Western Mutual Insurance Group

Had this company insure my home for nine years, and never filed a claimThen we had a bad hail storm that damaged our roof, and some siding on the houseFiled a claim for a roof, and they paid out, however they would not renew my insurance when it came time to renew because I don't meet their "underwriting" standardsI didnt seem to have a problem meeting their "standard" for yearsI guess their standard is: As long as you don't have a claim you can be our customerWhat a [redacted] shame the insurance industry is

Very terrible insurance companyMade me and my husband feel like we were lying a about the water damage we had to our kitchen in March of this yearWe are finally giving up since it looks like they actually want us to sue them to get our claim approvedThey are insinuating that we committed fraud by submitting a claim to repair damage caused by a ruptured pipe behind our dishwasherWe had contractors out immediately to remove and dry the water that caused damage to our cabinetry, flooring and wallsWhen the water removal guy came out the last time to remove his blowers he asked us about which homeowners insurance would be handling the claimClaim? In all the confusion and craziness we were going thru, we never even thought about the homeowners insurance being able to help with coverage of the damageWe called to put in a claim shortly after that conversationIn the meantime, while we were waiting for the insurance company to send out their 3rd party adjuster, we had already previously decided that we would just have everything torn out of our kitchen when we saw that we also had some moldwe proceeded to have that started as scheduled, so when the adjuster and the contractor came, we had already removed the molded cabinetry and the flooringBasically everything had already been demoed was ready for us to start rebuilding it slowlyWe were advised by the contractor and the adjuster not to continue with any more work in the kitchen until we had received the OK from the HO insuranceWe never asked for entire kitchen expenses to be covered, only what was damaged by the water as we stated in our claim requestThey gave us the run around for a very long timeWe were strung along for a very long timeSo long that I started to have breathing problems from the debris dust that was resulting from leaving our kitchen unfinishedEven my dog started have trouble breathingI wrote several emails requesting a status update, and only once did I hear anything backThat email said that they were waiting on the water removal guy and the plumber to get back to them with info that they'd requestedI called both of those persons and got ahold of them right away, and had them call the insurance company back to give them what they neededIf they'd attempted to make a single phone call themselves, they would most likely have been able to get the info they need in a more timely mannerIn the end, and a very, very long time later, we received a letter from them denying our claim, citing that they believed our claim to be fraudulent because 1) we failed to contact them immediately when the damage was found and 2) because we allowed our contractor to remove the damaged and molding materials from our home while they sat on their hands for several daysWe are very unsatisfied customers, who could have had our kitchen back in working order much more quickly, then they allowed us toAs if causing breathing issues in my family wasn't bad enough, you couldn't imagine how expensive it was to eat out or microwave every meal for months because I couldn't cook meals for my children

A few months ago, after heavy rainfall, I noticed there were water coming down the wall between the patio and my houseI got on my roof and noticed the tar around the vent was getting old so I repaired itThen I contacted my Residence Mutual Insurance and asked them to send someone out to make sure there are no additional problems or damage that my be caused by the heavy rainThey immediately sent someone out to inspect my roof and the walls and said that there are no damage done and the repair that I had done fixed the water leakThen last week, Residence Mutual without any notice sent someone out to my house while I was a workMy wife was home, but she did not open the door because she did not expect anyone to come overThe gentlemen that rand the door bell had regular clothes on, so of course my wife did not open the doorShe peeked out from the window and said the man was there for about two minutes then leftHe left a noticed on our door [redacted] which stated that he inspected the outside of our houseHow can someone spent minutes to perform an inspectionToday, I received a letter from the company stating that my roof is showing signs of wear and because of that, they are charging me a 40% surchargeThey also claimed the right side of my house is filled with debris and clutter, which is another statementWithout formally speaking with me, they are charging me a 40% surchargeTo me, this is robbery

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 belowAs my insurance, they were suppose to be responsible for the structural engineer reportThey are to fix my home and deal with the builder Regards, [redacted]

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 belowFirst of all these people never talked to Mr [redacted] .They talked to Mrs [redacted] .From the beginning of trying to open up a claim,we were given the run aroundWe were reporting water damage from an "accidental toilet overflow ".When the adjuster came to our house he spoke to my wife in a very unprofessional manner.He did take any of our concerns seriously, instead the adjuster along with residence mutual tried to pass the blame to the builder of the houseWe were told that there would be someone calling us to take a statement because the adjuster was so much of a hurry to not do his Job right and take a statement himself.We were also told that we would get copy of the report, to witch this day we have not receivedAgain builder and age of this house is one thing but the accidental part should be coveredAlso we have been with this company for over five years thinking we were covered,never opened a claimNow residence mutual will not renew our premiumThat's the insurance company saying " well since there is a reasonable cause for a claim we just won't acknowledge the claim and not renew it either"Residence should refund most of our premium for the years we have been with them since they won't honor our claimOne minute they are covering us the next it's blame the builder and you are on your ownThis is as close as you can get to insurance fraud as you can getRegards, [redacted]

Again, I do understand how this is frustrating and I apologize for that Unfortunately the flood cancelling is out of our hands The cancellation process is federally regulated, and the policy is with the flood company We have cancelled and refunded your homeowners policy on the date you requested

Revdex.com: Thank you for helping me get a response from Western Mutual Insurance You helped me get a response, which is something I could not get on our own Western Mutual Insurance is a horrible insurance company and I will make it my mission to publicly warn other consumers to beware of this organization, their communications, and their lack of payment for legitimate claimsThank you again for your assistance Regards, [redacted] ***

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 Regards, [redacted] This policy as stated previously was canceled effective the same date we closed escrow on our home your premium was too high and your Agent [redacted] realized this and apologized and told us that he was sorry and there would be mo problem cancelling so at that point he sent cancellation notice that we immediately sent back and he received by his confirmation at that point your customer service rep named “***” told me she can see no records as to it being submitted to [redacted] Then I was contacted by a so called underwriter of [redacted] who said his name was [redacted] he refused to give me his last name but was argumentive I felt like I was being beat up by a company that was forcing themselves on me I still gave plenty of notice for cancellation as it was effective the same date as my escrow closed

We understand that Ms [redacted] had hired the engineering firm AdvancedEngineering Tech to inspect her home and provide her with a report as tothe cause of her claimed damages This is the first time we were aware of,or given a copy of, this report We have completed our review of thereport.The report states the claimed damages may be due to lack of engineeringdesign and construction of the roof beam, defective construction methods,lack of soil compaction, and the building possibly not being built to code(the home was built in 1985)—all of which are excluded under her homeownerspolicy and communicated in our prior letters to her denying coverage.Based on this new information, we are still not able to find coverage forMs [redacted] ’s loss.Also, we would reiterate that the contractor who inspected the propertyobserved large cracks and undulations in the street outside Ms [redacted] 'srental property; he did not enter any neighboring structures.We are sorry that Ms [redacted] is unhappy with the lack of coverage for herloss, but these types of losses are commonly excluded under homeownersinsurance policies[redacted] ***

We are very sorry that our customer is upset by the denial of her claim However, her allegation that we have manipulated the results of the investigation to deny the claim is untrue Three separate companies inspected her rental property and all independently determined that the damage was caused by constant or repeated seepage from within a plumbing system All opined that the leak in the shower valve that caused the damage has been occurring for at least months, every time the shower was usedWhen we spoke to the customer to discuss the findings after the inspections, she advised us that one of her relatives rents the home and she admitted that she had not observed the condition of the bathroom for some timeWe informed her that based on our review of the photos and the reports that there was no coverage for this lossWe attempted to explain the reasons for the denial of the claim to her, however she ended the callDespite the fact that coverage did not exist for this loss, we paid Water, Smoke & Mold Restoration $for the emergency services they performedAgain, we are sorry that we could not find coverage for this loss despite three separate inspections However, we must apply the policy language fairly and there is no coverage for constant or repeated seepage or leakage of water or steam over a period of time from within a plumbing system

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 [Provide details of why you are not satisfied with this resolutionPlease respond in this space ONLY] Regards, [redacted] This is NOT out of your hands your Company name is shown as our agent we contacted FEMA and we were informed that we have the right to cancel and take whatever insurance provider we want Fema only has listed our current provider which is not you Our insurance flood policy and homeowners were canceled on 6/30/both thru your agent [redacted] FEMA says there ate no such rules as who we ate being for ed to go thruYou nust do not want to make the refund I have made a formal complaint with FEMA against your company for harrassment and misleading information by your employeesI supplied you with bothCancelation notice and declaration page as you requested

We do apologize for the inconvenience, but unfortunately it is our experience that once there is a leak on a pipe in the slab, it is only a matter of time before there will be leaks on other sections of the pipes in the slab If the insured intends to repipe the hot and cold pressurized
lines, and will have a contract to do so before the expiration date, we may reconsider the renewal as long as the work would be done within a reasonable time

We are very sorry that our customer is upset by the denial of her claim. However, her allegation that we have manipulated the results of the investigation to deny the claim is untrue. Three separate companies inspected her rental property and all
independently determined that the damage was caused by constant or repeated seepage from within a plumbing system. All opined that the leak in the shower valve that caused the damage has been occurring for at least months, every time the shower was usedWhen we spoke to the customer to discuss the findings after the inspections, she advised us that one of her relatives rents the home and she admitted that she had not observed the condition of the bathroom for some timeWe informed her that based on our review of the photos and the reports that there was no coverage for this lossWe attempted to explain the reasons for the denial of the claim to her, however she ended the callDespite the fact that coverage did not exist for this loss, we paid Water, Smoke & Mold Restoration $for the emergency services they performedAgain, we are sorry that we could not find coverage for this loss despite three separate inspections. However, we must apply the policy language fairly and there is no coverage for constant or repeated seepage or leakage of water or steam over a period of time from within a plumbing system

I apologize for any frustration or concern. We do show the policy paid in full, however we have not received any duplicate payment. If we do, it will be returned back quickly. I would recommend speaking with the lender to let them know it is paid and not to send a duplicate
payment

This company has been horrible to my grandfather2nd time they've ripped him offThey are in several lawsuitsSteve Spagan is utterly trash

I do understand the frustration this customer is feeling regarding the notice of non - renewal Unfortunately we feel that with his indication that he will not correspond with our designated person and his concern with our claim handling, we felt it is in the best interest of ALL parties that
we do not continue the relationship It would be difficult to establish a mutual trust in any future dealings which wouldn't be beneficial for either side and would delay communication I do understand his desire to view and have his policy, and I see in our notes that he was emailed and mailed a copy of his policy immediately on the day of his request to view the policy, and we would be happy to continue to provide another copy if he needs it

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that the company's response is evasive, meaningless, and would not resolve my complaint. See details below
Unfortunately, the company’s response does not address the issues presented in my complaint, but merely demonstrates a post-complaint attempt (by the insurer) to rehabilitate its previously-stated reason for non-renewal, which is misleading, and is indicative of a self-serving attempt to escape the spotlight of scrutiny gravitated by their questionable actions. The Notice of Non-Renewal does not show that such notice was generated by reason of any alleged lack of cooperation on my part with a third-party adjuster (or any adjuster for that matter). In fact, the notice does reflect that the notice was issued on the basis of an insurance claim that I filed with this company and which, allegedly, does not meet the company’s underwriting standards. I don’t see what the insurer’s underwriting standards have to do with a third-party adjuster, inasmuch as the homeowners policy does not allow for unaffiliated adjusters to take over a claim midstream or at any other time. Equally important is the fact that, as here, the third-party adjuster has consistently displayed to be grossly incompetent and alarmingly unscrupulous, causing needless delays in communications between the insured and the insurer, among other things, the details and supporting evidence of which are available upon request. Regarding the company’s allegation that I was e-mailed a copy of my policy, I have not received it. Besides, the company knows very well that it is no longer permitted to communicate with me via electronic mail because such a method of communication is insecure and the company has, in the past, included personally identifiable information about me that the company knew, or should have known, was constitutionally-protected material that must be safeguarded. BOTTOM LINE: The insurance company must determine to renew or non-renew upon its underwriting guidelines, which must be objective, have a substantial relationship to the risk of loss, and be applied consistently among insured consumers in the particular group being non-renewed. In this respect, the Western Mutual Insurance Group (Residence Mutual Insurance Company) has failed miserably, but it’s not too late for the insurer to redeem its blunder and fulfill its duties and obligations under the policy and in full compliance with the applicable laws. ATTACHMENTS: relevant documents (numbered through 7, appearing on lower-right corner). These documents are CONFIDENTIAL, so please respect their privacy. Thank you.
Regards,
*** *** ***

The insured filed a claim for a leak in a drain line under their kitchen sink. We covered the claim and paid the insured based on estimates provided by one of our preferred vendors. When it was determined that asbestos was found in the insured's home, our adjuster notified the insured in
writing that any costs related to asbestos were not covered.The insured submitted an estimate for the pack out of her kitchen cabinet contents that was needed due to the asbestos related repairs. The insured submitted the pack out estimate to us after the work had been completed. We did not pay the insured for the pack out expense because it was only needed due to asbestos related repairs, and because they did not submit the estimate to us until after the work had been completed.The insured also submitted hotel receipts requesting reimbursement. The insured never confirmed with us if there was coverage before she went to the hotel. The insured instead sent us the hotel receipts after the fact and demanded reimbursement. The policy requires that the home be "uninhabitable" for us to pay for temporary lodging expenses. In this case, the insured's home was not uninhabitable as a result of this loss, and as such we did not reimburse her for her hotel expenses. Had the insured contacted us prior to going to a hotel, we would have told her that the hotel expenses were not covered by the policy and she could have then made an informed decision about whether she wanted to incur the large hotel expense.While we believe our handling of the claim was proper, we have agreed to a compromise to settle the claim with our insured

We are sorry that the customer finds our continuing
offers to reinspect his property and address any remaining concerns to be an
unsatisfactory resolution to his complaint.
We note that the items the customer mentioned, such as a non-functioning
doorbell, do not render the home uninhabitable.
Further, we were advised by the contractor that in addition to not being
paid the insured’s deductible, they also completed additional non-claim related
items at the customer’s request for which they were not paid. These items included installing a new garbage
disposal, having the master bathroom toilet snaked, and performing additional
painting and other work throughout the customer’s home
As we have previously advised, if the customer remains
unsatisfied with the contractor’s work and/or believes additional monies are
owed, we will be happy to review and consider these items. However, we can only do so if the customer
allows us to reinspect the property. The
customer advises that we can inspect “at any time” and that we have his address
and contact information. That is correct, and we have
directed two letters - in addition to our original response to the Revdex.com
complaint - asking the customer to contact us to set an appointment so that we
can be certain someone will be at the property to let us in and to show us the
items of concern, but he has not responded to our requests. We remain willing to work with the customer
to address his remaining concerns, but we need him to cooperate with our
requests to reinspect his property

BUYER BEWARE! This company is all well and nice when your signing up but wait till you have one small problem! You WILL be cancelled! I have owned my home for 25yrs and never made a claim until the storm of and then only 546.06$! The damage they wouldn't cover they demanded still be repaired by their specific contractor and their cost! I have never heard of such a thing! Of course being our home, we were having the repairs done but its taken months to get roofers quotes and save funds to have the work done We were given one month to have the work completed and submitted back to this company! When you call to speak to one of the many under writers they act as if they have never talked to you before or you get their voice mail and no return callJust today I received mail from mark nix who is supposedly the claims manager who stated I didn't respond to a voice mail he left me when in fact I left him three voice mails in return! Apparently when you are a problem they don't attempt to resolve anything they just throw you away! I wonder how theyd feel if one of their family members was treated as they treat their loyal, OVERPAYING(as I found out while buying new insurance!) customers? Im sure it takes a certain type of person and this company is full of them! BUYER BEWARE!