by Yannick » Thu Apr 25, 2013 05:26 pm
Hello, there is my story. when i moved to my apartment they required an insurance policy, so i took one called American modern insurance company. Couple of months later i received a phone call from a security company that was offering me their service and when i told them that i was in an apartment they told me that it wouldn’t work. The day following i came back home from school and find my door open and my stuffs missing. I called the police, they came and made their report then i called my insurance company to report the lost. Three days later i received a theft package from my insurance. I filed it out and send it to them with proof of ownership of the missing stuffs. A week later i received a call from the adjuster and she told me that my renters insurance claim is denied because there was no force entry. I sent her the police report and a letter of the complex manager tell that the lock been change after the lost. Then i called the costumer service of the insurance company and ask information about my policy. I had the lady pull out my policy then i asked her about my theft coverage, and she told me that the insurance will take care of anything that i lost in the apartment if i ever had a burglary. I asked her if I will be covered if i ever forget to lock my door and somebody use it to get inside and take stuffs out of my apartment and her answer was that they will pay for the items lost. She then add that as long somebody get in my apartment without my permission and take stuffs they will pay for it no matter what. And i believe that this is the kind of insurance that i signed up for. Why would i pay for an insurance that would deny my claim because they said that there is no force entry?? Until now there are still taking money out of my account for the premium. Why would i pay for a service and when i need help the service doesn’t want to? I’m tired of the company and how disrespectful was the adjuster that even told me that she couldn’t understand me because of my accent(I’m from France) and hung up the phone after telling me that it is what is and that they will not cover my lost. I thought about hiring an attorney to handle this. Can anyone please tell me what he think about it and tell me what i should do? I live in Houston, Texas. Thank you
Posted: Fri Apr 26, 2013 01:11 am Post Subject: American Modern denied renters insurance claim
A week later i received a call from the adjuster and she told me that my claim is denied because there was no force entry
Did they send you a written denial? If not, your renters insurance claim has not been denied. If they sent a written denial, what does it state the reason for the denial is? I doubt no forced entry is an exclusion or that the policy requires it.
If you called the customer service person and she explained your type of loss would be covered why would you not then specifically ask about your claim being denied? Or get this person's name and then call your adjuster and ask why your claim was denied if this other employee was telling you it should be covered?
My recommendation is to review the written denial and see why the claim was really denied. If you don't have a written denial, contact your state Dept Of Ins and file a complaint. The complaint is that the carrier has a set time (no more then 30 days) from the date you submit a Proof of Loss form to either pay or deny your claim or explain what additional information is needed.
If you filed a policy report for the theft... then it's a theft. They should not be denying only because they don't know about forced entry. At best they are really telling you that there was no theft. If this is the case they need to put that in writing and you would probably have a good Bad Faith claim unless they have some good proof your items were not stolen.
Posted: Fri Apr 26, 2013 04:41 am Post Subject:
I tried to search for the company profile by visiting the website of the Texas Department of Insurance and found that they have many agencies under the umbrella American Modern Group. Click the link below to search on your own:
https://apps.tdi.state.tx.us/pcci/pcci_search.jsp
Anyway, you need not worry here since you have the police reports and the one that of the complex manager. Moreover, you must be having the original insurance agreement. You can do the following things now:
1) Call the customer care once again; talk the same shit and get everything recorded this time.
2) Call the adjuster, ask about the exact reason behind the denial. If you find anything awkward, tell her what the customer care representative told you and also tell her that you have all as recorded. Lastly, ask her for the written denial (as tcope said). If she doesn’t retreat from her rude behavior, tell her that you are going to file a complaint with the state department of insurance against them and particularly against her.
3) You must be having an agent/advisor. No? If yes, get him/her say the best step to take under such a circumstance.
4) File a complaint with the Texas Department of Insurance. Visit the Consumer Protection division and push your complaint by clicking on the link: http://www.tdi.texas.gov/consumer/complfrm.html
Posted: Fri Apr 26, 2013 06:29 am Post Subject: Rental insurance
Thanks to both tcope and MangoQurious for your answers. I received the denial letter that said that "since your loss was the result of theft and there is no forced entry, there is no coverage under your policy for the loss; therefore, your claim is denied." They also said that in the policy theft been replaced by theft-forcible entry and state :
a) this peril includes attempted theft, provided the loss is a result of a forcible entry, and there is evidence of forcible entry and loss of property from a known place when it is likely that the property has been stolen.
b) this peril does not include loss caused by theft:
(1) Committed by an "insured";
(2) In or to a dwelling under construction, or of materials and supplies for use in the construction until the dwelling is finished and occupied;
(3) From that part of a "residence premises" rented by an "insured" to someone other than another "insured" ; or
(4) That occurs off the "residence premises" of:
(a) Trailers, semitrailers and campers;
b) Watercraft of all types, and their furnishing, equipment and outboard engines or motor; or
(c) Property while at any other residence owned by, rented to, or occupied by an "insured" ,except while an "insured" is temporarily living there. Property of an "insured" who is a student is covered while at the residence the student occupies to attend school as long as the student has been there at anytime during the 60 days immediately before the loss.
I will definitely call back the customer service person that i talked to about the policy; I have her name and the date i made the call wrote down in my agenda. This time I will record it and I will let you guys know. Thank you again for the advices
Posted: Fri Apr 26, 2013 06:47 am Post Subject:
Check the original insurance papers once again. Have they mentioned this "forced entry" thing there? Yup, call that person, record and let us know.
I am keeping an eye on this...
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