QuestionQUESTION: Hi Jane, my car was stolen on the first of nov , I reported it to the police as well as the my insurance company. First the claim adjuster got me an external investigator who arranged with me a date to take down my statement, two days before the appointment date, she called and cancelled he appointment. That shaved off a week inform the claim process. Next I got another internal investigator attached to my insurance company this time, he booked a statement take down date with me. I went for it and provided all the documents asked for. But they sent back to me the proof of loss form because I didn't fill it well they c
Alleged. Later on the adjuster told me not to send in he proof form yet, that they re investigating my claim then after that I can submit it again. Anyways, they havent told me anything except without prejudice phrase and still under investigation for weeks now it's was a month last week Friday. The adjuster never picks up her calls and calls me back once in a week after multiple voice mail left. What shld I do now, are they employing delay tactics?' what re my options here cuz they won't even provide me a rental which is part of my coverage,they told me to pay with my money then if they accept my claim, they will re imburse me my rental charges.
ANSWER: Hello Tolu,
Understand that I really know nothing about the details of your claim. But having said that, let me give you a basic answer based on the information that I do have, all of which pertains to the investigation - or lack thereof.
First of all, your claim is now over a month old. It is difficult for me to imagine why an auto theft claim could take this long - unless you are not cooperating. However, based on your account, you have cooperated. You have provided all documents as well as the proof of loss. Now obviously the problem with the latter is that you apparently made some mistakes or omissions. You have since learned that you cannot do that. So here is my first piece of advice...
Disregard what the adjuster said about "waiting" on the form. That is nothing short of preposterous. Immediately complete the form in it's entirety, have it notarized if that is required, and return it to the adjuster NOW. Quite frankly, if it were me I would send it back return receipt mail for my own protection, but that is your choice.
For unknown reasons, your claim is under investigation. I cannot comment on whether or not additional investigation is warranted since I do not have the details. However I can say that assigning an investigator who later delays your claim for a week is unacceptable. The company should have assured that someone was available to take your statement as scheduled.
What is also unacceptable is for the adjuster to ignore your calls. Very unacceptable, in fact. I recommend that you call the company with your claim number and ask for the name and phone and email of the claims manager who is overseeing this claim. Call the manager and politely ask for a status on your claim and why it has been delayed for a week. You might discover that they are blaming you for not submitting the proof of loss in a timely matter! Again, take care of that immediately if not sooner.
If the manager does not answer, leave him a message to call you back. Also send him an email. It is likely that the manager will speak to you as the claim is ultimately his responsibility. If he throws blame to the investigator, ask for the name of the investigator's manager and contact that manager as well. Be prepared, however, if the investigation is being done by the Special Investigations Unit (SIU), they will probably not share details with you. Nonetheless, investigators are bound to the same responsibilities as adjusters are - they must investigate your claim fairly and in a timely manner. Period.
Is your claim being delayed? It certainly appears so. But, again I do not have your details. The only reasonable explanation for the delay would be if the investigator is actively pursuing your claim. But a month?
You are going to have to be proactive. Be polite but firm. You have paid your insurance to provide you with benefits. They must provide you with those benefits unless a valid, impartial, timely investigation proves otherwise.
For more detail information, I suggest you check out my consumer claim help articles on my website, http://insuranceexpertadvice.com
You should find the information very helpful.
Be proactive. Good luck.
Jane Pytel
http://InsuranceExpertAdvice.com
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
---------- FOLLOW-UP ----------
QUESTION: The adjuster called me today and said she still doesn't have anything to act on, however she added that shes meeting up with the Special investigator assigned to my case tomorrow to follow up. What do think she Might be trying to do.
My investigator has been horrible to me, he told me the case might go as long as 6months, before that he told me it will only take a week. Also, once I called him and asked why the delay, he told me that it won't make a different if he submits his report to the adjuster earlier as I would want or later on . Don't know what that means or what he's trying to say to me. !!!
After all the troubles they gave me I can only conclude that they are cooperating to delay my claim for whatsoever reasons. I have nothing to hide and I have signed off all consent forms. The car has not been found yet, why is it taking so long ? If they have anything on me, won't they have Denied my claim by now??
From your experience what should I expect from these two collaborative .
Answer Hello again Tolu,
A 6 month SIU and/or claim investigation is never justified. The only possible exception would be if the inured was totally refusing to cooperate. However in that case the company should take certain legitimate steps to deny the claim. This is NOT occurring in regards to your claim.
The adjuster has a legal obligation to investigate your claim fairly and in a timely manner. She cannot "blame" anything less on the SIU. If the SIU fails to act, the adjuster is responsible to take control of the claim.
The problem is, whether your claim should be paid or denied, neither the adjuster nor the SIU investigator, in my opinion, is acting in good faith. I can only give you one piece of advice, and that advice is based on what I would do if I was in your place.
Hire a lawyer who is skilled in insurance law. Initially you should request that the attorney prepare a strong demand letter to the insurance company. In my experience, this works. Let me repeat - this almost always works. With an attorney involved, ordinarily they understand that can no longer continue to violate good faith practices. They have to make a decision. Unless there is strong fraud evidence - which would be hard to imagine since your car has not been recovered - they need to pay your claim. If they continue to refuse, their actions can potentially be scrutinized by means of legal action. You would need to seek legal advice on that. This is why the attorney must understand and practice in the area of insurance law.
Begin by requesting that the attorney send a strong demand letter.
And to your own benefit, if you have not already done so, I urge you to read my consumer articles which address your problems directly. You can reach them via this link:
http://www.insuranceexpertadvice.com/Insurance-Expert-Advice-for-the-Consumer.ht
Obtain an attorney. I don't see any other option for you.
Jane
