State doi - What do they actually do?

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PostPosted: Thu Mar 27, 2008 10:47 pm   Post subject: State doi - What do they actually do?  

The insurance company is giving me a hard time. This is a ho claim third party. They have all medical records and bills and photos. Liability is pretty much clear. I even gave them prior medical records going 6years back just so they can see a prior injury never occurred. i spoke with the adjuster and supervisor and they both stated they cant process or evaluate my claim. The supervisor even started laughing during parts of the conversation. Its not the first time they said this its around the 5th time. Good thing i record the last time. I file a complaint with ny state doi. What do you think will happen? Do the state doi contact them?

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PostPosted: Thu Mar 27, 2008 11:03 pm   Post subject:   

Is this still about the pipe or something your landlord left out? I thought you'd already settled this one? No? What do you mean they are laughing and not evaluating your claim...didn't you send them all the paper work a month or so ago? Is this a different claim?



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PostPosted: Thu Mar 27, 2008 11:53 pm   Post subject:   

no this is the same one im trying to settle with them. They do have everything , even prior records i didnt have to send but still did.and they are just being mean. He laughed at me because i told him they dont handle claims fair and he said we handle all claims like this. I just wanna give up now. I dont see how adjuster like that sleep at nights. They rip off ppl and feel good. Not all.... But the bad ones make good one look bad too.


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PostPosted: Fri Mar 28, 2008 12:05 am   Post subject:   

What will happen after they find out i filed a complaint with the ny state doi? They will probably treat me worse? Arent they are suppose to settle a claim promptly when they have all the info they need and more and liability is clear? What is the use of fair claim practice law if they still treat claimants like this? What are some the fair practice act for ny? I cant find them. Thank you


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PostPosted: Fri Mar 28, 2008 12:45 am   Post subject:   

Let's calm down and try and take this a step at a time...



Quote:
He laughed at me because i told him they dont handle claims fair and he said we handle all claims like this. I just wanna give up now
.don't give up...I don't blame you though for being upset this is just terrible!
Quote:
I dont see how adjuster like that sleep at nights. They rip off ppl and feel good. Not all.... But the bad ones make good one look bad too.
I don't know how they sleep either....thanks for making clearly ''all'' adjusters aren't that way... Wink
Quote:
What will happen after they find out i filed a complaint with the ny state doi?


nothing with you, they will have a certain time limit in which to respond to the complaint...most state dois take these very seriously.
Quote:
Arent they are suppose to settle a claim promptly when they have all the info they need and more and liability is clear?
yep they are supposed to...



Tell me exactly what you said and what they said...when you called this time....(it might be tomorrow before I get back with you 11 month old grandson is needing my attention! Shocked )....discribe the conversation, what you ask what they said, have they made an offer? have they said when they will be making an offer? What is the hold up? etc....I'll also try and look up the fair claims practices for NY and atleast get you a link for them..if i have time before work I'll check thru them...remind me as well, when this injury happen, and when you turned it into the insurance company, when you began talking to the adjuster, how long ago did they get all of your records? didn't they tell you last time that they needed to requests them their selves? did you send the med.auth. into them so they could? if so have they got them?


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PostPosted: Fri Mar 28, 2008 1:44 am   Post subject:   

I called to see if she got anything new from adjuster. She said no. I asked about the claim. She said she cant process or evaluate it so it just sitting there. I said let me speak with your super. He came on and said the same thing i said that not fair. He laughed and said that is the way we handle claims.


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PostPosted: Fri Mar 28, 2008 1:55 am   Post subject:   

Injury happened april 26, 07. And first contact with insurance co was jan. 15,08. Bc landlord was trying to hide it bc he was at fault. I dont think i should of file a complaint they may treat me worse now.


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PostPosted: Fri Mar 28, 2008 2:02 am   Post subject:   

No offer on the table yet. What will the state doi do? Will they look at my claim file? How do they investigate the complaint? i hope they don't lie i got them on tape to prove it. I heard the state doi go to the office and check things. And fine them for things that isn't right?! True?


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PostPosted: Fri Mar 28, 2008 11:04 am   Post subject:   

Ok, GB first off you don't have to make mulitple posts dear, you can just put all the information in one if you'd like... Wink



I think I've figured this out (*maybe)

Quote:
I called to see if she got anything new from adjuster.
Is the ''she'' you are talking about the independent adjuster? Is that who you talked to and her supervisor? Have you talked to the actual company adjuster at all?



Let's leave the state doi questions aside until we get this figured out ok?


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PostPosted: Fri Mar 28, 2008 11:45 am   Post subject:   

They hired a independent adjuster. I dont really talk with him much. He is very nice. But i just go directly to the insurance co when i need answers. The lady adjuster and her supervisor work for the insurance co . They are the ones giving me a hard time. Sorry for the post


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PostPosted: Fri Mar 28, 2008 11:49 am   Post subject:   

Quote:
They hired a independent adjuster. I dont really talk with him much. He is very nice. But i just go directly to the insurance co when i need answers. The lady adjuster and her supervisor work for the insurance co . They are the ones giving me a hard time.
Ok, so it's the actual company....George did they tell you what they are waiting on...please explain a little more what the actual trouble is...have they got everything they need to evalutate your injury? If so and they are in the midst of this evaluation did they tell you how long this would take? when they would be ready to make you an offer?
Quote:
Sorry for the post
Smile no sweat don't worry about it...just wanted to be sure you knew would be easier to have it all in one post...each time ....not add to the same one, but a new one each conversation...ok? Wink


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PostPosted: Fri Mar 28, 2008 12:21 pm   Post subject:   

No they havent told me why. They have everything rigit in front of them. I shovldnt have waste my time sending prior records. All they said it is just sitting there and they cant evaluate it or process it. Im just sick of this whole thing.


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PostPosted: Fri Mar 28, 2008 12:46 pm   Post subject:   

Quote:
All they said it is just sitting there and they cant evaluate it or process it.
call them back, (record it)...do not lose your cool write out everything first if you need too...ask them...

do you have everything you need to evaluate my injury and make an offer of settlement to me for my injury? If they answer yes, then ask when can i expect an offer from your company..if they say no ask why? what do they need to move forward in the settlement of your claim...ask them if you have understood correctly and they have accepted liablity for this injury? If not ask why....what do they need to complete their investigation....then let us know....

Quote:
Im just sick of this whole thing.
i know you are hang in there .... Wink


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PostPosted: Sat Mar 29, 2008 10:30 am   Post subject:   

The adjuster lady is being very unethical. All she keep saying is she cant evaluate my claim. She gave me no reason of why. Im getting sick of this. Hopefully the state doi do something soon. I filed a complaint with them 3days ago. The lady at the doi told me it could take up to tuesday for an examiner to be assign.


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PostPosted: Sat Mar 29, 2008 10:56 am   Post subject:   

Quote:
All she keep saying is she cant evaluate my claim. She gave me no reason of why
You need to ask her point blank (while you are recording it) WHY can't she evaluate your claim, and the other questions I suggested you ask...


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