CLAIM AGENT- "SUSPISCOUS LOSS" RESERVATION OF RIG

by COUNTRYCOY » Tue Jul 21, 2009 03:43 am

I RECENTLY HAD MY 2008 MAGNUM vandalized at my job. I am a domestic violence teacher for court ordered abusers and i recently left my car in my jobs parking lot because i went out for drinks after work with a friend. After having a few drinks with my friend at our local applebees we were driving back to get my car and saw alot of county police out that night. Beeing that my drivers license was suspended at the time i decided not to take that chance and drive a lil intoxicated with a bad DL. So after a brief discussion we decided that my friend would take me home and me and my wife would come back and get my car the next day. I last saw my car round 11:30 pm with no damages or problems. I get awaken at my apt round 1:50 by my local police that my car was found in the next county at my job on fire. i speak to the police that night and was waiting on another call by the police when i fell asleep. i woke up and call progressive the next day and reported the claim. a fire and theft agent came to my house and took my statement. the police called me and asked a few questions but that was it. The next week the claims adjuster asked me for my phone records and stated that it was a suspicious loss, i asked him what that meant and he said it was just suspicious. i provided them with my phone records and the name of my friend who i was with. they eventually got me setteled into a rental after i got my DL reinsatated the same week. A special investigator showed up un announced at my job after looking at the scene of the vandalism. i answered his questions and was very cordial. My friend was eventually called as well as my wife and asked to give a recorded statement over the phone. they both did with no problem, recently after about three and a half weeks i recieved a RESERVATION OF RIGHTS LETTER from my claims agent and when i called him his voice mail said that he was on vacation for 10 days. in the letter i was asked to call and scheduled another recorded statement with another special investigator at there office. i checked my claim online and it said they had complete the at fault liability part of the claim but didnt give any other info but to contact my claims adjuster. it also showed that the payment part had not been completed and was ongoing. MY QUESTION IS WHAT IS GOING ON?? DOES THIS LETTER MEAN THAT MY CLAIM WILL NOT BE PAID OR THAT I AM A SUSPECT IN THIS SUSPICIOUS LOSS? I GO TALK TO THEM NEXT TUESDAY THE 28TH AND I AM WONDERING DO I NEED TO DO ANYTHING IN RESPONSE TO THE LETTER. more info available if needed to answer question. I am very confused and i am starting to get frustrated.

Total Comments: 17

Posted: Tue Jul 21, 2009 10:03 am Post Subject:

it also showed that the payment part had not been completed and was ongoing.


It's quite clear that there's been an on-going investigation over the liability part of your claim. Such investigations may take sometime before they would arrive at any conclusion. Now, are you going to meet the adjuster on the 28th? Or is it that they want you to meet someone else this time?

Posted: Tue Jul 21, 2009 10:38 am Post Subject:

Hello Countrycoy, unfortunately every such claims involving torching of vehicles can raise suspicions to the insurer's mind and the letter of reservation of rights is only their safeguard against paying out wrong claims.

The reservation of rights letter doesn't suggest that your claim would be denied rather it suggests that the claim might get denied depending upon the facts discovered during the investigation.

~Jeremy

Posted: Tue Jul 21, 2009 12:06 pm Post Subject:

MY QUESTION IS WHAT IS GOING ON??

They probably want to do an exam under oath. What's going on is that there are some 'red flags' in your claim. They just need to check them out prior to issuing any payment...

DOES THIS LETTER MEAN THAT MY CLAIM WILL NOT BE PAID OR THAT I AM A SUSPECT IN THIS SUSPICIOUS LOSS?

no, and yes...

I GO TALK TO THEM NEXT TUESDAY THE 28TH AND I AM WONDERING DO I NEED TO DO ANYTHING IN RESPONSE TO THE LETTER.

If the ROR said to call them then call him back when you get his/her voice mail zero out, and ask the rep that picks up to talk to his/her supervisor, and ask if anything else is needed other than the meeting next tues...ask where the investigation is..

more info available if needed to answer question. I am very confused and i am starting to get frustrated.

Let me ask you a couple of questions:
Have you EVER had any other fire or theft claims?
How long have you had this policy with this company?
Why were you driving at all with no license?
Have you been late on any of these or other payments?

Posted: Tue Jul 21, 2009 03:46 pm Post Subject: reply

@ STEVEN, JEREMEY, & LORI THANK YOU FOR REPLYING.

@Lori... Yes since moving to md from fla in 2005 i have had a 2003 Chrysler concord stole twice... the first time it was stole i was on University of Md's Campus and it was stole with a screwdriver in the ignition and recovered a few days later with not much damage but to the ignition where they used a screw driver to start it. i got it back and about a month later it was stole again this time from my apt and was found completly burnt, i believe the kids in the area saw that i was starting it with a screwdriver since i hadnt gotten it fixed yet. $ WAS TIGHT AT THE TIME AND I COULDNT AFFORD TO SPEND THE 500 for the deductible at the time. I had i believe Progressive and nothing was ever in question. That was 2006, i eventually had to get a loan and i bought a 99 police edition crown victoria for 5 grand and that was stole from the movies, xmas eve 2007 while i was watching blood diamond. it was found 30 days later in washington dc, with bullet holes in the wind shield and some other body damage, it was declared a total loss, and i think it was because the junk yard prolly had it a while it just sat there and looked like it had been striped of some parts. i believe that was progressive to and the claim was paid in a timely manner..

i have recently gotten married in april and me and my wife switched back to progressive after i had esurance for a while, so we have had progressive for at least 5 months because we were just renewed since my car was vandalized...

i was driving because my wife was out of town on business since that sunday and i had to get my daughter to school and i had to be to work and there was no other way i could drop her off at school and go to work and pick her up from after care without me driving. I had just recived the letter that my dl was suspended that week, i had gotten pulled over about a month earlier and the trooper said my dl was suspended because i got a ticket in GA IN 2007, I found that ticket (that i honestly forgot about) and he had the wrong state on my ticket so i never got the paper work, he had columbia south carolina instead of columbia md. i had recently gotten my dl replaced in late april because i lost them and the dmv didnt tell me my dl was suspended and the trooper saw the re-issue date on the dl and let me go.

Fortunately i make good $$ and my wife makes damn near double what i make so i have never been late or missed a payment in 14-15 months of paying my car note and my credit has actually gotten better in the past year and a half so $$ for us hasnt been a problem

i have the "follow up recorded statement set for the 28th" and i do not believe it is a under oath statement because it was worded follow up with the siu investigator, i have only given one recorded statement and that was with the claims agent. on line it says they have completed the determination of fault process but it doesnt say who is at fault, why would i have to do another statement if he has already determined in his mind who was at fault. His supervisor just called me back and said that he doesnt know why he did that because they ususally wait untill the end to determine whos at fault or at least wait til the end to say who's at fault.

i honestly am a little nervous due to the fact that i need my car and i have a a bay due in october, and i am not really sure whats going on, me and my friend will had a small debate on whether i should drive my car back home right next to my car before he talked some sense into me and we left it, i say that because i am a domestic violence coordinator and teacher and i have a criminal justice degree and i can not afford any type of criminal charges against me or i would be S.O.L in trying to find a job with my degree, so a dui and driving on a suspended licsense for a 2nd time in a 6 week span would have been a big NO NO, so i left it thinking i was doing the right thing. I now wish i would have just drove it home after sleeping for an hour or two but i doubt wifey would have bought that..lol

Posted: Tue Jul 21, 2009 09:45 pm Post Subject:

Yes since moving to md from fla in 2005 i have had a 2003 Chrysler concord stole twice..

Well there ya' go... GIANT red flag to an insurance adjuster..four total vehicle thefts in three years! and then,

was found completly burnt,

two out of the three thefts, are recovered burned! geeze, GIANT red flag number two! You haven't had this new policy for even one full term red flag number three!

Fortunately i make good $$ and my wife makes damn near double what i make so i have never been late or missed a payment in 14-15 months of paying my car note and my credit has actually gotten better in the past year and a half so $$ for us hasnt been a problem

Ok, but in the last three years have you been late on anything? Or defaulted on anything? Had anything repossed? (possible fourth flag here :wink: )

why would i have to do another statement if he has already determined in his mind who was at fault.

Could be several reasons, could be the first adjuster missed some questions, could be they have some other information and want to ask you some questions about that (ie, phone records, prior theft and burns, late or missing payments of any kind, license suspension etc.) When you filled out the application for insurance on this car, did it ask you about prior thefts or burns? If so did you answer them correctly and honestly?

His supervisor just called me back and said that he doesnt know why he did that because they ususally wait untill the end to determine whos at fault or at least wait til the end to say who's at fault.

Yeah, the rep just got too quick on the key board. He should still have the liability pending until they clear their investigation, most likely it will be changed back to pending, if you check late tonight or tomorrow, I'll bet it is.

i honestly am a little nervous

I'd be nervous too, but not about getting a car as much as just having to be grilled. Just be honest and you have nothing to worry about. If you had anything to do with this...at all......now is the time to back out of the claim, before any felony charges could be filed. If you didn't then go in there with your head held high, understand they are only trying to do their jobs. Try and look at it objectively. I've been driving for 33years, and I have NEVER had a vehicle stolen much less burned up. My sister is the only one in our family that has ever had a vehicle stolen. You are (I'm assuming) much much younger, and in the past three years had four! :shock: AND just took out your policy with this company...They just need to address all these flags waving around this claim.

due in october,

Congrats, this will be settled one way or the other long before that...

I now wish i would have just drove it home after sleeping for an hour or two but i doubt wifey would have bought that..lol

I wouldn't have bought it either. I'd have probably made your life a little ugly for awhile, (oh who are we kidding I still would, 'if you weren't out drinking none of this would've happened!' :lol: :wink: ) I thought she was out of town when this all went down?

Have you had any other claims, homeowners, renters, work comp etc?

Posted: Tue Jul 21, 2009 10:30 pm Post Subject:

Never had a car broken into untill i got up here, i wonder if it matters the frist two cars stolen all had florida plates because i didnt want to register them in md, now i see where u are saying red flags but up here in md thats what these bad ass kids do, steal ya car either for a joy ride or to commit a crime, all of my cars were very nice and hand after market radios and speakers. i beleieve the frist two cars stolen was a random thing and i want targeted but i believe this last time it was either a client, clients family or clients girlfriend that may have did it because they got kicked out of my class and have stiff repercussions to deal wit when they go back to court. i also thought it could be one of the ladies i had to let go when i got back with my wife...but those are just my thoughts out loud

switched policy to save money and i have already had progressive so if they had a problem with my record then i am sure they would have denied my request for insurance in my opinion, every time i have had a problem its been with them and they didnt ask about burnt cars or stolen cars on the app specifically but i did disclose everything they asked on the app and i just got the email with the documents about my renewl policy today....

never had anything repossesed and i was late on a kmart credit card payment one month back in september but that has been paid off (the whole credit card).

not worried about being grilled because i have nothing to hide, my statement the first day i met with him was truthful and honest and my phone records actually back my statement up, i had no idea i would have been asked for my phone records but everything i told him was the truth and i want them to contact my phone company so they can actually tell him where i was when i made every call...i felt alot better after looking at my phone records once i faxed them to him because there was nothing on them that i hadnt told him.

my wife had got back in from texas that thursday evening while i was workin. she was gone from sunday to thursday and she wasnt gonna be cool wit me calling saying i am gonna take a nap in the car before i come home when she aint seen me all week...

nope no other claims from anything...i feel like i just got bad luck with the cars i choose, they seem to be the cars everybody wants or the easiest to break in to....


Thank you for your time Lori the feed back is greatly appreciated and the questions you have for me are fine with me, my mind is just racing when i think about the $$ loss i could eventually take if they deny my claim...i loved that black on black magnum with 5% tint...

Posted: Wed Jul 22, 2009 06:42 am Post Subject:

Hello CountyCoy, do you still have a lien on the car? How much do you owe on it? Have you rolled over any previous loan to this one?

Please don't think that I'm nosey, but these are the factors that might affect the future of the claim. You have also said that you make quite good living but still you have poor credit score. Any reason?

i had gotten pulled over about a month earlier and the trooper said my dl was suspended because i got a ticket in GA IN 2007



Have all the tickets been taken care of?

Posted: Wed Jul 22, 2009 10:21 am Post Subject:

not worried about being grilled because i have nothing to hide,

Good, there ya' go..

i feel like i just got bad luck with the cars i choose

That's certainly possible. Just plain bad luck..

Thank you for your time Lori the feed back is greatly appreciated and the questions you have for me are fine with me,

My Pleasure, and good none of the questions bothered you. I'm sure it's just your run of luck. If they were really worried about it they would likely request an exam under oath. They just need to answer to theirselves (and bosses) that this guy just has bad lucky rather than commiting fraud. Let us know if we can be of further assistance, and certainly let us know how it goes with your next statement etc.

Posted: Wed Jul 22, 2009 03:01 pm Post Subject:

@jeorge...thanks for replying...
I never thought i implied i had a bad credit score but it has improved...i was cleaning up a lot of debt from college(dec 03 graduate) mostly from switching cell phone carriers way to much in college. and the reason i say my credit has improved is because the negative things have been on my credit have dropped off due to time or agreements with the collections agency to remove once payment was recieved. these things date back to 2001, 2002.

yep i got a lien on the car and i owe roughly about 25g and i did roll over bout 6g in to this loan. that was my first time ever rolling any thing over to another loan and the only reason i did was because the dodge magnum i was getting came with a LIFE TIME warranty. How might that affect the claim?

All tickets have been taken care of and dl was reinstated rather shortly after the vandalism.

@Lori..Thank you again. and i will..but i have one more question..my car wasnt stolen in this present claim. It was broken into and my head unit cd/dvd player and 2 "12" inch sub-woofers and amp were stolen and then the car was set a fire. In the eyes of the cliams rep is that not a little bit different? just wondering...

Posted: Wed Jul 22, 2009 03:23 pm Post Subject:

yep i got a lien on the car and i owe roughly about 25g and i did roll over bout 6g in to this loan. that was my first time ever rolling any thing over to another loan and the only reason i did was because the dodge magnum i was getting came with a LIFE TIME warranty. How might that affect the claim?

It's probably not going to affect the claim but the problem is that you probably owe much more then the vehicle is worth (due to the roll over of the other loan). Your carrier would pay the value of the vehicle less your deductible. This is going to leave you with a shortage.

But this is also the 5th or 6th red flag (I loose count)... owing much more then the vehicle is worth.

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