And … the William H. Kelly Insurance Agency in Atlanta, Too!
By Dr. David Edward Marcinko MBA [former insurance agent]
An Open Letter
TO: The Honorable Ralph T. Hudgens. Georgia State Insurance Commissioner. Two Martin Luther King, Jr. Drive. West Tower, Suite #704. Atlanta, Georgia 30334
RE: Appeal to Open Allstate Insurance Claim #0145606xxx
Dear Mr. Hudgens,
Thank you for allowing us to respond to a letter from Ron Waters of Allstate Insurance Company, dated November 11, 2011. In short, it is an obfuscation and its’ conclusion a fabrication.
For example, we did modify the contract and thereafter did receive partial payment, but we did not completely sign-off the claim, nor agree to same. And, in contract law, the concept of Contra preferendum prevails; especially against a behemoth company whose threatening agents or automatic signatory obviously did not read the modified contract but processed the clam en masse [no doubt to much hindsight embarrassment]. Moreover, the back of our partial payment check documents same. Therefore, any Allstate attestations to the contrary is meaningless and a bold-faced lie.
Additionally, Mr. Waters’ comment that our $1,000 deductible was subtracted from partial claim payment is FLAT-OUT WRONG. After AS investigation and defective valve biopsy, the entire deductible was, in fact, returned to us under the subrogation clause – proving that these folks are absolutely incompetent insofar as our claim is concerned. This includes agent William H. Kelly whose insurance license we request be immediately suspended until this claim is fully paid.
Simply, we challenged Allstate Insurance Company to show us [and you] written documentation where we completely signed off the claim …. It just DOES NOT exist … And please; do not allow AS to goad you into believing this is an oral dispute. It is contractual, and written, pure and simple.
And so, this situation is the one we are currently facing:
1. An open claim after nearly two years.
2. e-mail documentation from AS agents John Bell and Isis Ortega confirming the validity of our home duct HVAC and terminal house cleaning coverage – after partial claim payment – which was reneged, re-agreed, and then re-reneged again by hapless agents.
[page 2]
William Kelly Agency
1776 Briarcliff Road, Suite #B
Atlanta, GA 30306
In conclusion, we expect AllStateto pay for both services as per their written documentation. Of course, we are willing to completely sign-off on the claim, thereafter.
Mr. Hudgens, thank you for personally intervening immediately in this matter and NOT passing it off to subordinates. Allstate is disrespecting us who know better as a former insurance agent, [see Mary Ann Wargula LN: #5109xx NPN: #67710xx], and mocking you as Georgia State insurance commissioner.
Furthermore, please inform the dismissive Mr. Alonza Bennett that any carrier suggestion that we accepted the claim-in-full is FALSE; and that he is being played as a naive waif [or is too beholden to insurance industry PACs and lobbyists]. We trust you are NOT.
Finally – again – please consider this.
If Allstate was correct, they would simply provide you a signed copy of our total claim acceptance instead of their numerous explanations, positions and the recent nonsense of their November 11 2011 letter; and related gibberish of these many months. AGAIN, it does NOT exist.
We can not be more plainspoken than this!
Sadly, after much patience and benefit of doubt – it seems our claims experience may indeed represent a collusive Allstate policy of “bad-faith”, and not merely the actions of rogue and clueless agent employees. What do you think?
We await your investigation and affirmative reply.
Fraternally,
Dr. David Edward Marcinko; FACFAS, MBA, CPHQ, CMP™
cc: the universe
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Filed under: Insurance Matters, Op-Editorials Tagged: | Allstate, Allstate complaints, Georgia State insurance commissioner, Isis Ortega, John Bell, Mr. Alonza Bennett, Ralph T. Hudgens, Ron Waters, Tom Wilson, William Kelley Insurance Agency
Dr. Marcinko;
I wish you the best in this obvious “bad faith” litigation you have with Allstate. It is shameful that these big P&C insurance companies advertise how wonderful they are and how they will look after you when in fact that seems to be rarely the case in my experience when your really need them (hence, the reason you have “insurance”).
I can relate. Our family lost our home in Paradise Valley Arizona 10 years ago when a remodel went bad due to the annual Arizona monsoon rains that hit while the roof was off our house. Our insurance company was happy to help us until it became obvious the claim would be in the six digits. At that point the fingerpointing started. Our insurance company that we faithfully paid premiums to for years without a claim failed to accept their legal responsibility in handling the claim, suborgating the contractor’s insurance companies, and began denying facts and lawyered up. Our home in the mean time became uninhabitable due to the onset of Stacci botrus mold caused by our Insurance companies neglect and bad faith. Two years later only after hiring literally a team of lawyers we settled out of court, making several law firms rich while we recovered only a portion of the equity we had in the property and moved on.
So, Dr. Marcinko, if it helps, lessons I learned from dealing with a P&C Insurance company (PCIC) when you really need them (a large claim):
1. First lesson is that a PCIC will almost always fight any large claim (> $50k – $100k ), but will pay most all small claims promptly with a smile (A 30 year PCIC veteran agent told me this). This practice gives them statistically positive PR while at the same time making them statistically more profitable. After all, with a PCIC it is all about statistics.
2. While fighting your large property claim, the PCIC knows that the ball is in its court when playing defense. The longer the PCIC can drag this out, the more you will wear down and run out of money and be proned to settle for less than your loss. They will never run out of money. After a couple years you will have to make a choice: Your family, your marriage, your sanity OR do you continue the legal fight at $ xxxx.xx a month?
3. PCIC contracts, Insurance company management AND agents are not there to help you, nor do they have any fiduciary obligation to you. This isn’t just sour grapes or my opinion. This is spelled out in their contracts and agent agreements. Your only role is to make sure you pay your premium on time. As you are aware from the Life Insurance exam the agent’s only obligations are to the company he/she represents.
4. State Insurance Commissioners are there primarily to protect the Insurance companies in their State, not the consumers in their state. This is different than State Securities Commissioners, which spend most of their time prosecuting rogue RR’s and auditing financial advisory practices and protecting the consumer. When a State Insurance Commissioner talks about fighting “Insurance Fraud” it is not refering to prosecuting resident Insurance Agents commiting acts of deception and pilfering senior citizen’s bank accounts with sleazy Equity-Indexed Annuity sales or commission bloated whole life policies, but rather “Insurance Fraud” to a State Insurance Commissioner is when a consumer falsifies an insurance claim. This cannot be tolerated.
5. Seemingly good people will barefaced lie to you and deny everything to save their job. This is sad.
Again, Dr. Marcinko, you have my best wishes. Illegitimi non carborundum!
David K. Luke, MIM
Raising Rates
Dr. Marcinko – Allstate Corp., Travelers Cos. and State Farm Mutual Automobile Insurance Co. are among insurers raising homeowners’ rates after damage from natural disasters defied industry projections.
The stock of Allstate is especially in the toilet and there is growing sentinent for the CEO to resign. So, it is no wonder they won’t pay claims adequately. And, it is no surprise that your agent is not helpful.
http://www.fa-mag.com/fa-news/9638-insurers-lifting-rates-as-storms-defy-models.html
Edward