Texas Security General Insurance Agency, Inc.

TEXAS DEPARTMENT OF INSURANCE                                                                            ...

                     October 16, 2014
PROPERTY & CASUALTY, MAIL CODE 111-1A
[redacted]
AUSTIN, TX [redacted]
Insured: [redacted]  Problem Report ID: [redacted]                                    Policy#: [redacted]                                          Lloyd’s Market#: [redacted]
In response to your request, I hope the following information answers all of the pertinent points mentioned for the Notice of Complaint received. In the Complaint received, Mr. [redacted] (the Insured), has two issues with his renewal policy (1) the roof exclusion that was requested and (2) the premium returned after cancellation.
1)       The roof exclusion was requested on the Insured’s policy for the 2014-2015 policy term. As part of the standard underwriting procedures an inspection is ordered on each policy after the third renewal. In the process of reviewing the inspection photos for this policy it was determined that the roof on the insured structure is in extremely poor condition. This policy is written on a Texas Dwelling policy – Form 1 (TDP-1) policy form. The TDP-1 is a Named Peril policy. Named Peril means that if the Peril is not listed in the Insuring agreements, damage from that Peril is not covered. Maintenance is not a Covered Peril in this policy. Another characteristic of the TDP-1 policy form is that losses are settled on an actual cash value basis. Actual cash value is the amount of the settlement after the depreciation has been removed from the replacement cost value of the whole amount of damage. In the event of a loss being filed and then having the maintenance damage removed, the depreciation removed and the deductible removed from the settlement, it was determined there was a large probability of a loss not having a settlement due to the poor condition of the roof. TSGA obtains a signed exclusion as a way to verify that the Insured was aware that his coverage would be limited due to the poorly maintained condition of the roof.
Texas Security General (TSGA) requested the agent to obtain a signed roof exclusion from the Insured. The inspection showed that this Risk is of a poorer quality and shows a greater lack of maintenance than is expected. The increase in the premium that would have been charged due to the increase in hazard caused by the poorer than expected condition of the insured structure, especially the roof of the structure, offset any premium credit that would have occurred due to the reduction in coverage on this policy.
2)       The next issue mentioned in the Insured’s Complaint is regarding the unused/unearned premium that was returned to him. The Insured divided the whole premium by twelve months then added two months together. However, the amount of return premium for a cancellation is computed on a pro-rata basis using the formula set forth in the Texas Property Manual. The $125.00 policy fee is a fully earned fee. The whole premium for this policy was $468.00 and this policy used/earned 61 days of coverage or $79.00 of used/earned premium. The used/earned State premium tax is based on the total of fully earned policy fee plus the used premium times 4.85% and then the State stamping fee is times 0.06%.
The following is how the used/earned premium formula works:



Used/earned Premium


=$ 79.00




Fully earned policy fee


=$125.00




Subtotal


=$204.00




State Tax


=$ 9.89




State Stamping Fee


=$ 0.13




Total earned premium


=$214.02



The paid premium=$622.12 minus the earned premium $214.02=equals the unearned premium of $408.10
The cancellation return is confusing because it is not an exact division of the policy year by the months that a policy was in force. In this case the $408.10 return premium sent to Mr. [redacted] was the whole amount of the unearned premium and taxes.
I have included policy information for your convenience. Please let me know if I can be of further assistance. Sincerely,
[redacted]
Claims Management/Compliance Dept.

ID [redacted]
To whom it may concern!
In respone,to Your response,which I received on 11.01.2014, to a letter of mine,that was submitted to Your Office 09.19.2014.
I relise that the response of Your Office, having so many other complaints takes its time.Well I finally got Your response and I thank You for it.
I wish on the other hand,that Your Office allows half of the time,to those that it is in communication with,to respond.I had to hurry quiet a bit.To the point!The copies of that Building that You attached to Your letter,show on the one Hand,the Property of mine, that is located on [redacted],Killeen,Texas.,[redacted].0n the other hand,copies of a Building which I attach to my letter and return to Your Office,marked x,are not identifiable by me, as being my Building,located at [redacted],Killeen,Texas,[redacted].As formerly stated in my letter to Your Office.That Building was formerly insured with Best Insurance Agency,located at [redacted] in the City of Killeen,[redacted].I do not know if the Zip code is correct,there are so many Zip Codes.First of all ,I feel ,that me being insured with Best Insuranse Agency,which is located in the City of Killeen at [redacted] ,that Insurance Agency than vanishing out of the picture and its Headquarter in Austin appearing in the Picture,its Headquarters,having no first hand knowledge,of the Building being insured,since it is located in Austin,Making any determination of any Building,not in its field of vision,is bad business and should be prohibited by Law,since we all live by Law.It is bad Business practice but in reality on the norm,that People are being given a runaround,which often causes them to
give up,in the persuit of being treaded fairly.Big Companies can afford to travel,working People cannot,they have to give up,they do not have the funds exspendable to travell have had at least two,if not three years of Insurance with that Insurance Company and as formerly stated feel,that if that Insurance Company would have insisted on the Roof being replaced right at the time before renewal of the policy,I could say nothing.My point is,that the policy was renewed at the premium rate of $622.12 and nothing was said at that time about Roof replacement.The requirement for a Roof replacement was made close to two month later,after I had paid the full premium amount of $622.12.1f honesty means anything to that Insurance Company,I would like to say,they,the Insurance Company should have made that requirement,at the time imediately before collecting the $622.12 premium amount.I positively do not agree with how they are conducting business/That Insurance Company had at least two years time,preceding my last renewal,dating 06.09.2014,to make the decision that the Roof was in need of replacement.Doing so would have positively shown fair business practice on their part.Nothing was said at all.After I had paid the full premium amount of $62212 was that requirement made.That to me is bad business,note was is being said above,if the requirement would have ben made before or at the time of renewal,that,I consider would have ben fair business.Making that requirement afterwards,I consider bordersome,even an unwelcome interference in my life,such as bringing my life,its careful thought out tranquility,out of control.Every household has a Budget well thought out,I have one also,bad Business is not included in mine,My Building,that Building in question has never looked alike on the Pitures of which I attached copies.Either it's a mistake or You are being lied to! Yours,
[redacted]. Jesus loves You.