by gb298888 » Thu Mar 27, 2008 10:47 pm
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?
Posted: 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.
Posted: Fri Mar 28, 2008 12:46 pm Post Subject:
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....
Im just sick of this whole thing.
i know you are hang in there .... :wink:Posted: 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.
Posted: Sat Mar 29, 2008 10:56 am Post Subject:
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...Posted: Sun Mar 30, 2008 03:28 pm Post Subject:
I wont be able to talk to again until tuesday. She is out of her office on monday. Meanwhile Could you give me a range of what my claim is worth? Soon after they get the complaint from doi, i know they will make an offer. What is a good range?
Posted: Mon Mar 31, 2008 05:23 am Post Subject:
Gb,
I went back and re-read all of your posts from the past few months. One thing I never read was that they accepted liability. Have they ever told you they except liability? Have you had this conversation with them? Thinking about a settlement may be putting the cart in front of the horse. Looking back, this claim was not submitted until 7 months after the claimed accident (according to you it was due to the landlord). Were there any witnesses? Claims reported 7 months after the fact (depending on what your landlord told them) can be difficult. Did the landlord admit that the pipe was there to his insurance company? When was the porch damaged to expose the pipe - the day before or a week before? How long have you lived there? How many times do you pass by this pipe/porch per day/week. Is this the main entrance to your residence? Was the pipe out in the open where someone should have seen it? Has someone else tripped on the pipe? Has anyone complained about the pipe prior to your accident? Complained to who? You? Landlord?.....
There are a lot of questions that need to be answered prior to them accepting liability. Maybe they have asked them to you already and you just didn't post that part. Maybe your landlord said you were making things up and that the porch was okay. Maybe the landlord told them that you reported it to him 7 months after the fact. Like I said, late reported claims can be difficult if the landlord was not honest or if something does not add up. The adjuster has to put all the pieces together to see if the claim adds up.
If they have not accepted liability at this time, the DOI may just get them to speed up a denial, or at least send you a form letter letting you know they are still investigating. The DOI can not and will not determine liability.
Posted: Mon Mar 31, 2008 10:33 am Post Subject:
Meanwhile Could you give me a range of what my claim is worth?
No we can't really do that here, a person would need to review all the medical records, and the claim....do you know how much you have in actual expenses? All medical, loss of wage etc?Posted: Mon Mar 31, 2008 02:38 pm Post Subject:
Hi. Dasfux. They havent said anything about liability as of yet. My landlord maybe admit the pipe was there who knows. Thats my it good to have pictures. They dont lie they just snaps what in front of them. And the insurance co have these pics. I lived here for years. That is the main entrance but the pipe isnt noticable. I noticed it after the fall. The landlord is responible to do periodically checks to the apartment and do proper steps to make the place safe. The whold porch is unstable do he care and fix it..... no. It s a violation as well. He keeps the whole apartment in very harzardous ways. If he could fix the pipe/porch he should of flagged it. He had 2 duties by law on by ny tenant and landlord law and the porch violation of how he must keep it. And he breach both of them. That is negligence. Ex. If im driving down the road speed limit is 35 by law and im doing 45 and cause an accident im negligence because i didnt do what was required by law and in result of that i caused an accident.
Posted: Mon Mar 31, 2008 02:51 pm Post Subject:
Sorry for second post. Once again the landlord can say im making things up but pics dont lie. And he can say i just reported the accident 7months later but he respond to my lawyers letter that was sent to him a few days after the accident. i dont have them anymore not bc i didnt have a good case or the case merits. So he can lie if he wants that his problem he will just look dumb when he get proved wrong. Everything adds up on my end. i think liability is clear and he was negligence. And i dont think they are dealing with the claim right. So i will doi investigate to make sure they are. They want to deny im ready for court. I can wait a year or 2.
Posted: Mon Mar 31, 2008 05:07 pm Post Subject:
I forgot to mention. Landlords owe their highest duty to keep things safe to/for the tenants.
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