Listen to this horror story surrounding Explorer Insurance

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PostPosted: Fri Oct 12, 2007 8:30 am   Post subject: Listen to this horror story surrounding Explorer Insurance  

hi.. my name is Justin and I am a 20 year old male living in southern California. I work night stock crew at Von's pavilion and on May 15, 2007,I went to work at 10pm and finished around 5am on the 16th. A bunch of us walked out together and I will never forget that gut wrenching feeling I had when my car was not where I parked it and honestly, I think I went into shock!! I had only bought my Monte Carlo six months prior to someone stealing it. Lakewood Sheriff's sent an officer out who took the theft report and the minute I had this report to reference for my claim, I was on it. Two weeks later, my vehicle is recovered and held by the detectives for fingerprinting, and that same week it's at the body shop that I want to repair my vehicle. On June 15th, my insurance company sends me a 'vehicle theft affidavit' that I must have notarized and return so that they can process my claim without any further delays.I have my friend take me the next day to the notary where I had to make a written statement about the theft of my vehicle and I had to swear that this was the whole truth, which I did, and I mailed it. The end of June the body shop starts fixing the repairs that my insurance company authorized ... everything is looking good. My claim, is for the amount of 3800.00 and I have a 900.00 deductible so my insurance company is looking at 2900.00 to settle my claim and everyone is happy. By the end of July, when I have heard NOTHING from the body shop about my car and NOTHING from my insurance company, and we are now in the third month of faithfully making my car payment and still, I have NO transportation, I call the body-shop and they were waiting for a part needed to finish my car but they told me that it would be done within the week. The second week of August, the body shop owner is calling me because nobody from my insurance company will return their phone calls and until they receive payment for services rendered, my car isn't going to leave that shop. Last week of August, I am told by the owner of the body shop that my insurance company is now refusing to pay them. ShockedQuestion After numerous attempts to contact my adjuster, who is definitely away from his desk a lot more than he is at his desk, I am told by my adjuster's supervisor that my claim was under investigation and within a week or two, I would be receiving a letter from an attorney with a date and time reserved especially for me for an'examination under oath.' September 18th, at 9am, my attendance at a law office located almost 2hours from my home is mandatory and there are 13 different documents and demands that I must bring with me as well. Interesting enough, not one of those documents was a request for the police report. But, phone records and loan documents are what they need to render a decision on my claim?? Making this appointment was just physically impossible for me so I called and rescheduled for October 16th, 2007 which is exactly five months since I made my claim. I have filed two complaints with the Department of Insurance and the Better Business Bureau. I have given the attorney and my insurance company permission to obtain the records that they have demanded me to provide but I have informed them both that unless they want documents that pertain directly to my claim, it would be their responsibility,NOT MINE, to get. Certainly, five months is a long enough period of time for them to have gotten any and all documents they need to render a decision on my claim. I have missed days of work and doctors appointments that are vital to me being on this earth, as I am currently on the heart transplant list at UCLA medical center and the insurance company that I thought I was paying to help me in time of need has only victimized me and caused me undue hardships. By the way, my examination under oath has been changed to a law office that's only about 20 minutes from my home and that change didn't come about until the insurance company had to answer the department of insurance regarding my complaint. I received a promising letter from the department of insurance today telling me that this file is open and their investigation is active.. Sorry this is so long but the last thing I'd like to say is when the adjuster was at the body shop making an estimate for the damages on my vehicle, he made the statement that it looked like an inside job to him. WHY? How can a person who represents a company that I pay every month to be on my side, make such a slanderous statement?! QuestionRolling EyesIdea


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PostPosted: Fri Oct 12, 2007 10:28 am   Post subject:   

Well my friend...as for Mr Adjuster's comments are concerned you can't really do any good to it! But yeah, its really good to hear that the case is still open for you. Sometime back I had come across such a case, so I'd better wait till you communicate with the dept. of insurance & let me know whether they are truly pursuing your case. We can look into the matter from there!

Pearl_Choosy


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PostPosted: Fri Oct 12, 2007 11:25 am   Post subject:   

Justin all I can say is WOW...



I'm so sorry you are so ill especially at such a young age,

Quote:
I am currently on the heart transplant list at UCLA medical center
but encouraged that you can still drive and work, and will hope and pray your new 'heart' comes soon. I'm sure the stress of this has only added to your illness.



I think I might be able to prove some insight, no explaination however why on earth it is taking them so long.............



I'm a little surprised they are going this 'far' when the vehicle was recovered, (and not totaled) generally these 'inside jobs' (as your ignorant adjuster stated) occur when vehicles are not recovered.



Some of the reasons they want these,
Quote:
But, phone records and loan documents are what they need to render a decision on my claim??


They will check your phone records for activity prior to your vehicle being stolen, and also to see if you reported it stolen when you stated that you did. The loan documents are obvious and routine on any theft, they have probably (dependent upon the state laws) already ran a credit report, if you are late, not paying bills etc. Then this is a reason to 'get out from under' a loan i.e. have your vehicle stolen.



Quote:
when the adjuster was at the body shop making an estimate for the damages on my vehicle, he made the statement that it looked like an inside job to him.
Who did he say that to? Where you there or did he say this to a shop employee? Who then repeated it to you? Did you ask him about this? And what makes them think this is an 'inside job'?



Sorry to tell you this, but an 'examination under oath' is pretty serious, they must have some reason to believe that you are involved some way in this theft. I'm not saying you are, just that they clearly have a reason to think so....One reason I can think of is have you ever had any other total vehicle thefts, personal property thefts, fires (home or vehicle)?



I'm glad you have talked to the DOI,
Quote:
received a promising letter from the department of insurance today telling me that this file is open and their investigation is active




You don't say who your insurance company is, but many states dept of insurance websites will list 'repeat offenders' believe me insurance carriers take these complaints seriously and they (DOI) in all states I have experience in are/can be pitbulls. The complaints must be answered in a time frame, they can't just do it (respond to the DOI) when they want to or get around to it.



Think hard Justin, what would/could cause them to 'lean' this way in the investigation?



Please keep us updated, I'm sure some others in the community will weigh in on this and offer up some additional assistance, think about why there is a question here (by your company) maybe we can provide more assistance with more details....
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PostPosted: Fri Oct 12, 2007 11:28 am   Post subject:   

Hi, sorry that you had such a bad experience. But lemme tell you, not that all insurers behave the same way. However, you have done the right thing by registering complaint with the Department of Insurance. Hope it will solve your problem. Meanwhile, keep us update with the development of the case.


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PostPosted: Fri Oct 12, 2007 12:20 pm   Post subject:   

It,s really shocking to hear that you lost such a precious thing and that you are yet not out of it.SadI'm gonna guide you as much as possible.Actually fraud is common in the insurance industry.Smile And by now you have undertaken a lot of troubles to claim the insurance.At this stage you

may

    # go to the supervisor of the company and relate to him that you are being bothered and that nothing is being given to you in written.


    # maintain your politeness while speaking


    # Continuously inform them in writing clearly mentioning that what you have been facing in reality.


    # you can also send a letter to the supervisor attaching all supportive documents, claiming your part of reimbursement.




If you are yet not successful then contact your state's insurance department and inform the commissioner. The National Association of Insurance Commissioner is connected with the insurance department and the commissioner of every state. In such a case you can log into naic.org/state_web_map.html.These agencies normally look after the insurance dealings of every state.



Even if this doesn't work contact the attorney.The insurance company's avoid judicial complications. QuestionAfter complaining to the attorney your insurance company would soon a receive a letter that would stating the legal formalities.Now they would surely take necessary actions.



This would surely lessen your burden. :)And definitely inform us ,as you are out of it.Your real life experience would help all us to avoid such complication in due due course. SmileSmile


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Sarah
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PostPosted: Fri Oct 12, 2007 1:22 pm   Post subject:   

Sarah,

Please, re-read the orginal post, I think you might have missed some important points, there is already an appointment set with the insurance carriers attorney for an exam under oath.



Also, I'm sorry, but.........

Quote:
If you are yet not successful then contact your state's insurance department and inform the commissioner




He already did TWICE !! (from his post);
Quote:
I have filed two complaints with the Department of Insurance and the Better Business Bureau. I received a promising letter from the department of insurance today telling me that this file is open and their investigation is active
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PostPosted: Fri Oct 12, 2007 10:02 pm   Post subject:   

Guest, some people do commit fraud and have their vehicles stolen. Usually this happens when the are under financial strain and/or cannot afford to pay the loan on the vehicle. Now.. _only_ you know if you had anything to do with the theft. I'm not going to accuse you of anything... but I also can't rule out that the insurance company is correct.



I will say this, I've never seen an insurance company set up an examination under oath unless they feel _very_ strongly that there is something wrong with the claim and there is a very great possibility that they can prove it. They are very costly to the insurance company (as attorneys can make $200/hour and they charge for _every_ little thing they do).



I'm guessing that perhaps the lock on the vehicle was no defeated? A vehicle of your type cannot be started unless this happens. There must also be other indicators of fraud in this case.



It's insulting that they would ask you to drive 200 miles for an EUO. That is just stupid. While it's extremely inconvenience that theft claims take so long, keep in mind that the insurance company was set to have the EUO done a month ago and you rescheduled it. Not saying there is anything wrong with this... just that there are two sides to every story.



A word of advice... think about what you are going to say during the EUO. While you should be relaxed, the attorney is going to have some difficult questions for you. Some of these questions you will probably take offense to but you will need to answer them none the less. Not attending an EUO will almost certainly be good grounds for the insurance company to deny the claim (and the denial will be upheld). You should also be very truthful in answering the questions. If something does not add up, it will only slow down the processing of the claim even more and the insurance company may deny the claim. Again, insurance companies do no have EUO's just for the heck of it. They do _suspect_ something.



People commit insurance fraud _all the time_. Most of the time there is fraud but the insurance company cannot prove it, so they have to pay the claims anyway. In your case there may be several red flags that did not add up and actually no fraud involved. While you have every right to feel upset that the claim has not been settled as quickly as it should have, please also keep in mind what the insurance companies are up against as well. But I certainly understand your frustration and I'm not saying it's wrong.[/center]

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PostPosted: Sat Oct 13, 2007 4:31 am   Post subject: Answers etc...  

Before I financed my monte carlo, I had a chevy impala. My impala was my dream car and I put 'dubs' on it, had a huge stereo system installed, tinted the windows, and installed the top of the line viper alarm system. I live in LA County so that in itself may answer a lot of questions. I went to a hotel party in Norwalk one night and the next morning, my car was gone. The viper alarm activator on my key ring was still showing my vehicle as locked and that the alarm was still activated. When I sent viper the key ring and the vehicle theft report.. they couldn't apologize enough and reimbursed me the cost of the alarm, plus. I swore that this car would remain stock. When the found my impala in Compton it was stripped. I had gap insurance and a different insurance company than I have now.

I have written the claim's supervisor at Explorer, as well as the adjuster in my claim, both of which had the attorney respond. I have asked them repeatedly why the EUO because my car was stolen from Von's parking lot, where I work and that's where the officer took my report. The police report states that I was still in my work clothes and has a couple of my co workers listed as witnesses. I have informed the officer about all that my insurance company has put me through and how they told me that the police report will have no bearing on their decision and he just may be at the EUO on my behalf. I was an explorer scout with the lakewood police station and the reason I did not continue on to academy is because my heart condition restricted me from the physical examinations you must pass. I'm not worried how serious an EUO is because my position is.. tell me what I've gained from making a 360.00 a month car payment on a vehicle that I've had NO access to, what so ever. My finance company has informed the body shop there is to be NO lien sale on my vehicle,which would be commom practice after 5 months of storage, because my payments have remained current and up to date before the theft, to now. Up until last month I was still paying explorer insurance company 220.00 every month for insurance and on Monday I received a letter telling me that my insurance has lapsed and in order to reinstate it I must send the 188.00, which makes no sense. I have given the claim's supervisor as well as explorers' attorney my permission to obtain the documents that they have demanded I bring to the EUO... but I don't feel that any document other than the police report is my responsibility to obtain. "It is the duty of the Insured, to PROMPTLY and THOROUGHLY investigate claims"... explorer has had 5 months to investigate my claim and if the documents that they have demanded that I bring to examination under oath are that important in the decision that they are going to render on my claim, than they should have obtained them, or asked for my permission to obtain them, long before now. What my goal is... I want to know how many claims, explorer denies, that are made by males aging from 18-25 and if my hunch is correct... what a huge case action law suit. Explorer has used so many tactics throughout this 5 months, that clearly show bad faith and I know that the department of insurance agrees with me, that's why in the letter they sent me it states that they are anxiously awaiting the outcome of my October 16th EUO. Thanks for the great comments and I hope this answers some of the questions you all had. -JUSTIN


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PostPosted: Mon Oct 15, 2007 4:46 am   Post subject: As a side note  

As a side note, I do think you've been jerked around a bit. The whole driving 2 hours for an EUO is not acceptable. For your sake, I would add Rental Reimbursement coverage to your policy in the future if you don't have it already. I am someone who is EXTREMELY familiar with the EUO process. If you're truly innocent, just tell the truth and you'll have nothing to worry about. The entire point of an EUO, in most cases, if for the attorneys to question you to make a determination as to whether the company can deny your claim on the basis of fraud or misrepresentation, and win in court if you happen to sue them. Other times the EUO is scheduled because the SIU investigator didn't come up with anything, and this is the last ditch effort to try and get something on you before they pay the claim.



I agree, the whole thing sucks, you being without your car and all, and I do wish the very best for you. Good luck!


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PostPosted: Fri Oct 19, 2007 6:08 am   Post subject: EUO results  

I attended the EUO and found out that the reason for all of this is because when I gave my affidavit I said the theft of my car happened on the 15th and the police report says the 16th. I work graveyards and often confuse my dates. I have retained an attorney because I am to the point of being extremely ANGRY and explorer insurance company owes me a lot more than an explanation at this point. 6 months without a vehicle because of a one day discrepancy is just ABSURD!!


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PostPosted: Fri Oct 19, 2007 9:17 am   Post subject:   

Oh my gosh Justin! Did they tell you that was their WHOLE problem? Shocked If so I'd say the OVER REACTED A TOUCH! I've had a lot lot lot of claims where people get the date screwed up, but if you can square it pretty easily, yes even with a vehicle theft, then that's the end of it.........



I don't blame you at all for contacting an attorney, they are definately walking the 'bad faith' line.... Evil or Very Mad ......and have been for some time.



Please expand on exactly what they said, re: this date thing? Did they also after the EUO say, (in effect), ''sorry, you can pick your car up, we'll pay for it"?

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PostPosted: Fri Oct 19, 2007 12:01 pm   Post subject: EUO  

NO... here is the best part... the phone records that they specifically demanded me to bring was not, and has never been my phone number, so it would be illegal for me to obtain any records for that number. SO.. I was told that I should have known what was meant and should have brought my phone records for my phone number. I gave written consent for the insurance company and the attorney to obtain whatever documents they needed but I have 2 weeks to fax the attorney my phone records or I won't be complying. When I asked the attorney for the specific reason as to why my claim was being questioned ... she told me that when I gave my affidavit I said that my car was stolen on the May 15th and the police report said that it was stolen on May 16th. When I gave my affidavit I told them that the mileage on the car was approximately 67,000 and on the police report it stated the mileage as 67,500. Keep in mind that I gave my affidavit on June 15 and didn't have the police report in front of me when giving my answers. I did get a response yesterday from the better business bureau and they have sided in my favor against explorer insurance company. I wrote the department of insurance when I got home from the EUO, but haven't heard anything from them yet.


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PostPosted: Sat Oct 20, 2007 11:04 am   Post subject:   

OH MY GOSH (again) JUSTIN!!! Sounds to me like this company is a bunch of idiots. Like I said in my original post, most people that 'set up' their own thefts, those vehicle are NOT recovered. That should've been their first clue, and especially with as little damage as yours has....I think you have a really good case. Is your attorney talking about 'bad faith' ? As I said before those cases can have a real high value, they have 'punitive' damages allowed, and juries on a whole don't like insurance companies anyway.......man oh man, did they screw up.....the mileage thing, that's just stupid, most people have no idea the mileage on their vehicles, lucky if they can get within a thousand miles of what's on the odometer. I'm so glad you have the better busin. bureua, and Dept of Ins involved and especially an attorney! Make sure you talk with your attorney and should probably stay 'compliant'. I'm about to break my neck from shaking my head side to side, Wink Please keep us updated, your's is a very interesting case.

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PostPosted: Thu Nov 15, 2007 2:10 pm   Post subject: horror story continues into 7th month!!!  

Just though I would give everyone a quick update... It has been exactly one month since my EUO and for the record I did submit my cell phone records for the month of May. A few days ago, explorers' attorney contacted my attorney and now they want the names to match the phone numbers that are on my May statement. They also claim that they couldn't understand the work schedule that I gave them and want me to get a copy of my timecard instead... to prove that I was actually at work the night my car was stolen. I do have a question though.. the attorney that I have retained did not require any money up front but also does not specialize in insurance law. Should I reconsider my choice of attorneys' and if so are there attorneys that specialize in insurance law that won't charge me up front? Afterall, if I had any money I would have paid for my car and ended this nightmare. Thanks Justin

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PostPosted: Thu Nov 15, 2007 2:16 pm   Post subject:   

There are atty's that specialize in insurance...If you guy is doing a good job though stick with him...Is he looking at a possible bad faith suit?

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