nelp on claim denial

by pavrom » Tue Feb 12, 2013 04:23 am
Posts: 1
Joined: 12 Feb 2013

good evening experts
seeking for professional advice :
i have transportation company (transporting vehicle) , business insurance that covers liability , cargo and physical damage to insured equipment.
i had several claims during one year period.
last claims happend: mid june (i was out of country for 2 weeks), someone damaged the side of my tractor (intentionally or not) , mid july (my trailer got stolen).
insurance company decided to do investigation due to the suspicion that i have so many claims. i was questioned by the investigator , i did provided police reports for both losses , i did provide repairs expenses for stolen and damaged equipment , investigator questioned people around , friends , my drivers (current ones , they were not able to reach people who were fired) , i did provide my cell records for the last year august 2011-august 2012 , i did provide my current credit report (not late with payments or etc)
investigator or adjuster are hard to reach people , never return calls , i was able to reach them only when i insisted on talking to the real person and not their voicemail . all the time they were telling me that they need more time blablabla.
in december they requested 2 last pieces of information :
1. phone record from whoever phone i used(used my mom cell and parents land line phone) showing that friend of mine called me from illinois to russia (i was trying to explain the investigator that it is next to impossible , even friend of mine does not remember how did he call me to notify that my tractor was damaged i.e. phone card , pay phone .... sometime the phone calls shows on the called id as blocked )
2.bill of lading of the engine that happen to be on the trailer when it was stolen (i did) , i did not open cargo claim since we fixed the situation with the owner of the engine.
couple days ago i received letter from insurance company telling me claim denial because i did not provide 1 phone record listed above (i.e. not providing requested information) , and false statement on the engine cause investigator was not able to verify the engine information with the owner (i personally talked to the owner and he proved that no one contacted him regarding this matter)
to me all this situation seems unfair , i try to find public adjuster who will be able to help me out but most people i called - sorry we do fire , water...etc claim , i would like to sue insurance company and get all the steps in proper preparation , talked to traffic attorney and he said insurance law is so tough blablabla
i am sure there is a resolution in this situation.
stolen trailer was insured for $16k + $5k in upgrades and repairs (adjuster requested all the bills and i provided) , tractor damage was around $9k due to the insurance appraisal
due to all this situation i had to rent out another trailer to keep up with my business hoping to get claims resolved in my favor (additional $7k)
any help or advice would be highly appreciated
thank you

Total Comments: 2

Posted: Tue Feb 12, 2013 08:54 am Post Subject:

talked to traffic attorney and he said insurance law . . .


Well, what does an attorney that takes a person's money to fight a DUI or a parking ticket know about insurance law? He's probably never even read his own auto or homeowners or life insurance policy to know what is or isn't covered.

First, you should file a complaint with your state's Dept of Insurance. If that doesn't help, then you need to find an "insurance bad faith" attorney to file a civil action against the insurance company. That attorney will take 30% to 40% or more of any settlement you obtain. You can "google" that for references/advertisements.

Posted: Tue Feb 12, 2013 02:03 pm Post Subject:

Submit all of the information they have requested and then a Proof of Loss form (you can even ask your carrier for one... if they balk, let them know your policy states that one is required and if they don't give to you, you will obtain one and submit). If you need a Proof of Loss form, search the Internet. I'm sure ClaimPages has several. Send in the POL form and a cover letter giving them 30 days to pay. As Max states, file a complaint with the DOI. My guess is that these two things will get the claim settled within 30 days.

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