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: Wed Apr 02, 2008 11:57 am Post Subject:
Also i want to thank you two(lori & dasfuk) for your time and help. Your help have really helped me a ton. once again thanks.
Posted: Wed Apr 02, 2008 12:41 pm Post Subject:
Ok, when was it you got the letter from who? that said, (basically) "we have everything we need now to complete our investigation?" Or is that what it said?
Posted: Wed Apr 02, 2008 01:29 pm Post Subject:
The last letter i recieved was on march 13. This was from the insurance co. It stated they reviewed all the documents. And in addiction they need the names of anyone who was there. I told them from the start. It was only me. And that what the letter stating. No addition info other than names
Posted: Wed Apr 02, 2008 02:07 pm Post Subject:
And in addiction they need the names of anyone who was there. I told them from the start. It was only me. And that what the letter stating. No addition info other than names
I know you already told them this, but did you respond to this request? Either call them or write and tell them (again) no witnesses?Posted: Wed Apr 02, 2008 02:23 pm Post Subject:
No i havent i told them from the start. Should i tell them again?
Posted: Thu Apr 03, 2008 03:01 am Post Subject:
Yes, it would appear that they are waiting on a response from you as to any witnesses and you should respond by phone or in writing.
Short Story sorry:
I had a similar claim where a tenant claimed that she fell on some uneven concrete stairs at an insured's building. The claim was submitted about 3 months after the fact. After conducting my investigation I turned it into the insurance company. The insurance company requested that I ask for any witness names in writing to the claimant. I received a response of no witnesses from the claimant and the claim was denied the following day. With this claim, I really felt the claimant was making it up due to information uncovered about the claimant in the course of my investigation, but my point is they may be setting up their denial.
As far as when the porch was fixed after your accident does really come into play. The important thing for you to show is when the porch was damaged and the pipe exposed. You need to show that their insured had notice or should have had notice of the hazard. If the pipe was exposed only the day before the accident then their insured may not have had notice or implied notice of the problem, and thus did not have time to fix it or at least flag it for his tenants/their guests. (This is when what is reasonable for the insured to know that their is a problem).
Once again, it appears that they are setting up their denial. I would call them and let them know that there were no witnesses and see what they say. Then get the attorney.
One other thing - is this a multi-tenant building or are you the only tenant. If it is multi-tenant, check with other tenants to see if they can tell you when the pipe was exposed. If you are the only one that lives there (family members/friends would not be good witnesses) check with maintenance people, meter readers, phone company, whomever you can think of that is at the property on a normal basis that could confirm your story as to when the pipe was exposed. Also, with this type of injury did you go to the hospital the same day. Was an ambulance called? Any type of report filed?
Posted: Thu Apr 03, 2008 07:46 am Post Subject:
Hi. Dasfux, what do you mean by what information you uncovered about the claimamt? Also i have pictures almost 2weeks after the incident. So that wouldnt be a reasonable amount of time to fix something that only need a few screws? That seems reasonable. When he fixed it should matter. Because how much time is driving a few screw could take. He should of notice it if he didnt already know. I already showed that the porch was damage. It has other tenants but they moved out and new moved in.
Posted: Thu Apr 03, 2008 07:59 am Post Subject:
also what should i say after i give them that information should i ask for a updated or when the investigation is going to be finished. I dont think the adjuster will want to play any more run around games. She have recieved that complaint. Could you tell me what questions to ask her. The investigation should be complete after i tell them that info.
Posted: Thu Apr 03, 2008 09:49 am Post Subject:
No i havent i told them from the start. Should i tell them again?
Yes, if they specifically requested this information in a letter, then you need to respond to that question...they ''could'' hang their hat, on that alone...(re: can't complete investigation because claimant has not supplied requested information....) I know it shouldn't matter, but some adjuster would do just that... So call them tell them referencing their letter of blah blah date, 'no witnesses'...If you are the only one that lives there (family members/friends would not be good witnesses) check with maintenance people, meter readers, phone company
mailman always a good one, and likely passes it daily...in my prior life when I handled a lot of HO claims, I got tons of great information from mailmen/women, they could probably even attest to how long it was that way, when they noticed it repaired etc (assuming the mailman goes by it of course)...It has other tenants but they moved out and new moved in.
Get their forwarding addresses at the post office or find their phone numbers and call them!I dont think the adjuster will want to play any more run around games. She have recieved that complaint.
How do you know that? And was the complaint, re: time it has taken to investigate?should i ask for a updated or when the investigation is going to be finished
Absolutely...you also need to get on the witness thing...when you talk with the adjuster be sure and tell them there are no witnesses to your fall/injury, but there should be plenty re: the pipe..(this is correct right?)...then you need to get to finding those witnesses....yesterday......Posted: Thu Apr 03, 2008 09:11 pm Post Subject:
Gb:
You are missing my point. I does not matter how long he took to fix the porch after the incident. Should he have fixed it soon after….. sure, but it does not come into play as far as him being negligent as you had already fallen (or this is at least the way I understand how it happened). What comes into play is if the porch was damaged for an unreasonable amount of time prior to your incident. If he knew or should have known the porch was damaged prior to your incident and did not highlight or fix the problem within a reasonable time… that is where he is negligent. The fact that he is a scumbag landlord that does not take care of his property does not by itself make him negligent for your incident.
Mail men/women - They were always good for letting me know how long a property had been vacant. Wonderful people. Find witnesses.
As far as my claimant. It was found that she had a pending insurance fraud case against her and a history of questionable accident claims of a similar nature.
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