This letter is in response to your request for information pertaining to the above file.Our records indicate the Auto policy cancelled effective July 11, 2016 per Ms. [redacted]’s request. Abalance of $103.50 remained for coverage provided up to the cancellation date. Upon receiving theattached...
documentation, the Auto policy cancellation date was adjusted to June 14, 2016. Thebalance due was adjusted to $13.60.The balance will not be sent to collections as it is under the threshold of $20.01.If you require further assistance, please contact our [redacted], Dawn H[redacted], at###-###-#### or by email at [redacted]Sincerely,Erica C[redacted]
Thank you for the opportunity to provide an additional response to the Revdex.com regarding policy number [redacted] for Mr. [redacted]n.
Mr. [redacted] requested to have his spouse, [redacted] excluded from the policy because she was not going to be driving the listed vehicle. Ms. [redacted] was not required to be added to the policy but an exclusion form is required to be submitted when a household member of driving age is not going to be rated on the policy. Notice was mailed to Mr. [redacted] requesting this information on 9/15/2015. This was also verbally explained to Mr. [redacted] on 10/29/2015 and 11/09/2015.
The policy cancelled on 11/27/2015 because the exclusion form requested was not received.
If I can be of further assistance, please contact me at ###-###-####.
Sincerely,
Alexandria C[redacted]
there are several points Nationwide
tries to make that are false and extraordinarily misleading.
Let me outline some
confusing things that Nationwide sets forth in their purposefully confusing
explanation. This is clearly an effort to make this issue go away.
Since I won't permit them to defraud other consumers, let me take a
moment to highlight some obvious problems with their explanation.
Webster's dictionary defines the word 'processed' as "to subject to or handle through an established, usually routine set
of procedures (process insurance
claims) that lead to a result[i]"
By this widely accepted definition from a trusted
source, the "processing of a claim" means that the claim
follows a series of steps or procedures that lead to a result of either
being paid or denied.
Nationwide claims that they received and processed the
claim in 3 days. How is that possible since the claim was not denied
until July 21? The claim that they processed the claim in three days
is completely FALSE. They take a small bit of information and manipulate
it to look how they want it to look. If the claim was in fact,
"processed" in three days, how is it that the claim was still
active and being worked on right through May, June, and July? And
even after CLAIMING that they processed this claim in three days, they go
on to say that they hadn't actually issued a decision on the claim until
July 21 and outline the dates that things happened. They claim they
did the right thing in one breath, and tell you that they did not do the
right thing in the next breath. This is an ongoing theme with
Nationwide. I have only been a customer since April 17 and I already
know this.
What is this May 24 date they speak of? I was
never told anything about an additional waiting period for DENTAL.
No one ever mentioned that DENTAL and MEDICAL were separated and
never referred to the two separately. There is no separation in the
policy for dental and the premiums I paid were for MEDICAL. This was
inclusive of DENTAL and there was no additional waiting period. So
how is the date of May 24 even significant? The rep I spoke to on
the phone on July 22 did not know what the date of May 24 meant or why it
was mentioned. She had to put me on hold and ask a supervisor.
She had no explanation for the May 24 date or what it meant.
Where did it come from? What does it mean?
They claim that "Because a dental cleaning
had been done, future claims may be eligible after May 24, 2016."
I again ask, why May 24? What does that mean? And anyone
can tell you that they will DENY any claim relating to her teeth now that
they termed her periodontitis as preexisting. What they really mean
to say here is, "Future claims can be sumitted after May 24, but will
be DENIED and NEVER PAID, because we said she has preexisting disease.
The claim that Nationwide never delayed a claim is
FALSE. Clearly, as I outlined in my initial complaint, the claim was
left to sit until I made contact and started asking questions as to why it
was still pending. The only actions that took place came after I either
called in or made email contact asking about the status of the claim.
How many coincidences should be believed? Every time I asked
about the claim, the very next day, some action was taken on it. And
then it was left to sit longer....
The fact is that the claim was submitted on May 10,
2016 and was not finalized as denied for payment until July 22.
There is no defense for the timeline. The claim was not
processed in 3 days, it was PENDED for decision in 3 days and Nationwide
proceeded to delay making a decision made to pay or not pay for a total of
72 days with a series of delaying tactics that are total nonsense.
When I called in on June 14 to as(k why no decision had been made
after the medical records had been in the hands of Nationwide for three
weeks, I was told that the department was "backed up and has not been
able to review the records as quickly as usual." Really?
There were four doctor visits in my pet's voluminous records.
It takes five minutes to look the few pages over and figure out
whats going on. Of course, when you are trying to delay payments and are
looking for reasons to deny claims, I understand completely why it would
take longer. Amazingly, as usual, the day after my phone call, a
letter stating an additional 30 days would be needed to review the claim.
So I am surprised that Nationwide would LIE and say that they
processed the claim in 30 days, after they issued a letter, 35 days into
the claim process (May 10 to June 15=35 days), saying that ANOTHER 30 days
would be needed. So much for the 30 day claim of Nationwide's.
Further, the Vet did not diagnose her with
gastroenteritis (a viral stomach disorder that causes vomiting) or an
upper respiratory DISEASE. Nationwide DIAGNOSED my animal with these
illnesses for purposes of intentional exclusion if I were ever to bring my
animal in for treatment of these, or ANY OTHER illnesses. My cat did
NOT have GREEN DISCHARGE requiring medical treatment, did not have
VOMITING requiring medical treatment. Nationwide is taking ANY WORDS
in the medical record and making them exclusions- whether or not they
actually exist or were a problem. But then according to them, they
can confabulate, invent, or claim ANY ILLNESS was preexisting within the
UNETHICAL and IMMORAL wording of their policy. They state that
"a preexisting condition means ANY condition that began, was
contracted, manifested, or incurred within TWELVE MONTHS of the effective
date of this policy or during any waiting period, WHETHER OR NOT THE
CONDITION WAS DISCOVERED, DIAGNOSED, OR TREATED..." Under this
definition, ANY ILLNESS will be excluded by Nationwide as preexisting. The
only things Nationwide will pay are injuries that occur to a part of the
body that has never had anything wrong with it, because otherwise they
will claim it was part of a preexisting weakness or injury that occurred
and is PREEXISTING. This type of policy is FRAUDULENT and MISLEADING
to the consumer. Anything to not pay a claim. Anything,
whether immoral, already outlawed in treatment to humans, or misleading to
the customer. Along these same lines, Nationwide would say that
words in the medical record such as "the feline was breathing
heavy" would mean that she has a respiratory disease. Or
"feline was fearful of staff" would mean that the cat has some
kind of preexisting psychiatric problem or organic brain disorder or
disease. Or "feline sneezed" (once) would mean that the cat now has a preexisting allergy or preexisting respiratory disease- from a single sneeze. .Nationwide looks to take words in medical records out of
context and turn the into any kind of possible diagnosis that they can
count as a preexisting condition that they can exclude.In the 1980's and 1990's, in the infancy of human HMO's, insurance companies tried the same thing that Nationwide is doing with its pet insurance. Finding any sneeze and calling it preexisting respiratory disease. A day where a child vomited twice and calling it preexisting gastroenteritis. A doctor who asks "how is the baby doing overall," and when the mother says, "sometimes she has a stuffy nose," the insurance company says there is preexisting respiratory disease. This is exactly what Nationwide has done with pet insurance. Take note that the HMO's attempts to make anything outside of breathing preexisting was met with legislation that outlawed the practice. Obviously, we need tighter laws surrounding the pet insurance industry, because Nationwide is doing the same thing. Shame on you Nationwide. I will make sure that I pass along my experience with Nationwide to all pet owners I know.
Take some free marketing advice, Nationwide should change their catch phrase to: Any preexisting condition. Any word, anywhere, about anything. We can and will find it. Anything to not pay a claim. That's our Nationwide promise. Truth in advertising, right?
Nationwide
continues to lie and deny.
Regards,
[redacted]
I am writing in response to the above referenced file number. The member’s premiums are deducted from his paycheck and remitted by his employer. The member was also sending in checks for partial payments. Our records indicate that we spoke with this member on May 2, 2016 and advised him...
that we would work with his employer and conduct a complete review of his premium payments. An initial overpayment was identified and a refund in the amount of $29.36 was issued on April 21, 2016. A subsequent refund was issued in the amount of $92.52 on May 20, 2016. The member has been refunded the full amount identified in his correspondence. Our records show that both refund checks have been cashed by the member. If I can be of any further assistance in resolving this matter you may contact me directly at ###-###-####. Sincerely, Tom L[redacted]
We are in receipt of your correspondence dated April 25, 2017 addressed to [redacted] regarding[redacted]’s concern regarding the SmartRide program. I will be happy to respond to the concernsof Ms. [redacted] on her behalf.Policy [redacted] is a semi-annual personal automobile policy...
which incepted on October 1,2015 and most recently renewed on April 1, 2017. When Mrs. [redacted]’s 2016 Toyota Avalon wasadded to the policy on December 3, 2016 it was enrolled into the SmartRide program. The SmartRidedevice was installed in the vehicle on December 15, 2016.The normal period of time the device has to be installed is four months prior to renewal date. InMrs.[redacted]’s situation the device was installed 22 days prior to the Janurary 6th scoring date. TheSmartRide device would have needed to be installed by October 13,2016, in order to receive discounteffective at renewal date Apil 1st,2017. Since the device didn’t meet the time requirements,any eligiblediscount will apply to premium that renews on October 1st 2017.The SmartRide program provides personalized feedback to policyholders to help them make even saferdriver decisions. The SmartRide device doesn’t create dangerous driving situations. Mrs.[redacted]stated that she, will speed through yellow lights to prevent from getting a “hard brake penalty”. Thedevice is intended to document your driving habits and positively effect the way you drive.If you require further assistance please contact, Brandon C[redacted], at ###-###-#### or by email at[redacted].Sincerely,Jason M[redacted]
We are in receipt of your communicated dated April 13, 2016 submitted on behalf of Ms. [redacted] regarding communication concerns during her claim, as well as frustration with the payment process.I spoke with Ms. [redacted] on April 13, and we addressed her concerns. We apologize for any communication...
issues during the claims process, as we strive to maintain consistent contact throughout the claim to keep the member informed.While the insured should have been advised of her mortgage company’s inclusion on the check, her mortgage information was not updated on her policy. Therefore, when the claims team issued the payment, we were unaware of the outdated information. When this was brought to our attention, we re-issued the payment immediately and sent the check directly to the mortgage company per Ms. [redacted]’s request. The adjuster spoke with the mortgage company on April 18th to offer to send the estimate for repairs in order to expedite the process for our member.We regret that the complainant is unhappy with the handling of her claim, but we will continue to work with Ms. [redacted] to bring this claim to resolution.Should you require any further assistance in this matter, please contact our Customer Relations Coordinator, Patty G[redacted] at ###-###-#### or via email at [redacted].Sincerely,Averill Y[redacted]
Good Morning,Thank you for the quick reply and for contacting the business on my behalf. While I understand what was stated in the response, I believe it was generic. All that was mentioned was a change in 2016. However, I have been a customer since 2004. I expect more thorough research as to why a policy from 2004 to 2016 is still about $221 a month for a driver that does not have anything on her driving record. I would like a detailed response related directly to my account, not this basic one that I'm sure is used on a regular. In addition, I will attempt to go through the "solution" provided, but my inquiry was not directly answered. I do not need any procedural or policy information; I want direct responses. One 2016 move did not cause this expensive premium.
This inquiry has the incorrect insuring company name and NAIC#. Please update your files with the correct information.CORRECT INSURING COMPANY NAME: National Casualty CompanyCORRECT NAIC #: [redacted]We are in receipt of your request for information regarding the above referenced file. Ms. [redacted] is...
requesting reimbursement for claim 2[redacted]59 for her pet.Ms. [redacted] applied for the Medical Plan with a $100.00 annual deductible for her dog [redacted] on November 29, 2010. The policy was approved with an effective date of December 13, 2010. A medical records request was made on January 6, 2011 based on a claim submitted in close proximity to the policy effective date. No medical records were received for the request until February of 2018.Upon receipt of this complaint, we have reviewed the medical records provided and reprocessed claim [redacted] as eligible. Reimbursement was issued in the amount of $1645.00. Claim [redacted] was also reprocessed as eligible post review and reimbursement was issued in the amount of $120.00.We appreciate Ms. [redacted]’s patience with the review process and are happy to be able to resolve this matter in her favor.Should you require any further assistance in this matter, please contact our Customer Advocacy Coordinator, Kaitlin G[redacted], at ###-###-#### or via email at [redacted]@nationwide.com.Sincerely,Cindy CarterUnderwriting Director
Our records indicate a billing notice was sent for $137.29, which indicated a payment would be deducted from
the insured’s bank account on or after February 2, 2013.
On February 1, 2013, [redacted] contacted our Service Center and requested the draft for
February 2, 2013 be stopped...
so she could make a payment manually. The February draft was stopped,
however, a payment was not received.
A Notice of Cancellation was sent for $137.29 due February 24, 2013 or the policy would cancel effective
February 25, 2013. There was no payment received and the policy cancelled for non payment of premium.
The policy renewal date was September 2, 2012 and the policy cancelled February 25, 2013. During this time
period a total of $884.70 was charged. A total of $770.11 was received during the above time frame. The
$884.70 total charged minus the $770.11 total received in payments equals $114.59 balance due bill.
On March 8, 2013 the balance due bill for $114.59 was sent to the insured stating that this amount was due by
March 27, 2013. It was explained on this bill that the balance was for coverage provided from September 2, 2012
to the cancellation date of February 25, 2013.
The following documents have been attached for your review:
Policy Declarations
Bill
Notice of Cancellation
Proof of Mailing
Balance Due Bill
If you require further assistance, please contact Customer Relations Coordinator, Jane G[redacted] at ###-###-####,
or by email at [redacted] between the hours of 8:00 AM and 4:15 PM.
Sincerely,
Erica D[redacted]
Mr. [redacted] applied for a Home Equity Line of Credit (HELOC) with Nationwide Bank. The information he cites from www.bankrate.com is correct. The 4.4% rate shown, however, is dependent upon a maximum Loan to Value (LTV) ratio of 80%. When Mr. [redacted] applied for the Line of Credit, he agreed to...
Terms and Conditions, including, but not limited to, “All loans are subject to approval and rates vary based on your credit history and loan to value ratio.” Nationwide requested a drive-by appraisal of the home, which was completed on April 13, 2016. That appraisal provided a property value of $309,000.00. With that, the amount of the first mortgage, combined with the requested HELOC loan, determined a LTV in excess of the minimum of 80%. The appraisal was provided to Nationwide Bank and to Mr. [redacted]. Mr. [redacted] disputed the validity of appraisal. Upon receipt of the dispute, the appraisal was reviewed, considering the information included in the dispute. A new appraisal was completed on April 19, 2016. The appraised amount remained the same, and included an addendum responding to the concerns Mr. [redacted] raised in his dispute. The new appraisal was provided to Nationwide Bank and to Mr. [redacted] again. The HELOC application has not been closed. Mr. [redacted] is welcome to continue with his existing request, but at a higher interest rate and a lower maximum loan amount, determined by the LTV. Sincerely, Ann C[redacted] Sr. Analyst, Customer Advocacy Nationwide Bank
Thank you for your recent inquiry regarding a complaint you received from our insured [redacted]. We strive to provide quality service while conforming to the expectations of our customer and all regulations.
Ms. [redacted] had a water loss on March 22, 2015. ...
The water escaped from a pipe in a chase wall on an exterior bathroom. The water leaked down from the upstairs chase wall down into the living and dining area below requiring repair to the walls, ceiling and floor. A containment area was created to limit dust and disturbance to the other areas of the home during the drying and remediation process. On 4/30/15 Ms. [redacted] called our Customer Advocacy Center and stated she was unhappy that she was not placed in a hotel during her repair process and also that she was unhappy with the restoration company because they had not placed all her belongings back in the proper locations in the home. I notified the restoration company who responded and moved the contents into the areas she requested and we also discussed the considerations for additional living accommodations. I explained that while she does have coverage for ALE it was not initiated because the damages were limited to areas of the home that could be contained to prevent as much disturbance as possible. I spoke with her and explained that ALE (Additional Living Expenses) is cost incurred. In her situation as explained, she did not need nor was required to stay in a hotel and the cost was not incurred. No payment can be made since no cost was incurred.
I also apologized for any inconvenience that the loss and repairs caused her and for the issues with the general contractor who needed to return to properly move articles to her desired areas of the home.
Ms. [redacted] commented of a fall that was documented in her complaint to have occurred on May 5th. The fall was never reported to Nationwide but rather to the contractor, [redacted], following the completion of the restoration. The work was completed and a final walkthrough was held on 4/21/15. After the completion of the work Ms. [redacted] contacted the contractor and said she had tripped on the new carpet. It was determined that there was no installation issues with the new carpet but possibly tripped because the carpet was new.
I will include a copy of the estimate and photos in this response. If there are any additional questions or concerns please feel free to call my office at ###-###-####.
This letter is in response to your August 26, 2015 inquiry regarding the above-referenced claim. This claim resulted from an auto accident that occurred on July 31, 2015 in [redacted]The claim was reported to us on August 4, 2015. We promptly initiated our investigation into this accident on the...
same day and were able to speak to both our insured and the complainant. The loss involves a 2011 International Pro Star tractor, VIN [redacted], owned by our insured which was being operated by [redacted] Mr. [redacted] changed lanes and collided with the complainant’s vehicle. Liability for the accident is not contested; however, coverage for the accident was pending as the 2011 International Pro Star tractor was not listed on the policy at the time of the accident.Scottsdale Insurance Company provides [redacted]. with coverage under Policy No. [redacted], effective August 7, 2014 through August 7, 2015. Among other coverages, the policy provides liability coverage for specifically described autos as well as newly-acquired and temporary substitute vehicles.Complainant: [redacted]Both our insured and the complainant were advised that coverage was pending for this loss. We have also been in contact with, and provided the status of our coverage investigation to, the complainant’s insurance agent, [redacted] with Tompkins Insurance Agencies, Inc., on August 13th and August 27th as well as the complainant’s son, [redacted], on August 25th. It is our objective to return all calls within one business day.Today, August 31st, we have been able to confirm the 2011 International Pro Star tractor involved in this accident will be added to the policy as a scheduled auto prior to this accident. As coverage has now been confirmed, we have issued payment to the complainant for their estimated damages and also advised them today that payment is forthcoming.Should you require any further assistance in this matter, please contact our [redacted], Patty G[redacted], at ###-###-#### or via email at [redacted]Sincerely,Norm S[redacted]###-###-#### ###-###-####
I was made aware of this claim file yesterday. I have communicated with both Mr. and Mrs. [redacted] regarding the settlement amount. They understand the total loss process and the settlement amount presented. They are not in agreement with the amount at this time and we are working towards...
resolution. We hope to have this verbally settled today.
In addition, we have sent the required documentation to them for signatures. They understand it will need to be mailed back to Nationwide Insurance with the title.
We hope we can release settlement monies today, on good faith that the owners will mail the required paperwork to our office today.
Typically we must wait until the paperwork is received and is correct prior to 100% release of settlement money. However, given some time delay issues we have made an exception.
Sincerely, Sean C[redacted]
[redacted]
you can clearly see the wire marks in the rims from rubbing against the metal wire guard rail. If you compare the driver's side tires to the passenger side's tire you will see a remarkable difference. The passenger side tire does have normal wear and tear, however the driver's side tire has damages done to it due the accident. We have already come to an understanding that Nationwide is NOT responsible for the rear differential. I was using the payment for the diagnostic as an example to Nationwide to let you know that YOU made the request and I completed the task and paid for the diagnostic which found Nationwide not at fault for the rear end / differential.For the 3rd time my request is for there to be an independent evaluation of the GMC Sierra from an "outside" source to evaluate the accident value that Nationwide has said they will pay to me the customer. I disagree with the payment amount offered as I continue to disagree about the tires being due to wear and tear when you can clearly see wire marks through the rim.So in conclusion my request is for an outside estimate evaluation of the GMC Sierra in order to resolve the issue the I have with Nationwide.Thank you,
Regards, [redacted]
We are in receipt of your request for information dated December 30, 2015 regarding the above referenced file.Mr. [redacted] is disputing the denial of claim [redacted]. He states he had a covered service done the same day of cancellation and thought that the policy would terminate at the end of...
the day.Our records indicate Mr. [redacted] contacted our office twice on November 7, 2015. During the first call he inquired as to what wellness benefits he had used for the current term. The representative confirmed he had used the benefits for flea and heartworm prevention medication. Mr. [redacted] had indicated he wanted to take his pet in for an annual checkup. The representative confirmed he still had benefits available for the term and recommended Mr. [redacted] take the pet in before November 23rd (the date of policy renewal).During the second call on November 7, 2015, Mr. [redacted] inquired as to the expiration and renewal of the policy. He advised the representative that he decided not to renew and wanted to make sure the cancellation was in process. The representative explained cancellation requests must be in writing and submitted via email, fax, or mail.Based on the recorded call, it appears Mr. [redacted] was reading from the screen because he said, “…before submitting a cancellation…I was just seeing you had something online.” The representative explained that he could go to the website, www.petinsurance.com, and click on the “contact us” link located at the top of the page.Mr. [redacted] then explained where he was online, it [the online screen] said cancel policy and took him to the policy cancellation page and it was beginning to tell him what to do.The representative asked Mr. [redacted] if he was logged into his account. (Our policyholders have the option to create an account known as the policyholder portal). The representative explained she wasn’t sure the cancellation tool (on the policyholder portal) would be available since the policy was in its renewal time period (60 days prior to renewal.)Again, from the recorded call, it appears Mr. [redacted] was reading from the screen as he said “you’ll get an email from VPI.” He said it did allow him to cancel and the representative confirmed that the policy now showed cancelled in our policy administration system.At that point Mr. [redacted] explained that he had been with us for a long time but due to the rate and other concerns it was not cost effective. Mr. [redacted] did mention he had just put in a claim for wellness for the current policy. There was no elaboration on the treatment date.Please note, when a policy is cancelled utilizing the policyholder portal, the policyholder sees several screens prior to receiving a cancellation confirmation email. The first screen asks the user to confirm the contact information and reason for cancellation. The screen shows a cancellation effective date and the following statement:“Once you have selected a reason for your cancellation request, please confirm the cancellation date. This is the date the policy will no longer be effective and coverage will no longer be extended for the insured pet. Remember, any claims submitted on or after the cancellation date will be ineligible for coverage.”The next screen advises the user that a confirmation email will be sent, confirms the policy information, cancellation reason, and cancellation effective date. Additionally, the screen shows the following:“Please note: Claims for treatment dates on or after the cancellation effective date will not be eligible for coverage.”Our system does not maintain screen shots of each portal transaction; however we were able to process a cancellation in our test environment with a sample policy to show the exact screens Mr. [redacted] would have seen when he processed his cancellation. We have included screen shots with this response.Claim [redacted] was submitted on November 7, 2015 and does show a treatment date of November 7, 2015. The claim was denied appropriately in accordance with the terms of the policy contract. Mr. [redacted] chose to cancel the policy via the policyholder portal on November 7, 2015. As indicated above several screens showed that claims for the treatment date on or after the cancellation date would not be eligible.Should you require any further assistance in this matter, please contact our [redacted] Patty G[redacted] at ###-###-#### or via email at [redacted].Sincerely,Vincent G[redacted]
We are in receipt of the complaint on the above mentioned matter. Claims Associate, Eric V[redacted], hasbeen working with Mr. and Mrs. [redacted] regarding this claim. Mr. V[redacted] has made several revisionsto the estimate for repairs to address some of the concerns mentioned in the complaint as outlinedbelow:? After discussion with the [redacted]’s contractor and the cabinet installer, we agreed to thereplacement of the kitchen cabinets? The master bedroom carpet was to be resolved directly by [redacted] and their subcontractor. As thishas not been resolved at this time, we agreed to the replacement of this carpet.A copy of the revised estimate has been provided to the [redacted]. Mr. V[redacted] has reviewed therevisions named above with Mrs. [redacted] and she agreed and advised there is nothing additionalneeded at this time. A copy of the revised estimate is attached to this response.If you have any additional questions, please contact Customer Advocacy Coordinator AngelaS[redacted] at [redacted] or [redacted]Sincerely,Stacey H[redacted]
This is in response to [redacted] rejection of the Company’s March 16, 2017 resolution.The complainant is rejecting the prior response because we have not provided proof that the [redacted]Motor Vehicle Administration was notified that the accidents were not at fault. Nationwide Insurance doesnot report accidents to the Motor Vehicle Administration. The Motor Vehicle Administration has no record ofthese accidents. The Company does report accidents to LexisNexis. This is part of Ms. Lewis’ CLUE report.The Company has notified LexisNexis to add a not at fault indicator to the 09/11/15 and 11/03/16 accidents.The CLUE reported previously indicated that fault was not reported or unknown. LexisNexis will mail Ms.Lewis a notification once they complete the request. Ms. Lewis should have the confirmation within twoweeks.If you require further assistance, please contact our Customer Relations Coordinator, Dawn H[redacted], at 614-435-0124 or by email at [redacted]Sincerely,Shari D[redacted]
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[redacted]
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* Dear [redacted]: Thank you for the opportunity to respond to the complaint filed by [redacted] regarding her concerns with the above referenced policy with Nationwide Affinity Insurance Company of America. We have reviewed the concerns expressed by [redacted] and will attempt to address them in this letter. An explanation of [redacted] billing account for the above referenced policy is listed below. A copy of the complete premium and payment history for the last term is enclosed for your reference. Due to the late payment of the bill due on June 19, 2015, the premium due for July billed together with the August installment. The August installment reflected the balance due on the policy for the policy term March 19, 2015, until September 19, 2015. The renewal premium effective September 19, 2015, increased due to a rate adjustment and a chargeable accident dated January 4, 2015. The semi-annual premium increased from $905.30 to $1,491.70. Due to the late payment of the bill due on August 19, 2015, the premium due for September billed together with the October installment. The policy cancelled effective November 9, 2015, for non-payment of the renewal premium and a refund of $148.00 issued. The reinstatement payment dated November 27, 2015, was dishonored for insufficient funds. This caused the account to bill the premium with one less month in the billing cycle. Due to the late payment of the bill due on January 27, 2016, the premium for February billed together with the March installment. The policy cancelled effective April 17, 2016, for non-payment of premium. Below is information pertaining to the claim filed on January 4, 2015 and the chargeability of that loss and the increase in premium. A claim was filed with our Company with a loss date of January 4, 2015. Per the claims investigation it was determined that [redacted], was the operator of the [redacted]. There is no information in the file from the vehicle inspection to indicate that there were any mechanical issues that caused the vehicle to leave the roadway during icy conditions. Our filed and approved rating plan with the State of New York indicates that an accident is chargeable if the insured driver was involved in an accident that resulted in damage to any property in excess of $2,000. Due to the total amount of $2,340 being paid in Property Damage coverage, the January 4, 2015 loss would be chargeable according to our approved filed rating plan. On November 27, 2015 [redacted] auto policy was reinstated with our Company and a revised policy declarations was mailed to her on December 2, 2015. The chargeability of the January 4, 2015 loss was being applied accordingly. A copy of the policy declarations are attached for your reference. We appreciate the opportunity to review [redacted] business, and hope that this information will help to address her concerns. If you require further assistance, please contact our Customer Advocacy Coordinator, Cathy D[redacted], at ###-###-#### or by email at [redacted]. Sincerely, Suzana K[redacted] Manager, Support Services Operations Nationwide ###-###-####
[redacted] [redacted] Tell us why here...
[redacted]Dear [redacted]:This letter is sent in response to the inquiry received on October 1, 2015, from [redacted]. Ihave spoken with both [redacted] and our claims representative, Rob C[redacted]. In myconversation with CA C[redacted], he indicated he had several conversations with [redacted]and in those discussions did agree that the damages were not [redacted]’s fault, but advised thatwe would have to wait until the cause and origin investigation was completed prior to reaching acoverage decision.Once we received our Cause and Origin report, which listed the cause of the fire as undetermined,[redacted] was informed his damages would not be covered. Following this decision and the denialletter which was sent, we have reviewed the facts of loss once again. Based on that review, we haveagreed to pay [redacted]’s damages to his home. [redacted] has been contacted and a check hasbeen issued to him for $4,240.91 on 10/01/15 to cover the damages to his dwelling from the fire.Sincerely,Ron V[redacted]Claims ManagerAllied Property & Casualty I[redacted]Phone: ###-###-####Fax: ###-###-####Email Address: [redacted]Office of Customer Advocacy | [redacted]
This letter is in response to your request for information pertaining to the above file.Our records indicate the Auto policy cancelled effective July 11, 2016 per Ms. [redacted]’s request. Abalance of $103.50 remained for coverage provided up to the cancellation date. Upon receiving theattached...
documentation, the Auto policy cancellation date was adjusted to June 14, 2016. Thebalance due was adjusted to $13.60.The balance will not be sent to collections as it is under the threshold of $20.01.If you require further assistance, please contact our [redacted], Dawn H[redacted], at###-###-#### or by email at [redacted]Sincerely,Erica C[redacted]
Thank you for the opportunity to provide an additional response to the Revdex.com regarding policy number [redacted] for Mr. [redacted]n.
Mr. [redacted] requested to have his spouse, [redacted] excluded from the policy because she was not going to be driving the listed vehicle. Ms. [redacted] was not required to be added to the policy but an exclusion form is required to be submitted when a household member of driving age is not going to be rated on the policy. Notice was mailed to Mr. [redacted] requesting this information on 9/15/2015. This was also verbally explained to Mr. [redacted] on 10/29/2015 and 11/09/2015.
The policy cancelled on 11/27/2015 because the exclusion form requested was not received.
If I can be of further assistance, please contact me at ###-###-####.
Sincerely,
Alexandria C[redacted]
there are several points Nationwide
tries to make that are false and extraordinarily misleading.
Let me outline some
confusing things that Nationwide sets forth in their purposefully confusing
explanation. This is clearly an effort to make this issue go away.
Since I won't permit them to defraud other consumers, let me take a
moment to highlight some obvious problems with their explanation.
Webster's dictionary defines the word 'processed' as "to subject to or handle through an established, usually routine set
of procedures (process insurance
claims) that lead to a result[i]"
By this widely accepted definition from a trusted
source, the "processing of a claim" means that the claim
follows a series of steps or procedures that lead to a result of either
being paid or denied.
Nationwide claims that they received and processed the
claim in 3 days. How is that possible since the claim was not denied
until July 21? The claim that they processed the claim in three days
is completely FALSE. They take a small bit of information and manipulate
it to look how they want it to look. If the claim was in fact,
"processed" in three days, how is it that the claim was still
active and being worked on right through May, June, and July? And
even after CLAIMING that they processed this claim in three days, they go
on to say that they hadn't actually issued a decision on the claim until
July 21 and outline the dates that things happened. They claim they
did the right thing in one breath, and tell you that they did not do the
right thing in the next breath. This is an ongoing theme with
Nationwide. I have only been a customer since April 17 and I already
know this.
What is this May 24 date they speak of? I was
never told anything about an additional waiting period for DENTAL.
No one ever mentioned that DENTAL and MEDICAL were separated and
never referred to the two separately. There is no separation in the
policy for dental and the premiums I paid were for MEDICAL. This was
inclusive of DENTAL and there was no additional waiting period. So
how is the date of May 24 even significant? The rep I spoke to on
the phone on July 22 did not know what the date of May 24 meant or why it
was mentioned. She had to put me on hold and ask a supervisor.
She had no explanation for the May 24 date or what it meant.
Where did it come from? What does it mean?
They claim that "Because a dental cleaning
had been done, future claims may be eligible after May 24, 2016."
I again ask, why May 24? What does that mean? And anyone
can tell you that they will DENY any claim relating to her teeth now that
they termed her periodontitis as preexisting. What they really mean
to say here is, "Future claims can be sumitted after May 24, but will
be DENIED and NEVER PAID, because we said she has preexisting disease.
The claim that Nationwide never delayed a claim is
FALSE. Clearly, as I outlined in my initial complaint, the claim was
left to sit until I made contact and started asking questions as to why it
was still pending. The only actions that took place came after I either
called in or made email contact asking about the status of the claim.
How many coincidences should be believed? Every time I asked
about the claim, the very next day, some action was taken on it. And
then it was left to sit longer....
The fact is that the claim was submitted on May 10,
2016 and was not finalized as denied for payment until July 22.
There is no defense for the timeline. The claim was not
processed in 3 days, it was PENDED for decision in 3 days and Nationwide
proceeded to delay making a decision made to pay or not pay for a total of
72 days with a series of delaying tactics that are total nonsense.
When I called in on June 14 to as(k why no decision had been made
after the medical records had been in the hands of Nationwide for three
weeks, I was told that the department was "backed up and has not been
able to review the records as quickly as usual." Really?
There were four doctor visits in my pet's voluminous records.
It takes five minutes to look the few pages over and figure out
whats going on. Of course, when you are trying to delay payments and are
looking for reasons to deny claims, I understand completely why it would
take longer. Amazingly, as usual, the day after my phone call, a
letter stating an additional 30 days would be needed to review the claim.
So I am surprised that Nationwide would LIE and say that they
processed the claim in 30 days, after they issued a letter, 35 days into
the claim process (May 10 to June 15=35 days), saying that ANOTHER 30 days
would be needed. So much for the 30 day claim of Nationwide's.
Further, the Vet did not diagnose her with
gastroenteritis (a viral stomach disorder that causes vomiting) or an
upper respiratory DISEASE. Nationwide DIAGNOSED my animal with these
illnesses for purposes of intentional exclusion if I were ever to bring my
animal in for treatment of these, or ANY OTHER illnesses. My cat did
NOT have GREEN DISCHARGE requiring medical treatment, did not have
VOMITING requiring medical treatment. Nationwide is taking ANY WORDS
in the medical record and making them exclusions- whether or not they
actually exist or were a problem. But then according to them, they
can confabulate, invent, or claim ANY ILLNESS was preexisting within the
UNETHICAL and IMMORAL wording of their policy. They state that
"a preexisting condition means ANY condition that began, was
contracted, manifested, or incurred within TWELVE MONTHS of the effective
date of this policy or during any waiting period, WHETHER OR NOT THE
CONDITION WAS DISCOVERED, DIAGNOSED, OR TREATED..." Under this
definition, ANY ILLNESS will be excluded by Nationwide as preexisting. The
only things Nationwide will pay are injuries that occur to a part of the
body that has never had anything wrong with it, because otherwise they
will claim it was part of a preexisting weakness or injury that occurred
and is PREEXISTING. This type of policy is FRAUDULENT and MISLEADING
to the consumer. Anything to not pay a claim. Anything,
whether immoral, already outlawed in treatment to humans, or misleading to
the customer. Along these same lines, Nationwide would say that
words in the medical record such as "the feline was breathing
heavy" would mean that she has a respiratory disease. Or
"feline was fearful of staff" would mean that the cat has some
kind of preexisting psychiatric problem or organic brain disorder or
disease. Or "feline sneezed" (once) would mean that the cat now has a preexisting allergy or preexisting respiratory disease- from a single sneeze. .Nationwide looks to take words in medical records out of
context and turn the into any kind of possible diagnosis that they can
count as a preexisting condition that they can exclude.In the 1980's and 1990's, in the infancy of human HMO's, insurance companies tried the same thing that Nationwide is doing with its pet insurance. Finding any sneeze and calling it preexisting respiratory disease. A day where a child vomited twice and calling it preexisting gastroenteritis. A doctor who asks "how is the baby doing overall," and when the mother says, "sometimes she has a stuffy nose," the insurance company says there is preexisting respiratory disease. This is exactly what Nationwide has done with pet insurance. Take note that the HMO's attempts to make anything outside of breathing preexisting was met with legislation that outlawed the practice. Obviously, we need tighter laws surrounding the pet insurance industry, because Nationwide is doing the same thing. Shame on you Nationwide. I will make sure that I pass along my experience with Nationwide to all pet owners I know.
Take some free marketing advice, Nationwide should change their catch phrase to: Any preexisting condition. Any word, anywhere, about anything. We can and will find it. Anything to not pay a claim. That's our Nationwide promise. Truth in advertising, right?
Nationwide
continues to lie and deny.
Regards,
[redacted]
I am writing in response to the above referenced file number. The member’s premiums are deducted from his paycheck and remitted by his employer. The member was also sending in checks for partial payments. Our records indicate that we spoke with this member on May 2, 2016 and advised him...
that we would work with his employer and conduct a complete review of his premium payments. An initial overpayment was identified and a refund in the amount of $29.36 was issued on April 21, 2016. A subsequent refund was issued in the amount of $92.52 on May 20, 2016. The member has been refunded the full amount identified in his correspondence. Our records show that both refund checks have been cashed by the member. If I can be of any further assistance in resolving this matter you may contact me directly at ###-###-####. Sincerely, Tom L[redacted]
We are in receipt of your correspondence dated April 25, 2017 addressed to [redacted] regarding[redacted]’s concern regarding the SmartRide program. I will be happy to respond to the concernsof Ms. [redacted] on her behalf.Policy [redacted] is a semi-annual personal automobile policy...
which incepted on October 1,2015 and most recently renewed on April 1, 2017. When Mrs. [redacted]’s 2016 Toyota Avalon wasadded to the policy on December 3, 2016 it was enrolled into the SmartRide program. The SmartRidedevice was installed in the vehicle on December 15, 2016.The normal period of time the device has to be installed is four months prior to renewal date. InMrs.[redacted]’s situation the device was installed 22 days prior to the Janurary 6th scoring date. TheSmartRide device would have needed to be installed by October 13,2016, in order to receive discounteffective at renewal date Apil 1st,2017. Since the device didn’t meet the time requirements,any eligiblediscount will apply to premium that renews on October 1st 2017.The SmartRide program provides personalized feedback to policyholders to help them make even saferdriver decisions. The SmartRide device doesn’t create dangerous driving situations. Mrs.[redacted]stated that she, will speed through yellow lights to prevent from getting a “hard brake penalty”. Thedevice is intended to document your driving habits and positively effect the way you drive.If you require further assistance please contact, Brandon C[redacted], at ###-###-#### or by email at[redacted].Sincerely,Jason M[redacted]
We are in receipt of your communicated dated April 13, 2016 submitted on behalf of Ms. [redacted] regarding communication concerns during her claim, as well as frustration with the payment process.I spoke with Ms. [redacted] on April 13, and we addressed her concerns. We apologize for any communication...
issues during the claims process, as we strive to maintain consistent contact throughout the claim to keep the member informed.While the insured should have been advised of her mortgage company’s inclusion on the check, her mortgage information was not updated on her policy. Therefore, when the claims team issued the payment, we were unaware of the outdated information. When this was brought to our attention, we re-issued the payment immediately and sent the check directly to the mortgage company per Ms. [redacted]’s request. The adjuster spoke with the mortgage company on April 18th to offer to send the estimate for repairs in order to expedite the process for our member.We regret that the complainant is unhappy with the handling of her claim, but we will continue to work with Ms. [redacted] to bring this claim to resolution.Should you require any further assistance in this matter, please contact our Customer Relations Coordinator, Patty G[redacted] at ###-###-#### or via email at [redacted].Sincerely,Averill Y[redacted]
Good Morning,Thank you for the quick reply and for contacting the business on my behalf. While I understand what was stated in the response, I believe it was generic. All that was mentioned was a change in 2016. However, I have been a customer since 2004. I expect more thorough research as to why a policy from 2004 to 2016 is still about $221 a month for a driver that does not have anything on her driving record. I would like a detailed response related directly to my account, not this basic one that I'm sure is used on a regular. In addition, I will attempt to go through the "solution" provided, but my inquiry was not directly answered. I do not need any procedural or policy information; I want direct responses. One 2016 move did not cause this expensive premium.
This inquiry has the incorrect insuring company name and NAIC#. Please update your files with the correct information.CORRECT INSURING COMPANY NAME: National Casualty CompanyCORRECT NAIC #: [redacted]We are in receipt of your request for information regarding the above referenced file. Ms. [redacted] is...
requesting reimbursement for claim 2[redacted]59 for her pet.Ms. [redacted] applied for the Medical Plan with a $100.00 annual deductible for her dog [redacted] on November 29, 2010. The policy was approved with an effective date of December 13, 2010. A medical records request was made on January 6, 2011 based on a claim submitted in close proximity to the policy effective date. No medical records were received for the request until February of 2018.Upon receipt of this complaint, we have reviewed the medical records provided and reprocessed claim [redacted] as eligible. Reimbursement was issued in the amount of $1645.00. Claim [redacted] was also reprocessed as eligible post review and reimbursement was issued in the amount of $120.00.We appreciate Ms. [redacted]’s patience with the review process and are happy to be able to resolve this matter in her favor.Should you require any further assistance in this matter, please contact our Customer Advocacy Coordinator, Kaitlin G[redacted], at ###-###-#### or via email at [redacted]@nationwide.com.Sincerely,Cindy CarterUnderwriting Director
Our records indicate a billing notice was sent for $137.29, which indicated a payment would be deducted from
the insured’s bank account on or after February 2, 2013.
On February 1, 2013, [redacted] contacted our Service Center and requested the draft for
February 2, 2013 be stopped...
so she could make a payment manually. The February draft was stopped,
however, a payment was not received.
A Notice of Cancellation was sent for $137.29 due February 24, 2013 or the policy would cancel effective
February 25, 2013. There was no payment received and the policy cancelled for non payment of premium.
The policy renewal date was September 2, 2012 and the policy cancelled February 25, 2013. During this time
period a total of $884.70 was charged. A total of $770.11 was received during the above time frame. The
$884.70 total charged minus the $770.11 total received in payments equals $114.59 balance due bill.
On March 8, 2013 the balance due bill for $114.59 was sent to the insured stating that this amount was due by
March 27, 2013. It was explained on this bill that the balance was for coverage provided from September 2, 2012
to the cancellation date of February 25, 2013.
The following documents have been attached for your review:
Policy Declarations
Bill
Notice of Cancellation
Proof of Mailing
Balance Due Bill
If you require further assistance, please contact Customer Relations Coordinator, Jane G[redacted] at ###-###-####,
or by email at [redacted] between the hours of 8:00 AM and 4:15 PM.
Sincerely,
Erica D[redacted]
Mr. [redacted] applied for a Home Equity Line of Credit (HELOC) with Nationwide Bank. The information he cites from www.bankrate.com is correct. The 4.4% rate shown, however, is dependent upon a maximum Loan to Value (LTV) ratio of 80%. When Mr. [redacted] applied for the Line of Credit, he agreed to...
Terms and Conditions, including, but not limited to, “All loans are subject to approval and rates vary based on your credit history and loan to value ratio.” Nationwide requested a drive-by appraisal of the home, which was completed on April 13, 2016. That appraisal provided a property value of $309,000.00. With that, the amount of the first mortgage, combined with the requested HELOC loan, determined a LTV in excess of the minimum of 80%. The appraisal was provided to Nationwide Bank and to Mr. [redacted]. Mr. [redacted] disputed the validity of appraisal. Upon receipt of the dispute, the appraisal was reviewed, considering the information included in the dispute. A new appraisal was completed on April 19, 2016. The appraised amount remained the same, and included an addendum responding to the concerns Mr. [redacted] raised in his dispute. The new appraisal was provided to Nationwide Bank and to Mr. [redacted] again. The HELOC application has not been closed. Mr. [redacted] is welcome to continue with his existing request, but at a higher interest rate and a lower maximum loan amount, determined by the LTV. Sincerely, Ann C[redacted] Sr. Analyst, Customer Advocacy Nationwide Bank
Thank you for your recent inquiry regarding a complaint you received from our insured [redacted]. We strive to provide quality service while conforming to the expectations of our customer and all regulations.
Ms. [redacted] had a water loss on March 22, 2015. ...
The water escaped from a pipe in a chase wall on an exterior bathroom. The water leaked down from the upstairs chase wall down into the living and dining area below requiring repair to the walls, ceiling and floor. A containment area was created to limit dust and disturbance to the other areas of the home during the drying and remediation process. On 4/30/15 Ms. [redacted] called our Customer Advocacy Center and stated she was unhappy that she was not placed in a hotel during her repair process and also that she was unhappy with the restoration company because they had not placed all her belongings back in the proper locations in the home. I notified the restoration company who responded and moved the contents into the areas she requested and we also discussed the considerations for additional living accommodations. I explained that while she does have coverage for ALE it was not initiated because the damages were limited to areas of the home that could be contained to prevent as much disturbance as possible. I spoke with her and explained that ALE (Additional Living Expenses) is cost incurred. In her situation as explained, she did not need nor was required to stay in a hotel and the cost was not incurred. No payment can be made since no cost was incurred.
I also apologized for any inconvenience that the loss and repairs caused her and for the issues with the general contractor who needed to return to properly move articles to her desired areas of the home.
Ms. [redacted] commented of a fall that was documented in her complaint to have occurred on May 5th. The fall was never reported to Nationwide but rather to the contractor, [redacted], following the completion of the restoration. The work was completed and a final walkthrough was held on 4/21/15. After the completion of the work Ms. [redacted] contacted the contractor and said she had tripped on the new carpet. It was determined that there was no installation issues with the new carpet but possibly tripped because the carpet was new.
I will include a copy of the estimate and photos in this response. If there are any additional questions or concerns please feel free to call my office at ###-###-####.
Sincerely,
Warren Y[redacted]
[redacted]
This letter is in response to your August 26, 2015 inquiry regarding the above-referenced claim. This claim resulted from an auto accident that occurred on July 31, 2015 in [redacted]The claim was reported to us on August 4, 2015. We promptly initiated our investigation into this accident on the...
same day and were able to speak to both our insured and the complainant. The loss involves a 2011 International Pro Star tractor, VIN [redacted], owned by our insured which was being operated by [redacted] Mr. [redacted] changed lanes and collided with the complainant’s vehicle. Liability for the accident is not contested; however, coverage for the accident was pending as the 2011 International Pro Star tractor was not listed on the policy at the time of the accident.Scottsdale Insurance Company provides [redacted]. with coverage under Policy No. [redacted], effective August 7, 2014 through August 7, 2015. Among other coverages, the policy provides liability coverage for specifically described autos as well as newly-acquired and temporary substitute vehicles.Complainant: [redacted]Both our insured and the complainant were advised that coverage was pending for this loss. We have also been in contact with, and provided the status of our coverage investigation to, the complainant’s insurance agent, [redacted] with Tompkins Insurance Agencies, Inc., on August 13th and August 27th as well as the complainant’s son, [redacted], on August 25th. It is our objective to return all calls within one business day.Today, August 31st, we have been able to confirm the 2011 International Pro Star tractor involved in this accident will be added to the policy as a scheduled auto prior to this accident. As coverage has now been confirmed, we have issued payment to the complainant for their estimated damages and also advised them today that payment is forthcoming.Should you require any further assistance in this matter, please contact our [redacted], Patty G[redacted], at ###-###-#### or via email at [redacted]Sincerely,Norm S[redacted]###-###-#### ###-###-####
I was made aware of this claim file yesterday. I have communicated with both Mr. and Mrs. [redacted] regarding the settlement amount. They understand the total loss process and the settlement amount presented. They are not in agreement with the amount at this time and we are working towards...
resolution. We hope to have this verbally settled today.
In addition, we have sent the required documentation to them for signatures. They understand it will need to be mailed back to Nationwide Insurance with the title.
We hope we can release settlement monies today, on good faith that the owners will mail the required paperwork to our office today.
Typically we must wait until the paperwork is received and is correct prior to 100% release of settlement money. However, given some time delay issues we have made an exception.
Sincerely, Sean C[redacted]
[redacted]
you can clearly see the wire marks in the rims from rubbing against the metal wire guard rail. If you compare the driver's side tires to the passenger side's tire you will see a remarkable difference. The passenger side tire does have normal wear and tear, however the driver's side tire has damages done to it due the accident. We have already come to an understanding that Nationwide is NOT responsible for the rear differential. I was using the payment for the diagnostic as an example to Nationwide to let you know that YOU made the request and I completed the task and paid for the diagnostic which found Nationwide not at fault for the rear end / differential.For the 3rd time my request is for there to be an independent evaluation of the GMC Sierra from an "outside" source to evaluate the accident value that Nationwide has said they will pay to me the customer. I disagree with the payment amount offered as I continue to disagree about the tires being due to wear and tear when you can clearly see wire marks through the rim.So in conclusion my request is for an outside estimate evaluation of the GMC Sierra in order to resolve the issue the I have with Nationwide.Thank you,
Regards, [redacted]
We are in receipt of your request for information dated December 30, 2015 regarding the above referenced file.Mr. [redacted] is disputing the denial of claim [redacted]. He states he had a covered service done the same day of cancellation and thought that the policy would terminate at the end of...
the day.Our records indicate Mr. [redacted] contacted our office twice on November 7, 2015. During the first call he inquired as to what wellness benefits he had used for the current term. The representative confirmed he had used the benefits for flea and heartworm prevention medication. Mr. [redacted] had indicated he wanted to take his pet in for an annual checkup. The representative confirmed he still had benefits available for the term and recommended Mr. [redacted] take the pet in before November 23rd (the date of policy renewal).During the second call on November 7, 2015, Mr. [redacted] inquired as to the expiration and renewal of the policy. He advised the representative that he decided not to renew and wanted to make sure the cancellation was in process. The representative explained cancellation requests must be in writing and submitted via email, fax, or mail.Based on the recorded call, it appears Mr. [redacted] was reading from the screen because he said, “…before submitting a cancellation…I was just seeing you had something online.” The representative explained that he could go to the website, www.petinsurance.com, and click on the “contact us” link located at the top of the page.Mr. [redacted] then explained where he was online, it [the online screen] said cancel policy and took him to the policy cancellation page and it was beginning to tell him what to do.The representative asked Mr. [redacted] if he was logged into his account. (Our policyholders have the option to create an account known as the policyholder portal). The representative explained she wasn’t sure the cancellation tool (on the policyholder portal) would be available since the policy was in its renewal time period (60 days prior to renewal.)Again, from the recorded call, it appears Mr. [redacted] was reading from the screen as he said “you’ll get an email from VPI.” He said it did allow him to cancel and the representative confirmed that the policy now showed cancelled in our policy administration system.At that point Mr. [redacted] explained that he had been with us for a long time but due to the rate and other concerns it was not cost effective. Mr. [redacted] did mention he had just put in a claim for wellness for the current policy. There was no elaboration on the treatment date.Please note, when a policy is cancelled utilizing the policyholder portal, the policyholder sees several screens prior to receiving a cancellation confirmation email. The first screen asks the user to confirm the contact information and reason for cancellation. The screen shows a cancellation effective date and the following statement:“Once you have selected a reason for your cancellation request, please confirm the cancellation date. This is the date the policy will no longer be effective and coverage will no longer be extended for the insured pet. Remember, any claims submitted on or after the cancellation date will be ineligible for coverage.”The next screen advises the user that a confirmation email will be sent, confirms the policy information, cancellation reason, and cancellation effective date. Additionally, the screen shows the following:“Please note: Claims for treatment dates on or after the cancellation effective date will not be eligible for coverage.”Our system does not maintain screen shots of each portal transaction; however we were able to process a cancellation in our test environment with a sample policy to show the exact screens Mr. [redacted] would have seen when he processed his cancellation. We have included screen shots with this response.Claim [redacted] was submitted on November 7, 2015 and does show a treatment date of November 7, 2015. The claim was denied appropriately in accordance with the terms of the policy contract. Mr. [redacted] chose to cancel the policy via the policyholder portal on November 7, 2015. As indicated above several screens showed that claims for the treatment date on or after the cancellation date would not be eligible.Should you require any further assistance in this matter, please contact our [redacted] Patty G[redacted] at ###-###-#### or via email at [redacted].Sincerely,Vincent G[redacted]
We are in receipt of the complaint on the above mentioned matter. Claims Associate, Eric V[redacted], hasbeen working with Mr. and Mrs. [redacted] regarding this claim. Mr. V[redacted] has made several revisionsto the estimate for repairs to address some of the concerns mentioned in the complaint as outlinedbelow:? After discussion with the [redacted]’s contractor and the cabinet installer, we agreed to thereplacement of the kitchen cabinets? The master bedroom carpet was to be resolved directly by [redacted] and their subcontractor. As thishas not been resolved at this time, we agreed to the replacement of this carpet.A copy of the revised estimate has been provided to the [redacted]. Mr. V[redacted] has reviewed therevisions named above with Mrs. [redacted] and she agreed and advised there is nothing additionalneeded at this time. A copy of the revised estimate is attached to this response.If you have any additional questions, please contact Customer Advocacy Coordinator AngelaS[redacted] at [redacted] or [redacted]Sincerely,Stacey H[redacted]
This is in response to [redacted] rejection of the Company’s March 16, 2017 resolution.The complainant is rejecting the prior response because we have not provided proof that the [redacted]Motor Vehicle Administration was notified that the accidents were not at fault. Nationwide Insurance doesnot report accidents to the Motor Vehicle Administration. The Motor Vehicle Administration has no record ofthese accidents. The Company does report accidents to LexisNexis. This is part of Ms. Lewis’ CLUE report.The Company has notified LexisNexis to add a not at fault indicator to the 09/11/15 and 11/03/16 accidents.The CLUE reported previously indicated that fault was not reported or unknown. LexisNexis will mail Ms.Lewis a notification once they complete the request. Ms. Lewis should have the confirmation within twoweeks.If you require further assistance, please contact our Customer Relations Coordinator, Dawn H[redacted], at 614-435-0124 or by email at [redacted]Sincerely,Shari D[redacted]
July 8, 2016 *
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* Dear [redacted]: Thank you for the opportunity to respond to the complaint filed by [redacted] regarding her concerns with the above referenced policy with Nationwide Affinity Insurance Company of America. We have reviewed the concerns expressed by [redacted] and will attempt to address them in this letter. An explanation of [redacted] billing account for the above referenced policy is listed below. A copy of the complete premium and payment history for the last term is enclosed for your reference. Due to the late payment of the bill due on June 19, 2015, the premium due for July billed together with the August installment. The August installment reflected the balance due on the policy for the policy term March 19, 2015, until September 19, 2015. The renewal premium effective September 19, 2015, increased due to a rate adjustment and a chargeable accident dated January 4, 2015. The semi-annual premium increased from $905.30 to $1,491.70. Due to the late payment of the bill due on August 19, 2015, the premium due for September billed together with the October installment. The policy cancelled effective November 9, 2015, for non-payment of the renewal premium and a refund of $148.00 issued. The reinstatement payment dated November 27, 2015, was dishonored for insufficient funds. This caused the account to bill the premium with one less month in the billing cycle. Due to the late payment of the bill due on January 27, 2016, the premium for February billed together with the March installment. The policy cancelled effective April 17, 2016, for non-payment of premium. Below is information pertaining to the claim filed on January 4, 2015 and the chargeability of that loss and the increase in premium. A claim was filed with our Company with a loss date of January 4, 2015. Per the claims investigation it was determined that [redacted], was the operator of the [redacted]. There is no information in the file from the vehicle inspection to indicate that there were any mechanical issues that caused the vehicle to leave the roadway during icy conditions. Our filed and approved rating plan with the State of New York indicates that an accident is chargeable if the insured driver was involved in an accident that resulted in damage to any property in excess of $2,000. Due to the total amount of $2,340 being paid in Property Damage coverage, the January 4, 2015 loss would be chargeable according to our approved filed rating plan. On November 27, 2015 [redacted] auto policy was reinstated with our Company and a revised policy declarations was mailed to her on December 2, 2015. The chargeability of the January 4, 2015 loss was being applied accordingly. A copy of the policy declarations are attached for your reference. We appreciate the opportunity to review [redacted] business, and hope that this information will help to address her concerns. If you require further assistance, please contact our Customer Advocacy Coordinator, Cathy D[redacted], at ###-###-#### or by email at [redacted]. Sincerely, Suzana K[redacted] Manager, Support Services Operations Nationwide ###-###-####
[redacted] [redacted] Tell us why here...
October 7, 2015[redacted]...
[redacted]Dear [redacted]:This letter is sent in response to the inquiry received on October 1, 2015, from [redacted]. Ihave spoken with both [redacted] and our claims representative, Rob C[redacted]. In myconversation with CA C[redacted], he indicated he had several conversations with [redacted]and in those discussions did agree that the damages were not [redacted]’s fault, but advised thatwe would have to wait until the cause and origin investigation was completed prior to reaching acoverage decision.Once we received our Cause and Origin report, which listed the cause of the fire as undetermined,[redacted] was informed his damages would not be covered. Following this decision and the denialletter which was sent, we have reviewed the facts of loss once again. Based on that review, we haveagreed to pay [redacted]’s damages to his home. [redacted] has been contacted and a check hasbeen issued to him for $4,240.91 on 10/01/15 to cover the damages to his dwelling from the fire.Sincerely,Ron V[redacted]Claims ManagerAllied Property & Casualty I[redacted]Phone: ###-###-####Fax: ###-###-####Email Address: [redacted]Office of Customer Advocacy | [redacted]
THEY STILL FAIL TO HONOR DATE OF CANCELLATION. IT APPEARS AS IF THEY CANNNOT READ AND COMPREHEND!
Regards, [redacted]