a Notice of Premium Due was mailed requesting payment forearned premium due of$Finally, on December 6, 2014, a Delinquent Notice wasmailed requesting the outstanding amount due of$Mr*** contacted our Customer Service Department on January 6, to discussreinstatement of his policyHe was advised that due to the length of time the policy hadbeen cancelled; he would need to reapply; and prior to reapplication, the outstandingamount of $would have to be paidA representative in our Inquiry/Quoting Department spoke to Mr*** on January 6,and the information was taken for the new quotation (Quote #** ***).However, prior to clearing and releasing the quote, Mr*** was again advised the priorbalance must be paidOn January 7, 2015, Mrs*** *** spoke with arepresentative and she, too, was advised the prior balance needed to be paid before thequote could be releasedMrs*** then contacted our Customer Service Department toobtain assistance in making the payment on our EZ-Pay online service and the paymentof$ was made on January 8, Mr*** then contacted our New BusinessDepartment; and after receiving confirmation of the payment, Mr*** was advised thequote would be sentQuote #** * * * *** * was emailed at 3: the same day to***Mr*** requested a call back from a supervisor; and theunderwriter gave the message to a supervisor for the call backAn underwriting supervisor contacted Mr*** that same day and Mr*** expressedhis frustrations regarding the service and the reapplication requirementAfter explainingthe process, the supervisor asked Mr*** how he could provide additional assistance toobtain his businessMr*** advised there was nothing the supervisor could do as hehad already obtained insurance elsewhereMr*** thanked the supervisor for the callback and the call was endedMr*** states in his complaint that he is uninsured although he advised the supervisorhe had obtained coverageResearch into our quoting database shows the quoteprepared for Mr*** has not been returnedAs qualified applicants, Mrand Mrs.*** are welcome to return their application for insurance coverageHowever, due tothe length of time, the prior policy has been cancelled, we would be unable to apply theLoyalty Discount as this discount applies to policies that have been continuously in forcefor more than one yearBecause there was an interruption in Mr***'s prior policy inexcess of days, he no longer qualifies for the Loyalty DiscountBased on the information explained, I ask that this complaint be classified as invalidIfyou need further assistance regarding this matter, please feel free to contact meSincerely,Underwriting ManagerWawanesa General Insurance Company*** *** ***
I have been a Wawanesa customer for 15+ years and I cannot believe how much they have changed
After being in an accident I felt like they were fighting against me! My wife was in an accident where the other person was 100% at fault (car was unattended) and they would not go to bat for us as the other insurance company came after us
I realize every business needs to make money but when you need someone in your corner I guess you have to pay for itWawanesa is very reasonably priced and great to have if you never need themBut when it comes down to helping you out, in my experience, they are not proactive (policy ***)
This letter is in response to the inquiry made by our insured regarding his inability to contact ourCustomer Service DepartmentA copy of my response is enclosedWe are currently experiencing, on a monthly average, an increase of calls to our Customer Servicequeue of approximately
25%That combined with training and implementation of a new processingsystem has hindered our ability to provide the type of service our policyholders are used to receiving.We are actively working on solutions to improve serviceWe have recently just had new CSRcomplete training and start taking live calls this weekWe will continue with the hiring processOurtraining program takes a minimum of weeks to completeFinding qualified applicants has beenchallenging with the improvement in the unemployment rateOur employees are working extra hours;supervisors and managers are taking calls; departments with employees who previously had experiencein our call center are offering help; and we have worked with our IS Department to extend systemsoperationsAs you can see in our response, our sincere apologies have been extended to Mr***I have providedhim with my direct contact informationIf I you have any additional questions or if I can be of any service, please do not hesitate to contact meSincerely
*** ***
Customer Service Manager
Ms***:
The attachment below provides a more detailed history of your payments for the both your home and your automobile policies As well, there are copies of endorsed refund checks of which you had noted you had not received.
The last payment you made to your automobile policy was in September of We were not able to accept the payment you made in January for a policy that had been cancelled for more than three months.
I hope this information provides the clarification needed to satisfy your complaint.
Regards,
*** *** | Customer Service Manager
When our insured first called us on September 22nd, there were some data fields in our new processing system that needed to be filled outUnknowingly, there was a glitch that occurred and generated a premium increaseOur insured contacted us September 28th after receiving a statement
of accountThe increase was backed outWhat did not happen were the payments returning to the way they were billed prior to the glitch.Unfortunately, the request to our Accounting Department to correct this matter was not completed and our insured had to contact us again on October 24thThe Supervisor she spoke with that day advised that she would personally make sure the corrections were made and call her backOur insured requested that someone with higher authority call her on MondayOur Customer Service Division Supervisor contacted our insured on Monday, October 26, While she was unable to speak with our insured directly, she did leave a detailed message which included an apology for the service she receivedOur Division Supervisor also left her contact information if there were any questionsAs of the writing, we have not heard from our insuredThis matter has been resolvedWe sincerely apologize for not being able to provide and meet expected customer Service
Dear Ms***:
I am in receipt of your complaint to the Revdex.com regarding the billing of the above
referenced automobile policy
Enclosed you will find a copy of your Automobile Insurance Application (#1)The total premium, for
your
policy effective March 25, 2014, was $You selected the 9-pay planBased on that
payment plan, 20% of the total premium was due to start the policy; you would then be billed 10% of
the total the 1st through 8th months after the policy startedThere is a $service charge for each
paymentI have highlighted this section of the application
Also enclosed is a copy of your Auto Policy New Declaration (#2)That declaration confirms receipt of
$and the subsequent payments to be billedAs you can see, your payments were scheduled
April through November
In May, a Notice of Cancellation (#3) was mailed to you because of non-payment of premiumThat was
for the April and-May paymentsWe received $via an online payment on June 13,We
mailed you a confirmation (#4) that payment was received and your new payment schedule
In August, another Notice of Cancellation (#5) was mailedThis was for the June and July paymentsWe
received $148.00, the amount billed on notice (#4), on September This only took care of your June
outstanding payment
We mailed you confirmation (#6) that payment was received and your new payment schedule
In October, a Notice of Cancellation (#7) was mailedThis was for July, August, and SeptemberI can
confirm that an online payment of $was submitted November (#8)
You stated in your complaint that you had not received any reminder notices that a payment was due
However, you did receive the notices of pending cancellation and the declarations confirming payment
had been received and the new payment scheduleI can see that the reminder notices were generated
and it is curious that you did not receive themWe have no record of any returned mail
You stated in your complaint, and you told one of our Customer Service Representatives, that your
husband had made a payment over the phoneAs our Representative advised, we have never taken any
payments over the phoneYou can make a payment online via our website, but not by phone
I am uncertain where the confusion has come from regarding your payment scheduleThe terms of the
9-pay plan were clearly stated on you application for insuranceAnd why you haven't received payment
reminder notices yet you have other correspondence sent from us
I hope this information has clarified the issues you raised to the Revdex.comIf you have any
further questions, please do not hesitate in contacting me directly
Sincerely,
*** ***, Customer Service Manager
We are in receipt of a letter from the Revdex.com dated May 20, 2015, in which theyincluded a copy of your complaint to their officeThis letter was received in our office onMay 21, 2015, at which time I reviewed the file with the adjuster, *** ***, to learn that he
hadthat day sent an email to *** *** with a tender of the Uninsured Motorist Bodily Injury limitsof $15,in settlement of *** ***'s claimPayment in the amount of $15,was issued thatsame day.Mr*** was able to conclude his evaluation of the claim at that time as he had received the recordsfrom your Chiropractor's office on May 20, 2015, after they had been retrieved and uploaded by ourcopy serviceI realize that you were both anxious to resolve this matter as quickly as possible and it isour desire to meet the expectations of our customersThere are times that retrieval of information fromother parties, such as medical providers, even when we are requesting it to be done on a rush, is notwithin our controlMr*** continued to follow up on the requested records in an effort to resolvethe matter with you as quickly as possibleAs soon as we had the remaining information we tenderedthe amount of your policy limits to you and issued paymentIt is our practice to not require a UM Release and Trust Agreement for injury claims in which we havepaid the full amount of the limitsThis allows you to seek further recovery from the responsible partyif you desireI hope that this matter has been concluded satisfactorilySincerely,WAWANESA GENERAL INSURANCE COMPANY
This letter is in response to your complaint to the Revdex.com regarding the loss of the above
reference policy numberI have read your complaint and reviewed the transactions that took place
starting with the posting of your payment for $to the above referenced
policy on May 1,
As we discussed today by telephone, we will honor the Persistency Discount and apply the discount to
your new policy ** *** which is effective September 4,
I did, however, want to provide you with a timeline of the events as well as copies of documents you
may not have received
You had a policy in force with the policy period June 24, to June 24, You paid the policy in
full June The payment posted on May 1, 2014, was almost two months before the policy would
expireThe policy term to be effect June 24, had not even been created yetThe payment of
$908.00, as noted, was applied on May to the policy term in force, on which no payment was due, so a
refund in the same amount was generated and mailed to you May 19, This refund was processed
by your bank on May 23,
The renewal process for the policy was initiated on May 30, 2014, by mailing to you an" Offer to Renew"
for the policy term effective June 24,
On June 30, 2014, we mailed to you a "Final Termination Notice" because a payment to renew the policy
had not been received
We did not hear from you regarding this matter until August 27, By that time, the policy had been
cancelled for almost two months
Our Persistency Discount does not apply to applicants who are not currently insuredUnfortunately,
this was your current status when you contacted us
As noted above, we will agree to apply the Persistency Discount
The policy and refund will follow shortly
Sincerely,
*** ***
Customer Service Manager
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.I do not ask Wawanesa to change MY policy. I ask them to change THEIR policy for all future leases. They state that they cannot, because they are regulated. I am currently purchasing new insurance that is also regulated by the state and it DOES cover my lease and official OEM Parts. It seems that Wawanesa doesn't know that they can become a better company.
I DO ask them to teach their salespeople to not fraudulently state that they will use ONLY OEM parts for any and all repairs. I did not "misunderstand" the customer service reps. I pointedly asked them numerous times. The salespeople and the supervisors I spoke with all admitted they were incorrect to try to sell me something they never had to sell.
I wish Wawanesa had admitted any failure on their part. The supervisors admitted it over the phone, but the company will not. I have paid well over $12,000 to Wawanesa in insurance payments over the years. For their lack of truth and integrity, I am now going to pay that amount to someone else for all future insurance needs.
Regards,
[redacted]
The truck tire popped on my wife while she was driving on the freeway recently. She was picking up our son from college a long distance away from home. This happened fairly early in the day (before noon). She contacted the company to help with changing a spare tire. The staff took way too long to arrive (at least an hour and a half), and when it turned out she did not have the tool to fix the spare and they didn't either, they were supposed to send a tow truck to take her and my sons to the nearest tire shop. They waited another couple of hours until a public highway tow truck that had passed by many times was forced to take them off the freeway because it was unsafe to remain there. She called up the company to let them know of their new location. She told them very specifically of their new whereabouts. After another few hours she called them up again, and the company told her they could not locate her. It eventually hit 6pm and still nothing. She had to call them up and tell them that all the local tire shops were closed and that towing them to a tire shop would be pointless by then since the shop wouldn't be able to help out that late.
My family ended up staying in a motel nearby and having to change their tires the next day. I filed a claim asking to be reimbursed for the costs of changing the tire and having to stay in a motel, since the costs were a direct consequence of their inability to help my family out in a timely manner. After weeks of waiting and terrible customer service, I finally asked again today. They replied by telling me that they were not responsible for the costs of the tire change or motel.
The fact that it took that long to get a reply over a measly $130 and still got a no from the company, despite being a loyal customer for many years, is ridiculous. I am immediately changing companies, as I do not want to deal with this type of incompetence. I hope the $130 were worth the long-time customer you just lost.
Re: Our Insured : [redacted]
margin-bottom: 5pt;">Policy Number : [redacted]
Claim Number : [redacted]
Date of Loss : December 01, 2015
Revdex.com ID Number : [redacted]
Dear Ms. [redacted]:
We are in receipt of your compliant as referenced above, We made successful contact with Mr. [redacted] on February 9", 2016. We advised him that settlement of his unrecovered stolen vehicle claim will be processed upon receiving his completed notarized proof of loss form. Mr. [redacted] confirmed he did receive this document, but believes he lost it. We have sent him another one as of this date. This sworn proof of loss is mandatory before we can issue any payments on his stolen vehicle claim. Prior to this conversation our adjuster had spoken to Mr. [redacted] on December 30", in which a recorded statement was taken and the claims process explained, including the need for his notarized proof of loss. We thank you for your inquiry into this matter.
Sincerely,
[redacted]
Material Damage Supervisor
Please see attached, thank you.
Dear Ms. [redacted]:
This office is in receipt of a letter from the Revdex.com, dated October 2, 2016, advising us you lodged a complaint on October 1, 2016.
The loss occurred September 6, 2016, and the claim was reported to us...
by your insurance company, [redacted] Insurance, on that same date. The claim was assigned to Adjuster, [redacted], who immediately initiated the investigation. Based on the information available to us, liability was accepted and we made arrangements to appraise the damage to your vehicle.The initial inspection of your 2011 [redacted] revealed it sustained damage to the right corner of the front bumper in the amount of $1,087.44. We issued payment to you in this amount on September 16, 2016. We subsequently received a supplement repair invoice in the amount of $498.99 and issued payment in this amount to your shop, [redacted].
When I reviewed the claim file, I found the appraiser who inspected your vehicle inadvertently used a hyphen instead of an underscore after your first name when emailing the damage estimate to you. I suspect this is the reason you did not immediately receive the estimate from him.
On September 21, 2016, you contacted Ms. [redacted] to notify her you did not receive the initial damage estimate and the estimate was emailed to you that date.
With respect to the rental car portion of your claim, I found that on September 23, 2016, you notified Ms. [redacted] you had an appointment with [redacted]. As such, she made a reservation for you with [redacted], and authorized $53.34 per day for a comparable vehicle. Ms. [redacted] does not select the [redacted], location when making the reservation, as the [redacted], computer system automatically selects the branch closest to the customer’s residence. The reservation is valid at any [redacted], location. [redacted], can access the reservation by the reservation number and/or the customer’s name and address, if the customer does not have a reservation number available. Ms. [redacted] sent you an email with the reservation number; unfortunately, there was a typo in her email. The [redacted], was able to look up your reservation under your name and home address. Ms. [redacted] sent you an email on September 29, 2016, apologizing for any inconvenience she may have caused you.
October 4, 2016, the repairs to your vehicle were completed and you returned the rental vehicle. We issued payment to [redacted], in the amount of $535.78, which effectively resolved your property damage and rental claims.
Please be advised it is our position that your claim for lost wages from this property damage claim is not legally compensable. Please understand that as an insurance company we do not pay all claims, but only those claims for which our insured is legally liable. In this particular case, you are not owed compensation for missed time from work due to the property damage.
I apologize for the mistakes made by us when emailing you during the course of your claim and for the rude manner of your adjuster. It is our goal to provide the best possible service to all our customers and I agree the service you received was below our company standards.
If you feel your claim has been wrongfully denied or rejected, please contact the undersigned at [redacted], extension [redacted]. If we are unable to resolve this matter amicably, you may elect to have the entire matter reviewed by the California Department of Insurance, Claims Services Bureau, [redacted], [redacted], telephone number [redacted].
Sincerely,
Wawanesa General Insurance Company
Please be advised this office is in receipt of a second letter from the San Diego Revdex.com, dated May 20th 2016, wherein, you express your continued dissatisfaction with the handling of your claim.
In response to this letter, I have tried telephoning you to discuss the claim and have left three voice mail messages but have not yet been able to speak with you. If we have not yet spoken by the time this letter reaches you, please call me toll free at (800)427-9669 [redacted] or directly at (858)522-7909. My office hours are Monday through Friday, 7:30am to 4:00pm.
I am very sorry the San Bernardino County Risk Management representative [redacted] was rude and unprofessional in her dealings with you. However, I am unable to take action with respect to her behavior because she is not an employee with our company.
Please know we continue efforts to collect your deductible and the money we paid under your Collision coverage from San Bernardino County. We cannot guarantee success. However, will forward the deductible to you if we are successful in our collection efforts.
Please understand we are unable to pursue the collection of money that is not paid to you by us under your policy with our company. Inasmuch as you did not elect to have Rental Expense coverage on your policy, no payments for rental expenses were issued by us to you. As such, we are unable to seek collection of the money you paid out of pocket for rental from the County of San Bernardino.
I am very sorry that the claims experience you are having with San Bernardino County Risk Management office and our office has been unsatisfactory. Please contact me by telephone if we have not already spoken and you would like to speak about the claim.
Sincerely, WAWANESA GENERAL INSURANCE COMPANY
Please be advised we have received an inquiry from the Revdex.com (Revdex.com) of San Diego,the California Department of Insurance and through Wawanesa General Insurance Company's website"feedback" page regarding the above-captioned lossAttached to all three pieces of
correspondence wereceived your description of your concerns and your desired outcomePlease accept this letter toaddress your concerns as registered to the entities mentioned above.By way of background, this will confirm you carry an HHomeowners policy with WawanesaGeneral Insurance CompanyYou reported a water loss to our staff on November 4, 2014, indicatingyou noticed a leak at your kitchen ceiling, which is directly below an upstairs showerWe immediatelyestablished a claim and initiated an investigationDetermining the cause, origin, and duration of the water escape is a common and critical component inthe investigation of any presented water lossAs such, we provided referrals to you for plumbers whohave expertise in leak detectionAfter conducting your own research about plumbing vendors, youselected American Leak Detection to inspect the plumbing leak in questionThey visited your home onNovember 10, After performing a thorough inspection, they determined that the water leak wasfrom failed tile grouting and that re-grouting of the shower was a needed maintenance item.Importantly, the plumber opined the water escape from the failed grout was days oldWe discussed the claim further with you on November 13, 2014, at which time you confirmed the tileshower enclosure was original to your home, which was built in We also reviewed yourhomeowner policy contract wording with you regarding an exclusion which appears to apply to thislossThe pertinent portion of the policy reads as follows:
SECTION I- EXCLUSIONSAWe do not insure for loss caused directly or indirectly by any of the followingSuch loss isexcluded regardless of any other cause or event contributing concurrently or in any sequence tothe lossThese exclusions apply whether or not the loss event results in widespread damage oraffects a substantial areaWaterThis means:eContinuous or repeated seepage or leakage of water or the presence or condensationof humidity, moisture or vapor, over a period of time greater thanldays.The policy also outlines duties of policyholder, such as youIn particular, please refer to:SECTION I- CONDITIONSCDuties After LossIn case of a loss to covered property, we have no duty to provide coverage under this policyif the failure to comply with the following duties is prejudicial to usThese duties must bepe1jormed either by you, an "insured" seeking coverage, or a representative of either:Cooperate with us in the investigation of a claim;As often as we reasonably require:aShow the damaged property;
We offered to inspect your damages and secure your statement, but you declined these offers and statedyou were expecting a denial letter from usInstead, we sent you a letter on November 21, 2014,confirming you were withdrawing your claimWe next heard from you on December 2, 2014, with a request that a different plumber inspect the loss.We agreed to this request and *** *** inspected your residence anew on December 3, 2014.Not surprisingly, that plumber confirmed the findings of the first plumber; namely, that worn tile groutand caulking were the leak failure sources, and that the duration of the leak was "more than a monthprior to discovery on October 30, 2014." Wood rot at the subflooring was also observed, whichprovides further evidence of the long-term nature of the water leak eventWe informed you of these further investigative results on December 4, 2014, and have been attemptingto obtain your recorded statement ever since, in order to conclude our investigationJanice *** ofAdams Adjusting is assisting in this portion of the investigationYou may recall she completed aninspection at your homePlease contact her to provide your statementShe can be reached atIn the meantime, we have offered to pay for the kitchen ceiling drywall access cutmade by the *** *** technician, as part of the inspection and diagnosis processWe willforward this payment to you under separate coverIn closing, we respectfully disagree with your various critiques surrounding our handling of yourreported claimIn fact, we have gone to great lengths to provide superior customer service whileconducting a thorough and accurate investigationPresent evidence leads us to advise you of thehomeowner's policy exclusionary language mentioned above, and we encourage you to mitigate yourdamages at this timePlease continue to cooperate with our investigation by providing your statementto Ms***, so we can reach a final conclusion in this matterIn the meantime, by copy of thisletter, I'm informing the San Diego Revdex.com and the California Department of Insurance of our positionthat while we have handled this matter in an appropriate manner we are attempting to conclude ourinvestigation and provide you with a resolution
February 9, The Revdex.comAttention: Ms*** ***Viewridge Avenue, Suite 200San Diego, CA RE: Complaint ID Number: ***
Dear Ms***:
Enclosed is our response to the above referenced complaint numberAs explained to
our insured, we are experiencing a very unexpected 17% increase in phone volume toour call centerWe are doing everything we possibly can do at this time to address our service levels.I have placed several calls to our insured hoping to speak with him directly about his concernsI havehad no replyOur insured did speak with a representative on February rd to change vehiclesThat change was placedon hold per his request pending his approvalIn seeing that this complaint was made after he spoke with us and his desired settlement is to cancel hispolicy, we will do as he has requested and cancel his policyAs explained to our policyholder, we are actively interviewing, hiring, and training new Customer ServiceRepresentativesRegrettably, this process does not happen overnightCall Center Leaders have beeninstructed to assist serving the Customer Service queue during this timeWe sincerely apologize for not being able to provide and meet expected customer serviceSincerely,*** * *** _Vice President, U.SOperationsWawanesa General Insurance Company*** *** ***
What has happened to Wawanesa? They no longer answer their phones, nor do they call customers back as they say they will This leads me to worry that my prepayment for insurance through April is money thrown out the window I took the day off from work to ask a question regarding dropping a car and driver from my insurance, but it looks as though it was a day wasted They used to be a good company years ago, but now it's rate increases and customer service decreases I am posting this to warn off new, unsuspecting customers I believe your A+ rating does not reflect the current picture
We are in receipt of your complaint filed with the Revdex.com on March 19,
In response, I have reviewed the claim file
I understand you spoke to supervisor, *** ***, on March 19, 2014, regarding the payment of
your rental car expenseSince you
feel your vehicle is not safe to drive as a result of the
damaged mirror, *** *** agreed to pay your rental expense, per the terms of your policy
The Rental Expense coverage pays up to $per day for a maximum of days
In addition, you spoke to supervisor *** *** on March 20, 2014, and he explained the use of
like kind and quality parts in the damage estimate we wroteI hope the two supervisors
answered you questions adequatelyIf they did not, please feel free to contact me directly
I would like to apologize for the misinformation you received from our office regarding
payment of your rental car expenseIt is our desire to provide the best possible service to our
policyholdersHowever, the service you received on this claim was below this standard, and
certainly below your expectation
Again, should you have any additional questions or concerns, please don't hesitate to contact
me directlyMy office hours are Monday through Friday, 7:30am to 4:00pm at (858)522-
Sincerely,
Wawanesa General Insurance
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
It was said in the response letter that *** *** has been trying to contact me and that is an outright fabricationI have left several messages at 858-522-*** after we received a letter from Wawanesa and have received nothing back in turnThis is the typical treatment we have been getting from Wawanesa in regards to this problemThey are an insurance company that we have been with for close to yearsWe have a letter dated in January from *** *** saying that they denied our claim and we had months to get a lawyerNo lawyer will touch this because its not worth their time money wise*** *** and the Risk management Division of San Bernardino are outright Liars and should be released of their positions
If *** *** or Wawanesa needs to get a hold of me all they have to do is call my number ***I have good coverage and do not miss callsThe last message left for this individual was 05/25/at 3:34pm so please do not lower yourself and state you tried to get a hold of me when its obvious you have not
Regards,
*** ***
Telephone support still plagues customer supportAs a policy holder, I required some information on my policyI called the number on Saturday Octand waited on hold for over minutesThe automated system gave me the choice of pressing "*" for a return call (not loosing my place in order)Pressing "*", on the third attempt, I was finally successful in getting a response to leave a message for a return callCome Monday morning I still had not received a return callCalling again on Monday morning resulted in a minute hold before connection with a representative where I registered my complaint and received the same excuses they have been expounding for the past seven months (at least)Not a good situation for a company in business
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
We did contact *** *** who is an extremely rude individual and tried to pit my wife and me against each other by lyingWe have a letter sent to us by her denying our claim and did send a letter to them letting them know of ***'s lack of decencyWe pay you the insurance company to deal with these incidents and you have failedYou have stressed my wife and I beyond belief by your laziness and lack of decency
Regards,
*** ***
January 22, *** ***Revdex.comVIEWRIDGE AVE, STE 200SAN DIEGO CA Re: Complaint ID: ***Insured: *** ***Cancelled Policy Number: ** ***Quotation Number: ** ***
Dear Ms***:
We have
received and reviewed the complaint filed with your organization by our priorpolicyholder, Mr*** ***The following is a summary of the policy transactionsand an explanation of the handling of Mr***'s cancelled policy and quotation issued.Mr***'s original policy, ** ***, was effective March 22, and has renewedeach consecutive yearPrior to the cancellation, the below transactions occurred on thepolicy:
February 27, - An "Offer to Renew" effective March 22, 2014-March 22,2015was mailedTotal policy premium $Down payment of$due before March 22, 2014; Payments to be billed:$due June 22, and September 22, March 26, - Mr*** contacted our Customer Service Department to makethe renewal paymentA renewal payment of $was madeand the policy was reinstated effective March 27, April16, - Mr*** contacted our Customer Service Department to add avehicle to his policyThe policy changes were made effectiveMarch 27, 2014; and an amended declarations policy was mailedshowing new payments to be billed in the amounts of $dueJune 22, and September 22, 2014.Mr*** also requested to delete a vehicle from his policyeffective April17, 2014; and a subsequent amended declarationspage was mailed with payments to be billed in the amount of$due June 22, and September 22, May 19,- Mr*** requested to add another vehicle to his policyThispolicy request was effective May 8, and the total policypremium with all the policy changes was $(includingservice charge)After subtracting the payment of$312.00previously received, the account balance was $Anamended policy declarations page was mailed showing newpayments to be billed in the amount of$due June 22, 2014and September 22, June 25, - A payment of $was made on the policy leaving a balancedue of$No additional payments were made on the account although billing notices were mailedOn October 25, 2014, a Notice of Cancellation effective November 14, 2014, was mailed.Since no payment was received by October 25, 2014, the policy cancelledOn November 22, 2014, a Notice of Premium Due was mailed requesting payment forearned premium due of$Finally, on December 6, 2014, a Delinquent Notice wasmailed requesting the outstanding amount due of$Mr*** contacted our Customer Service Department on January 6, to discussreinstatement of his policyHe was advised that due to the length of time the policy hadbeen cancelled; he would need to reapply; and prior to reapplication, the outstandingamount of $would have to be paidA representative in our Inquiry/Quoting Department spoke to Mr*** on January 6,and the information was taken for the new quotation (Quote #** ***).However, prior to clearing and releasing the quote, Mr*** was again advised the priorbalance must be paidOn January 7, 2015, Mrs*** *** spoke with arepresentative and she, too, was advised the prior balance needed to be paid before thequote could be releasedMrs*** then contacted our Customer Service Department toobtain assistance in making the payment on our EZ-Pay online service and the paymentof$ was made on January 8, Mr*** then contacted our New BusinessDepartment; and after receiving confirmation of the payment, Mr*** was advised thequote would be sentQuote #** * * * *** * was emailed at 3: the same day to***Mr*** requested a call back from a supervisor; and theunderwriter gave the message to a supervisor for the call backAn underwriting supervisor contacted Mr*** that same day and Mr*** expressedhis frustrations regarding the service and the reapplication requirementAfter explainingthe process, the supervisor asked Mr*** how he could provide additional assistance toobtain his businessMr*** advised there was nothing the supervisor could do as hehad already obtained insurance elsewhereMr*** thanked the supervisor for the callback and the call was endedMr*** states in his complaint that he is uninsured although he advised the supervisorhe had obtained coverageResearch into our quoting database shows the quoteprepared for Mr*** has not been returnedAs qualified applicants, Mrand Mrs.*** are welcome to return their application for insurance coverageHowever, due tothe length of time, the prior policy has been cancelled, we would be unable to apply theLoyalty Discount as this discount applies to policies that have been continuously in forcefor more than one yearBecause there was an interruption in Mr***'s prior policy inexcess of days, he no longer qualifies for the Loyalty DiscountBased on the information explained, I ask that this complaint be classified as invalidIfyou need further assistance regarding this matter, please feel free to contact meSincerely,Underwriting ManagerWawanesa General Insurance Company*** *** ***
I have been a Wawanesa customer for 15+ years and I cannot believe how much they have changed
After being in an accident I felt like they were fighting against me! My wife was in an accident where the other person was 100% at fault (car was unattended) and they would not go to bat for us as the other insurance company came after us
I realize every business needs to make money but when you need someone in your corner I guess you have to pay for itWawanesa is very reasonably priced and great to have if you never need themBut when it comes down to helping you out, in my experience, they are not proactive (policy ***)
This letter is in response to the inquiry made by our insured regarding his inability to contact ourCustomer Service DepartmentA copy of my response is enclosedWe are currently experiencing, on a monthly average, an increase of calls to our Customer Servicequeue of approximately
25%That combined with training and implementation of a new processingsystem has hindered our ability to provide the type of service our policyholders are used to receiving.We are actively working on solutions to improve serviceWe have recently just had new CSRcomplete training and start taking live calls this weekWe will continue with the hiring processOurtraining program takes a minimum of weeks to completeFinding qualified applicants has beenchallenging with the improvement in the unemployment rateOur employees are working extra hours;supervisors and managers are taking calls; departments with employees who previously had experiencein our call center are offering help; and we have worked with our IS Department to extend systemsoperationsAs you can see in our response, our sincere apologies have been extended to Mr***I have providedhim with my direct contact informationIf I you have any additional questions or if I can be of any service, please do not hesitate to contact meSincerely
*** ***
Customer Service Manager
Ms***:
The attachment below provides a more detailed history of your payments for the both your home and your automobile policies As well, there are copies of endorsed refund checks of which you had noted you had not received.
The last payment you made to your automobile policy was in September of We were not able to accept the payment you made in January for a policy that had been cancelled for more than three months.
I hope this information provides the clarification needed to satisfy your complaint.
Regards,
*** *** | Customer Service Manager
When our insured first called us on September 22nd, there were some data fields in our new processing system that needed to be filled outUnknowingly, there was a glitch that occurred and generated a premium increaseOur insured contacted us September 28th after receiving a statement
of accountThe increase was backed outWhat did not happen were the payments returning to the way they were billed prior to the glitch.Unfortunately, the request to our Accounting Department to correct this matter was not completed and our insured had to contact us again on October 24thThe Supervisor she spoke with that day advised that she would personally make sure the corrections were made and call her backOur insured requested that someone with higher authority call her on MondayOur Customer Service Division Supervisor contacted our insured on Monday, October 26, While she was unable to speak with our insured directly, she did leave a detailed message which included an apology for the service she receivedOur Division Supervisor also left her contact information if there were any questionsAs of the writing, we have not heard from our insuredThis matter has been resolvedWe sincerely apologize for not being able to provide and meet expected customer Service
Dear Ms***:
I am in receipt of your complaint to the Revdex.com regarding the billing of the above
referenced automobile policy
Enclosed you will find a copy of your Automobile Insurance Application (#1)The total premium, for
your
policy effective March 25, 2014, was $You selected the 9-pay planBased on that
payment plan, 20% of the total premium was due to start the policy; you would then be billed 10% of
the total the 1st through 8th months after the policy startedThere is a $service charge for each
paymentI have highlighted this section of the application
Also enclosed is a copy of your Auto Policy New Declaration (#2)That declaration confirms receipt of
$and the subsequent payments to be billedAs you can see, your payments were scheduled
April through November
In May, a Notice of Cancellation (#3) was mailed to you because of non-payment of premiumThat was
for the April and-May paymentsWe received $via an online payment on June 13,We
mailed you a confirmation (#4) that payment was received and your new payment schedule
In August, another Notice of Cancellation (#5) was mailedThis was for the June and July paymentsWe
received $148.00, the amount billed on notice (#4), on September This only took care of your June
outstanding payment
We mailed you confirmation (#6) that payment was received and your new payment schedule
In October, a Notice of Cancellation (#7) was mailedThis was for July, August, and SeptemberI can
confirm that an online payment of $was submitted November (#8)
You stated in your complaint that you had not received any reminder notices that a payment was due
However, you did receive the notices of pending cancellation and the declarations confirming payment
had been received and the new payment scheduleI can see that the reminder notices were generated
and it is curious that you did not receive themWe have no record of any returned mail
You stated in your complaint, and you told one of our Customer Service Representatives, that your
husband had made a payment over the phoneAs our Representative advised, we have never taken any
payments over the phoneYou can make a payment online via our website, but not by phone
I am uncertain where the confusion has come from regarding your payment scheduleThe terms of the
9-pay plan were clearly stated on you application for insuranceAnd why you haven't received payment
reminder notices yet you have other correspondence sent from us
I hope this information has clarified the issues you raised to the Revdex.comIf you have any
further questions, please do not hesitate in contacting me directly
Sincerely,
*** ***, Customer Service Manager
We are in receipt of a letter from the Revdex.com dated May 20, 2015, in which theyincluded a copy of your complaint to their officeThis letter was received in our office onMay 21, 2015, at which time I reviewed the file with the adjuster, *** ***, to learn that he
hadthat day sent an email to *** *** with a tender of the Uninsured Motorist Bodily Injury limitsof $15,in settlement of *** ***'s claimPayment in the amount of $15,was issued thatsame day.Mr*** was able to conclude his evaluation of the claim at that time as he had received the recordsfrom your Chiropractor's office on May 20, 2015, after they had been retrieved and uploaded by ourcopy serviceI realize that you were both anxious to resolve this matter as quickly as possible and it isour desire to meet the expectations of our customersThere are times that retrieval of information fromother parties, such as medical providers, even when we are requesting it to be done on a rush, is notwithin our controlMr*** continued to follow up on the requested records in an effort to resolvethe matter with you as quickly as possibleAs soon as we had the remaining information we tenderedthe amount of your policy limits to you and issued paymentIt is our practice to not require a UM Release and Trust Agreement for injury claims in which we havepaid the full amount of the limitsThis allows you to seek further recovery from the responsible partyif you desireI hope that this matter has been concluded satisfactorilySincerely,WAWANESA GENERAL INSURANCE COMPANY
This letter is in response to your complaint to the Revdex.com regarding the loss of the above
reference policy numberI have read your complaint and reviewed the transactions that took place
starting with the posting of your payment for $to the above referenced
policy on May 1,
As we discussed today by telephone, we will honor the Persistency Discount and apply the discount to
your new policy ** *** which is effective September 4,
I did, however, want to provide you with a timeline of the events as well as copies of documents you
may not have received
You had a policy in force with the policy period June 24, to June 24, You paid the policy in
full June The payment posted on May 1, 2014, was almost two months before the policy would
expireThe policy term to be effect June 24, had not even been created yetThe payment of
$908.00, as noted, was applied on May to the policy term in force, on which no payment was due, so a
refund in the same amount was generated and mailed to you May 19, This refund was processed
by your bank on May 23,
The renewal process for the policy was initiated on May 30, 2014, by mailing to you an" Offer to Renew"
for the policy term effective June 24,
On June 30, 2014, we mailed to you a "Final Termination Notice" because a payment to renew the policy
had not been received
We did not hear from you regarding this matter until August 27, By that time, the policy had been
cancelled for almost two months
Our Persistency Discount does not apply to applicants who are not currently insuredUnfortunately,
this was your current status when you contacted us
As noted above, we will agree to apply the Persistency Discount
The policy and refund will follow shortly
Sincerely,
*** ***
Customer Service Manager
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.I do not ask Wawanesa to change MY policy. I ask them to change THEIR policy for all future leases. They state that they cannot, because they are regulated. I am currently purchasing new insurance that is also regulated by the state and it DOES cover my lease and official OEM Parts. It seems that Wawanesa doesn't know that they can become a better company.
I DO ask them to teach their salespeople to not fraudulently state that they will use ONLY OEM parts for any and all repairs. I did not "misunderstand" the customer service reps. I pointedly asked them numerous times. The salespeople and the supervisors I spoke with all admitted they were incorrect to try to sell me something they never had to sell.
I wish Wawanesa had admitted any failure on their part. The supervisors admitted it over the phone, but the company will not. I have paid well over $12,000 to Wawanesa in insurance payments over the years. For their lack of truth and integrity, I am now going to pay that amount to someone else for all future insurance needs.
Regards,
[redacted]
The truck tire popped on my wife while she was driving on the freeway recently. She was picking up our son from college a long distance away from home. This happened fairly early in the day (before noon). She contacted the company to help with changing a spare tire. The staff took way too long to arrive (at least an hour and a half), and when it turned out she did not have the tool to fix the spare and they didn't either, they were supposed to send a tow truck to take her and my sons to the nearest tire shop. They waited another couple of hours until a public highway tow truck that had passed by many times was forced to take them off the freeway because it was unsafe to remain there. She called up the company to let them know of their new location. She told them very specifically of their new whereabouts. After another few hours she called them up again, and the company told her they could not locate her. It eventually hit 6pm and still nothing. She had to call them up and tell them that all the local tire shops were closed and that towing them to a tire shop would be pointless by then since the shop wouldn't be able to help out that late.
My family ended up staying in a motel nearby and having to change their tires the next day. I filed a claim asking to be reimbursed for the costs of changing the tire and having to stay in a motel, since the costs were a direct consequence of their inability to help my family out in a timely manner. After weeks of waiting and terrible customer service, I finally asked again today. They replied by telling me that they were not responsible for the costs of the tire change or motel.
The fact that it took that long to get a reply over a measly $130 and still got a no from the company, despite being a loyal customer for many years, is ridiculous. I am immediately changing companies, as I do not want to deal with this type of incompetence. I hope the $130 were worth the long-time customer you just lost.
Re: Our Insured : [redacted]
margin-bottom: 5pt;">Policy Number : [redacted]
Claim Number : [redacted]
Date of Loss : December 01, 2015
Revdex.com ID Number : [redacted]
Dear Ms. [redacted]:
We are in receipt of your compliant as referenced above, We made successful contact with Mr. [redacted] on February 9", 2016. We advised him that settlement of his unrecovered stolen vehicle claim will be processed upon receiving his completed notarized proof of loss form. Mr. [redacted] confirmed he did receive this document, but believes he lost it. We have sent him another one as of this date. This sworn proof of loss is mandatory before we can issue any payments on his stolen vehicle claim. Prior to this conversation our adjuster had spoken to Mr. [redacted] on December 30", in which a recorded statement was taken and the claims process explained, including the need for his notarized proof of loss. We thank you for your inquiry into this matter.
Sincerely,
[redacted]
Material Damage Supervisor
Please see attached, thank you.
Dear Ms. [redacted]:
This office is in receipt of a letter from the Revdex.com, dated October 2, 2016, advising us you lodged a complaint on October 1, 2016.
The loss occurred September 6, 2016, and the claim was reported to us...
by your insurance company, [redacted] Insurance, on that same date. The claim was assigned to Adjuster, [redacted], who immediately initiated the investigation. Based on the information available to us, liability was accepted and we made arrangements to appraise the damage to your vehicle.The initial inspection of your 2011 [redacted] revealed it sustained damage to the right corner of the front bumper in the amount of $1,087.44. We issued payment to you in this amount on September 16, 2016. We subsequently received a supplement repair invoice in the amount of $498.99 and issued payment in this amount to your shop, [redacted].
When I reviewed the claim file, I found the appraiser who inspected your vehicle inadvertently used a hyphen instead of an underscore after your first name when emailing the damage estimate to you. I suspect this is the reason you did not immediately receive the estimate from him.
On September 21, 2016, you contacted Ms. [redacted] to notify her you did not receive the initial damage estimate and the estimate was emailed to you that date.
With respect to the rental car portion of your claim, I found that on September 23, 2016, you notified Ms. [redacted] you had an appointment with [redacted]. As such, she made a reservation for you with [redacted], and authorized $53.34 per day for a comparable vehicle. Ms. [redacted] does not select the [redacted], location when making the reservation, as the [redacted], computer system automatically selects the branch closest to the customer’s residence. The reservation is valid at any [redacted], location. [redacted], can access the reservation by the reservation number and/or the customer’s name and address, if the customer does not have a reservation number available. Ms. [redacted] sent you an email with the reservation number; unfortunately, there was a typo in her email. The [redacted], was able to look up your reservation under your name and home address. Ms. [redacted] sent you an email on September 29, 2016, apologizing for any inconvenience she may have caused you.
October 4, 2016, the repairs to your vehicle were completed and you returned the rental vehicle. We issued payment to [redacted], in the amount of $535.78, which effectively resolved your property damage and rental claims.
Please be advised it is our position that your claim for lost wages from this property damage claim is not legally compensable. Please understand that as an insurance company we do not pay all claims, but only those claims for which our insured is legally liable. In this particular case, you are not owed compensation for missed time from work due to the property damage.
I apologize for the mistakes made by us when emailing you during the course of your claim and for the rude manner of your adjuster. It is our goal to provide the best possible service to all our customers and I agree the service you received was below our company standards.
If you feel your claim has been wrongfully denied or rejected, please contact the undersigned at [redacted], extension [redacted]. If we are unable to resolve this matter amicably, you may elect to have the entire matter reviewed by the California Department of Insurance, Claims Services Bureau, [redacted], [redacted], telephone number [redacted].
Sincerely,
Wawanesa General Insurance Company
Please be advised this office is in receipt of a second letter from the San Diego Revdex.com, dated May 20th 2016, wherein, you express your continued dissatisfaction with the handling of your claim.
In response to this letter, I have tried telephoning you to discuss the claim and have left three voice mail messages but have not yet been able to speak with you. If we have not yet spoken by the time this letter reaches you, please call me toll free at (800)427-9669 [redacted] or directly at (858)522-7909. My office hours are Monday through Friday, 7:30am to 4:00pm.
I am very sorry the San Bernardino County Risk Management representative [redacted] was rude and unprofessional in her dealings with you. However, I am unable to take action with respect to her behavior because she is not an employee with our company.
Please know we continue efforts to collect your deductible and the money we paid under your Collision coverage from San Bernardino County. We cannot guarantee success. However, will forward the deductible to you if we are successful in our collection efforts.
Please understand we are unable to pursue the collection of money that is not paid to you by us under your policy with our company. Inasmuch as you did not elect to have Rental Expense coverage on your policy, no payments for rental expenses were issued by us to you. As such, we are unable to seek collection of the money you paid out of pocket for rental from the County of San Bernardino.
I am very sorry that the claims experience you are having with San Bernardino County Risk Management office and our office has been unsatisfactory. Please contact me by telephone if we have not already spoken and you would like to speak about the claim.
Sincerely, WAWANESA GENERAL INSURANCE COMPANY