Western Mutual Insurance Group

While *** *** is one of our preferred vendors, it is not accurate that we work “exclusively” with themThe customer alleges that we rushed the repairs to avoid paying the Mortgage Protection coverage, which does not begin until the home has been uninhabitable due to a covered loss for
more than daysWe note that the customer signed a Completion and Satisfaction Notice on 1/27/2016, approximately six weeks after the loss occurred, stating that the repairs were satisfactoryThere was no effort to avoid paying Mortgage Protection, rather, it is always our goal to assist our insureds in getting back into their homes as soon as reasonably possibleTo date, we have paid over $63,for this claimAfter the Notice was signed, the customer began making a variety of accusations against the contractorWe have requested a reinspection so that we can investigate the customer’s concerns about the water damage repairs done in his homeThe customer was unable to meet on the initially scheduled date of 3/11/2016, and has not responded to our request to advise us of a future date when he is availableWe are unable to proceed with investigation of the alleged improper repairs unless and until the customer allows us to reinspect the property
The Mortgage Protection coverage does not apply because the customer’s home was habitable within daysAs far as food cost and “all additional cost of living that was refused,” we are confused by this statementThe food he is referring to was left in the refrigerator by the customer, and eventually went bad; this is not covered by insuranceFurther, we paid over $16,for the days that the customer was unable to occupy the home while repairs were being completed, which would seem more than sufficient to cover any reasonable additional living expenses the customer incurred
We will be happy to review any additional information the customer chooses to provide, but we need him to allow us to reinspect his property if he wants us to consider any additional funds for the repairs

We apologize for incorrectly referring to Mr*** when the claim was reported and handled by Mrs***We are unsure why Mr*** is now stating that their original claim was for an "accidental toilet overflow." When Mrs*** called in the claim, it was summarized by the person who took her call as "Since after home was built there have been issues to home, south wall inside and outside, tile bath fall, tile on bathtub, windows have damage." Mrs*** did not mention any toilet overflow, although she did point out long-term damage to the bathroom floor when the Independent Adjuster was there. We sent an Independent Adjuster to inspect the property because we do not have a local adjuster living near their residence in Galt. The Independent Adjuster noted that there was a failed toilet wax ring which has caused long term damage, but there was no mention of any "accidental toilet overflow." Again, we are sorry that Mr*** is unhappy with the denial of his claim and the nonrenewal of his policy, but we are unable to reconsider our decision on the claim absent documentation of the newly alleged "accidental toilet overflow." If Mr*** has any documentation to support his allegation that there was an "accidental toilet overflow," he is welcome to submit it to the Claims Department for review

I apologize if you have any difficulty receiving your requested policy copy, one was mailed on 5/15/upon your request I have submitted a request to have another copy printed and mailed by end of day today as well Please let us know if you do not receive either copy Unfortunately, there has been a break in trust and communication that would be difficult to repair for any future claims, which isn't beneficial to either party in an insurer/insured relationship We will of course continue to work with the insured on his claim and make sure all authorized payments are made and to the correct person, and honor his policy until the end date We apologize for any inconvenience in obtaining alternate coverage

This is an unfortunate situation and we understand the frustration. However, the constraints on cancellation are coming from the flood company that wrote her policy with the NFIP, which is a separate, unrelated company. The issue stems from the first elevation certificate that she had a
surveyor due prior to applying for a policy, on which the surveyor put the incorrect information. Our sales agent is doing everything he can to help Ms*** and advocate on her behalf to the flood company

Revdex.com:
Residence Mutual Insurance Company agreed to a settlement on my master bathroom and laundry room. Two claims were filed and we’re closed. .
[redacted]

I understand this is a frustrating situation.  Again, your homeowners policy that you bought with our company, was cancelled as requested on June 30, 2017.  The flood policy that our agent contracted for you at your request was rated by the information he received from you, the customer, which was incomplete.  When the flood company underwriters discovered the correct information, the price increased to the correct rate.  Two of our agents have advocated on your behalf in this, but due to federal NFIP guidelines there are processes that need to be followed, as explained to you by the flood insurance company agent.

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:
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]
As I have  explained over and over again that your policy was canceled on 6/30/2017 your agent made the cancellation notice effective as of 6/6/17.  I am the customer and I have the right to cancel with your company.  Your underwriters never told me why it was such a high premium other than we were a high risk so this is why we cancelled.   What happened after the cancellation should not concern you because of the fact we had indeed canceled and no longer were your customer.   The cancellation notice even stated that the reason for cancellation was because of misquote.  Our lender is not even acknowledging you as our insurance carrier because we indeed canceled with you.   You can deduct one months premium and send us remainder.   I can not believe how your company is trying to force a customer to pay for something they do not want.  So let me get this straight you are trying to say that any customer that takes your insurance is never allowed to cancel??? I would always be in fear of your company always pulling this every renewal period!!!! All of your future customers need to be made aware of your  underhanded practices. I did everything I was told to do in order to cancel but your agent dropped the ball and I was told by your office the cancellation notice was never forwarded to [redacted] Flood so that was not our fault!  So I was in the right to obtain a new provider.

The insured filed a claim for water damage to her 2nd floor master bathroom and 1st floor garage.  To investigate the claim, we sent out Larry's Plumbing and Revive Restoration.  Larry's Plumbing found a leak in the shower cartridge (faucet) in the master bathroom, which caused ensuing...

water damage to the master bathroom and garage below.  Revive Restoration dried out the areas affected by the leak in the shower cartridge.  After the dry out was completed, the insured complained about water damage to the tile floor in her laundry room.  This was not related to the leak from the shower cartridge in the master bathroom.  The insured disagreed and alleged that the damage to laundry room floor should be included in this claim.  We agreed to send Larry's Plumbing back out to the insured's property to see if the damage to the laundry room floor was related to this claim.  Larry's Plumbing found a small leak in the water supply line for the washing machine, which was not related to the leak in the shower cartridge.  We informed the insured that this leak was not related to her claim, and that she would need to file another claim for the repair the repair of the laundry room floor.  The insured agreed to file another claim, which has been subsequently been paid and closed.

According to the insured's correspondence with us, the loss happened on 7/28/16 but wasn't reported to us until 9/16/16.  Upon report of the loos, we assigned a local independent adjuster, who inspected the dwelling on 9/21/16, with total damages from covered loss of $1571.13 found during...

inspection.  This total however doesn't exceed the insured's 1% wind/ hail deductible of $2,690.00, and insured was advised of this. 
  
 
In other areas the insured requested inspection, there wasn’tevidence of covered loss but of long term damageand maintenance issues, so unfortunately these damages were denied in a letter to the Insured 9/28/2016. Atthe insured'sexpressed disagreementwith our position, we reopened the claim and suggested a re-inspection. This was declined by the Insured,so a reservation of rights letter was sent 11/10/16.
 
We subsequently received estimates from the Insuredafter she completed the work that had been expressed would not be covered by her policy.  Thus, we must stand by our denial. While we do apologize for any frustrations in communication, we overallfeel that this claim has been handled properly and according to our records all communications have been timely.

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 resolution. Please 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 6/30/17 both thru your agent [redacted]. FEMA says there ate no such rules as who we ate being for ed to go thru. You 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 employees. I supplied you with both. Cancelation notice and declaration page as you requested.

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 “[redacted]” 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

This company is one of the worst insurance companies I have ever dealt with and they wouldn't even cover my whole water damage loss claim in Phoenix Arizona

Homeowners insurance is intended to cover sudden and
accidental losses, not loss that develops over time due to faulty construction,
wear and tear, long term...

water seepage, or losses caused by domestic animals.  When Mr. [redacted] reported the claim to us, he
indicated that he had had problems with the home since it was built, which was
in 2000.  While we advised Mr. [redacted]
that there may be coverage issues based on his initial description of his loss,
we did send out an Independent Adjuster and a Contractor to evaluate the losses
at the home.  They reported the following
to us:
 
1) Several kitchen ceramic tiles along the back
splash have fallen off the mortar. The cause of this loss is from long term
water damage due to repeated seepage of water leaking through a window above
this area and/or repeated seepage of water getting leaking through hairline
cracks in the grout eventually causing the tiles to lose their bond with the
mortar. This damage has been ongoing for several years.
2) The windows seal gaskets and frames that are
facing the south are deteriorating due to faulty construction of the windows
and/or improper installation. Rainwater has leaked through several of these
windows and caused long term damage to the drywall and sills of the interior.
These damages have occurred over many years.
3) There is a previous drywall patch on the ceiling
of the family room from an old plumbing leak that has been repaired.
4) At the time of our inspection, all of the carpet
and pad downstairs, some of the stairway and the entire upstairs hallway had
been removed by the insured. We observed a large amount of fungus was growing
at the baseboard areas in these rooms. The insured admitted that their two dogs
had been repeatedly urinating on the carpet for several years. There was still
a very strong urine smell at the time of our inspection. We found urine stains
on the remaining carpet in several rooms and on the exposed upstairs hallway
sub-floor.
5) The upstairs hall bathroom is very soft around the
toilet and near the tub/shower, which is an indication of wet rot and dry rot.
The vinyl flooring is also discolored. The cause of this is due to long term
repeated seepage of water around the toilet wax ring and also from repeated
over spray from the tub/shower around the shower curtain. The water has
repeatedly seeped down to the ceiling of the garage causing long term damage to
the drywall. Our inspection found a previous attempt to patch this area of
damage in the garage.
6) The fence exhibits evidence of long term wear and tear
along with evidence of several previous repairs.
 
Thus, the primary cause of the damage is due to repeated
and continuous exposure to moisture over time, improper installation, wear,
tear, deterioration and wet/dry rot to the dwelling as a direct result of poor
maintenance, neglect and damage from domestic pets.   This type of damage is not both sudden and
accidental, and is not covered under the homeowners policy; as a result, the
claim was properly denied.  While there
were actually multiple separate losses claimed, we opened only one claim file as
a courtesy to Mr. [redacted].
 
Later, the policy was nonrenewed due to the evidence of
wet and/or dry rot and the long term, unmitigated water damage.  We were concerned that the lack of
maintenance could eventually result in a covered loss.
 
We are very sorry that Mr. [redacted] was unhappy with our
denial of his claim and the nonrenewal of his property.  We are a preferred insurer and we employ
strict underwriting guidelines.  Mr.
[redacted]’s policy will expire on 12/9/2015, but if he obtains coverage elsewhere
prior to that date, we will be happy to refund any unearned premium.
 
CC 11/13/2015

Had this company insure my home for nine years, and never filed a claim. Then we had a bad hail storm that damaged our roof, and some siding on the house. Filed 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" standards. I didnt seem to have a problem meeting their "standard" for 9 years. I guess their standard is: As long as you don't have a claim you can be our customer. What a [redacted] shame the insurance industry is.

Very terrible insurance company. Made me and my husband feel like we were lying a about the water damage we had to our kitchen in March of this year. We are finally giving up since it looks like they actually want us to sue them to get our claim approved. They are insinuating that we committed fraud by submitting a claim to repair damage caused by a ruptured pipe behind our dishwasher. We had contractors out immediately to remove and dry the water that caused damage to our cabinetry, flooring and walls. When the water removal guy came out the last time to remove his blowers he asked us about which homeowners insurance would be handling the claim. Claim? 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 damage. We called to put in a claim shortly after that conversation. In 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 mold. we proceeded to have that started as scheduled, so when the adjuster and the contractor came, we had already removed the molded cabinetry and the flooring. Basically everything had already been demoed was ready for us to start rebuilding it slowly. We 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 insurance. We never asked for entire kitchen expenses to be covered, only what was damaged by the water as we stated in our claim request. They gave us the run around for a very long time. We were strung along for a very long time. So long that I started to have breathing problems from the debris dust that was resulting from leaving our kitchen unfinished. Even my dog started have trouble breathing. I wrote several emails requesting a status update, and only once did I hear anything back. That email said that they were waiting on the water removal guy and the plumber to get back to them with info that they'd requested. I 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 needed. If 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 manner. In 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 days. We are very unsatisfied customers, who could have had our kitchen back in working order much more quickly, then they allowed us to. As 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 6 children.

We are sorry that our customer is disappointed that her claim for cracks in the walls of one of her properties was denied.  We asked a licensed general contractor to inspect the property to assist us and our customer in determining the cause of the cracks.  The contractor believes that the...

cracks were caused by expansive soils in the area.  We note that the contractor did not enter other homes in the area; he advised that he noted significant cracks in the street outside the home consistent with his conclusion that the cracks in the home were caused by expansive soils.  Unfortunately, the policy does not cover losses involving settling, cracking; shrinking, bulging, or expansion of pavements, patios, foundations, walls, floors, roofs, or ceilings.  As a result, the claim was properly denied.  As our customer was upset that her claim was denied, we engaged the services of a leak detection company to perform a non-destructive leak detection to investigate the possibility that there may be some water leak that could have caused cracks in different areas of the home, even though the insured had not reported any water leaks.  The leak detection technician tested the plumbing and found no active leaks. Based on the inspections by both a licensed general contractor and a leak detection company, we remain unable to find coverage for our customer’s loss.  We have sent another copy of the original inspection, and will also be sending a copy of the leak detection report to the customer for her review.

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.
As 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]

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]

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.As 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]