American Family Insurance Complaints

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PostPosted: Sat Jan 02, 2010 8:44 am   Post subject:   

Just a short follow-on to something InsTeacher wrote above.



Insurance companies are in business to make money. (All businesses are in business to make money, some just don't figure out how to do it. McDonald's figured it out by selling fried dead cow parts they claim are hamburgers [what part of the cow is the angus?], fat sponges they call french fries, and paint remover called soda pop.)



Insurance companies stay in business by paying claims. (But they don't have to pay claims they are not entitled to pay.)



Insurance laws force insurers to act quickly in evaluating/paying claims or be in danger of losing their authority to do business as the result of unfair claims practices. It can and does cause human beings in the claims department to make mistakes in haste -- and insurers will usually make things right as needed. If they do delay in the payment of a claim, they had better have a good reason. Like the fraud is so obvious, even the three blind mice would spot it. And, on occasion, they have been found guilty of acting in bad faith. No excuse for that.



Insurers often pay claims they know they shouldn't just to avoid any accusations of being unfair, then conduct a more thorough investigation of the claim, only to discover fraud on the part of the insured or claimant. The money may have been paid, but the crime is still a crime. If convicted, the offender can be ordered to pay restitution to the insurer. That's why state laws generally require insurers to notify the Dept of Insurance within a short time (60 days in California) of discovering or suspecting fraud.



Wrongdoing on the part of an insurer makes for bad PR, and gives all of us as agents a black eye (even if we don't represent that company), not to mention disgruntled policyowners. But one look at the facts, and you'll find that there is far more wrongdoing being perpetrated against insurers than the other way around.



In California, home to more insurance fraud than any other state (some $16,000,000,000+ in a typical year), it is believed that up to 50% of all auto insurance claims are fraudulent. No wonder our auto insurance premiums are significantly higher than most other states.



So temper your rush to judgment on insurance companies. They all do a pretty good job. Some are a little better, some a little worse. Imagine, for a moment, what things would be like without insurance.



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PostPosted: Sat Jan 02, 2010 1:20 pm   Post subject:   

well put Max



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PostPosted: Tue Aug 24, 2010 3:12 am   Post subject: ROOF  

AMER FAMILY IS GIVING ME LOTS OF TROUBLE. DOES IT HELP TO CONTACT YOUR AGENT FOR HELP..I HAVE AND HEARD NOTHING BACK...YET..MY IS A BAD LEAKING ROOF. THE RUDE BRISK ADJUSTER..GAVE US AN ESTIMATE UNDER OUR DEDUCTIBLE...WHEN I CALLED MY OWN ROOFER ..HE WAS APPALLED THAT WE WERE TOLD TO PATCH IT IN ONE PLACE. HE SAID I'D PROBABLY NEED A NEW ROOF. ITS STILL LEAKING BUCKETS IN THE KITCHEN...WHEN I HAD A LIGHTENING STRIKE LAST SUMMER AND IT HIT A WATER TUBEING (COPPER) THE ADJUSTER..SAID IT WAS A WATER PROBLEM AND NOT COVERED AND LEFT. I COMPLAINED AND GOT THAT CHANGED BUT IT'S BEEN HELL TO GET REIMBURSED ...A FIGHT ALL THE WAY..


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PostPosted: Tue Aug 24, 2010 4:57 am   Post subject:   

Quote:
MER FAMILY IS GIVING ME LOTS OF TROUBLE
So why are you YELLING AT US??!!!! Turn your CAPS LOCK KEY OFF!!!!!!



File a complaint with your states Dept of Ins. This should kick it way up the ladder in the company. Insurance companies take DOI complaint _very_ seriously.
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PostPosted: Mon Sep 27, 2010 7:19 pm   Post subject: AmericanFamily  

My sons Truck was stolen out of our drive way in January 2010 and they still have not sellted with us All as we have asked for was to have the truck fixed AMFAM has acused my son of stealing his own truck He paid 15,000 cash for the truck 3 years ago it was in good shape They want bank statements phone records tax records ect. Which we have given them and a statement under examination under oath of everyone on the policy This has been goiing on for 9 mos This is bad faith How many other people do the do this to?


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PostPosted: Tue Sep 28, 2010 3:52 am   Post subject:   

You're right, this has gone on way too long.



File a complaint with the state Dept of Insurance! They will help as much as they can.



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PostPosted: Wed Mar 02, 2011 8:23 am   Post subject: American Family Insurance_non-renewal home ins.  

Today I found out due to a weather related damage to my semi-attached shed to garage was damaged...2010..they denied the claim to pay for damages; now, my shed is the reason for non-renewal of home policy.

I was NEVER notified, They sent non-renewal correspondance to a PO BOX I HAVE NOT used since 2008.

Now my auto policy bill, and other correspondance comes to my home address in which, the claim was filed on the shed.. So, he is stating I instructed him to send things to PO BOX when he sends me mail to my home address...and personal email. I have hired an attorney. I did go through some hardship in 2007 - 2009 and my rates went up due to credit score decreasing a few points; so, now they are trying to decredit my integrity... I've been unable to get new insurance due to claims from 5 years ago that are false...and I did not even know they existed... now, I'm a risk home policy so, my rate with a new agent will be out of this world.

I THINK we need to form a class action lawsuit, respond to this thread if you want to join a lawsuit, POWER IN NUMBERS.[/quote]


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PostPosted: Wed Mar 02, 2011 2:00 pm   Post subject:   

See my sig!



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PostPosted: Mon Mar 14, 2011 10:11 pm   Post subject: Homeowners insurance policy  

We just signed up for American Family insurance after years with another company. 2 weeks later they came and took pictures, 1 week after that, our agent called and said that there was a problem that our yard was too messy with appliances and other debris. We admitted that it was very messy but had no appliance. The agent told us we had 2 weeks to clean it up.



We were very surprised when 1 1/2 weeks later we got a letter informing us that our homeowners policy had been cancel (but they were nice enough to give us information on a 'high risk' insurance company to check out). They also stated that we have a detached shed with peeling paint, something that was not stated at all before now! By this time, the yard was already cleaned up. I called the agent, no response, I emailed the agent including new pictures showing that yard was cleaned, no response and have called again - still no response.



So the bottom line is they are not willing to work with us at all and we had our homeowners policy cancelled for having a 'messy yard' (back yard only - front is fine) - they didn't even care that the house is in great shape - and the yard is fully fenced. They didn't even check inside. Really????


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PostPosted: Tue Apr 05, 2011 12:40 am   Post subject: Scamming Incompetent Agents  

AMERICAN FAMILY ADVERTISES THE FOLLOWING:



For more than 80 years, we've made it our business to give our customers peace of mind by making their insurance experience easy and convenient. American Family Insurance understands you are looking for a relationship with a stable and trustworthy company. You want an expert, caring advisor who works toward making your insurance experience easy and convenient. An advisor who ensures there are no unwelcome surprises and peace of mind, especially in your time of need. Our knowledgeable agent advisors provide auto, home, life, health, business, and farm & ranch insurance



American Family Insurance

1811 Pioneer Park Way

Springfield OR 97477-1141

Monica Smith Agency



Complaint Description:

I have been with American Family Insurance for over 10+ years.I have had the best agents up to when my agent Brandy Clayton retired to have a family, we were moved to another agent that had a bad personality and moved to the MONICA SMITH AGENCY. That was not much better. We wanted to immediately move from her agency too. I decided not too and just stay and see if she would work out or not. We'll that was a BIG MISTAKE!!! I asked for UMPD to be put on my policy 3 months ago, when I changed my comp. to a $1000 ded. Monica Smith recommended that I get UMPD coverage because of the high ded. I added that coverage. Monica forgot or ???? and just did not add that coverage to my policy ( I thought I had UMPD coverage like I had discussed with Monica 3 months earlier). 30 days later I was informed I have never had UMPD, of course not since it was added 3 months ago over the phone. My son and daughter also have it. My suv is the most expensive of the 3 cars and even the adjuster said that my car should have UMPD over the other 2, since it was the most expensive. The adjuster did not understand why my agent had the coverage on their cars and not mine when I am the main policy holder. I was in a car accident and was told that I would have a $200 ded. when filed police report. After 30 days and getting the police report filed, I was told that I do not have UMPD. I have a $1000 ded. which I'm fine with, but the UMPD that my agent was supposed to add has $200 ded. which a hit and run would go under. My damages are $750. Monica Smith has lied to the insurance commissioner and other agents that I asked her not to put UMPD on my coverage which is a total lie. I write on envelopes what is being said during phone conversations. I have one envelope that I wrote my desired insurance changes I wanted when talking to Monica Smith 3 months ago. I have 10 other envelopes that have info from other services. It's a common practice for me, I never have paper around, yet I always have envelopes around to write on. FUNNY TOO-MONICA WAITED 30 DAYS TO TELL ME I DO NOT HAVE UMPD COVERAGE. She cannot own up to her mistakes.

And American Family says they make your insurance experience easy and convenient. An advisor who ensures there are no unwelcome surprises and peace of mind, especially in your time of need.

I'm not receiving convenient and easy service without unwelcome surprises. I sure had a very UNWELCOME Surprise.

My family has given american family $500 a month for 3 cars and homeowners insurance. I also had business insurance with them for 6 years which added to a lot of money going to am/fam.My agent Monica Smith has also lied to her customers about PIP insurance. You can have a $250 ded and she told us it was against Oregon law to have a ded. on PIP. (against the law, great way to get extra $$$$ by not telling the truth to her clients) She checked into it and found out you can. Also told me that I was the first person ever in the history of her being an agent that has written a policy with a ded. on PIP coverage. Just think of all the customers she is taking advantage of. Out to make an extra buck where ever she can. Oh yeah!, My agent wrote a letter to the insurance commisioner and said that I was trying to twist her (Monica Smiths) words etc.. to get the outcome I wanted. Can you believe that???? Pretty much telling her customer that they are a con artist. WOW. She would not even have a paycheck if it was not for customers!!! Stay away from this company and especially this rude, incompetent agent!!! Cant even write my policy changes right. Then she says she took the ethical road, because it would not be fair to American Family to have to cover this claim under a coverage that the customer did not want to pay the premium to add. Monica is UN ETHICAL. Not putting on the UMPD on my Honda Passport for $11 a month. It is such a small expense and that is why I wanted to go with her recommendation. To be covered for an accident that was not caused my me. My son has left the insurance asap as soon as he saw what they (am/fam-monica smith) were doing to me.


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PostPosted: Wed Apr 13, 2011 4:19 pm   Post subject: American Family Refuses to pay for my mothers cancer policy.  

On March 11, 2011 my mother passed away from cancer. I found her American Family Policy and call the company to be sure her policy was in place. It was paid in full and the lady I spoke with said as long as my mother was on Medicare and not medicade that all the bills generated concerning the cancer treatment would be paid directly to her or her heirs. I submitted all the bills from the treatment facilities which came to 160,000.00 approx. After weeks of waiting for a reply I finally heard from American Family. They said that all but 800.00 would be denied. My father was a decorated war hero and I am sure if he knew that the policy he had signed up for was absolutely fraud, he would have taken matters into his own hands. We have American Family on record as saying all the bills associated with her cancer would be paid. I am looking for people that may have had a similar experience.


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Mark Clemens
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PostPosted: Wed Apr 13, 2011 9:10 pm   Post subject:   

To Mark Clemens:



Regarding your post... AmFam was legally required to inform you as to why they are not going to pay the claim. They cannot simply deny to pay without giving a specific reason within the denial correspondence.



Can you find the paperwork and see specifically why they denied to pay the claim? That will give us the information necessary to help you out.



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PostPosted: Thu Apr 14, 2011 7:28 pm   Post subject: My mothers claim with American Family  

The company said and I quote: " Your policy does not provide payment for laboratory tests, diagnostic x-rays, office calls, chemotherapy or diagnostic procedures such as bronchoscopy, cystoscopy, or a biopsy." I,m sure my parents assumed that these items would be covered under the policy, but even if they were not, the surgery to remove the tumors and treatment of the tumors should have been covered. What would be the point of having the policy if less than 10% of the costs would be paid.


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PostPosted: Thu Apr 14, 2011 8:35 pm   Post subject:   

To Mark Clemens



Thanks for responding. The next question is this- specifically, what type of policy did she have? Your comment of

Quote:
Your policy does not provide payment for laboratory tests, diagnostic x-rays, office calls, chemotherapy or diagnostic procedures such as bronchoscopy, cystoscopy, or a biopsy."




indicates to me that this was probably not true medical expense insurance, but some off-shoot type of policy. I need to know, as specifically as possible, exactly WHAT her policy was. There are a lot of policies out there that pay for only certain medical expense situations and this is why I need the details!



As well, if the policy isn't going to pay for the costs, Medicare should absolutely come into play here...assuming that she was on Medicare. Medicare provides excess coverage in the event the Medicare beneficiary also has an individual private medical plan.



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PostPosted: Fri Apr 15, 2011 12:27 pm   Post subject:   

If Medicaid paid any portion of the claims, the state may have the right of asset recovery against the estate. Medicare either pays or it doesn't, and unless covered by other insurance that would make Medicare the secondary insurer, subrogation is usually a non-issue with Medicare.



The insurance you describe, as InsTeacher has said, is probably some form of supplemental benefits. It would not be in conflict with Medicare at all, but could be considered "income" under Medicaid, and affect benefits payable under that program.



This is what happens to people when we let the government interfere in too many aspects of our lives.



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