Dealy, Deny and Defend Standard operating procedures

Mr. Cuarsema

I am in receipt of your January 14, 2012 letter written after Farmers Insurance Exchange received an important letter from Esther Matson at the State of California Department of Insurance, instructing Farmers to move forward despite excuses with issuing a scheduled date for the required Examination Under Oath. Farmers Insurance Exchange has been on record causally talking about requiring a Second Examination Under Oath as Farmers has claimed with the State of California. Farmer’s claims to be waiting to hear from me as the sole reason too not have acted upon scheduling this second EUO. Despite many, many inquiries and reminders over the last 221 Days since the June 8, 2011 EUO, cooperating and attempting to get Farmers to cooperate and accomplish coordinating a EUO date to be scheduled. I made it simple and asked for any available date be scheduled that is convient for Richard Eichenbaum. Farmers now falsely claim the EUO has not been scheduled because requested documents have not been produced.

To that end, I contacted Farmers Insurance Exchange on January 10, 2012 following Esther Matson’s instructions to me and send one more reminder to Farmers to schedule the EUO date and to advise. I have been waiting over six months for this action (DATE SCHEDULED) to be accomplished by Farmers. Despite my many e-mails expressing my willingness to comply and attempt to schedule this EUO complained as being necessary in order to pay my claim by Farmers while producing additional documents in advance as a courtesy for the first available ever given date September 22, 2011, I choose to comply. I cannot force Farmers to cooperate properly on this claim or stop the engineered delays now creating scenarios where Farmers must withhold scheduling for the list of dates previously given and for not reissuing a list of dates or a date since the date list late October/early September 2011.

Farmers has now taken action that could thwart and fend off a reasonable Good Faith effort with the State of California Department of Insurance in resolving this EUO date issue by giving new more complicated reasons and excuses for not scheduling the EUO date and imposing a 14 day deadline in some sort of penalty context upon me. Possibly avoiding the need to comply and reply in 15 Days to the Esther Matson’s letter bringing more time period manipulations into play. Attempting to avoid Farmers from scheduling a EUO as requested by denying the claim with the 14-day time limit imposed by Farmers.


Farmers has decided the best course of action is to move the target and/or change/changing the reasons it claims to now have/had and evolved the reason into the new reason(s) for the delaying my claim and in scheduling a second EUO, creating more delays on my claim. Farmers withheld this unapparent reasoning/issue to further delay the claim until convient for Farmers. Farmers should have complied with Esther Matson’s request to schedule the EUO date instead of imposing a 14-day deadline on the claim.

In addition, Nick you misquoted the letter as follows you quoted,

"I will receive documents, communications online or by picking any documents you have at your Attorneys office or 1190 Saratoga Avenue S.J".

The correct quote in context is,

"As you are aware I will receive documents, communications online or by picking any documents you have at your Attorneys office or 1190 Saratoga Avenue S.J".

Farmers was noticed June 8, 2011 mail was no longer an option. Any failure to produce any documents or send any letters in this manner previously based on sending by mail is invalid and simply silly at best.

In my e-mail of January 11 2012, I made it clear again, once more, the reason for avoiding the mail is as stated by me “mail has been abused by Farmers in its ongoing effort to delay, avoid deadlines and prevent from paying the claim”. The reason is simply to try to protect against the type of tricks and games employed by Farmers to date.

Furthermore explanations where included in this paragraph and you are also aware AMY said she mailed the receipts, then indicated they are lost, AMY could not then find any receipts within Farmers and they where not returned by mail to Farmers. In fact, at one point AMY was saying they do not exist anymore. I have written on how serious that is without response. Among the documents AMY Brasseur had are documents Farmers has made a duplicative request to provide per the many differing documents requests. Documents AMY Brasseur and Farmers Claims Office had possession. It is interesting to note that Farmers knows I am under the impression per Richard that these documents where to be available September 28 2011, the EUO date Farmers withdrew at the last minute. The EUO Date that was ripped away by Farmers by delaying the logistics. In addition, Nick refused to help keep matters on track. Ignored me! Then Farmers went singing the lyrics claiming logistics where not their fault. Yet Vicki has just produced those documents after that September 28 2011. How could this be? In addition, recently Richard Eichebauam described the documents as being from another claim. Therefore, it does appear Farmers does not intend to provide those documents that had been provided late Friday December 3, 2011 at Farmers Claims Office at 1190 Saratoga Avenue San Jose, Calif 95129. I will not even know what they end up being despite the claims and contradictory claims as to what documents there will be. Let alone be able to advise Farmers as to any discrepancy time wise most likely until you have gone ahead and denied this claim in 14 days as stated.

In regards to those documents, the originals are hereby demanded returned. Farmers was allowed to copy the documents. That would eliminate electronic delivery of originals. Originals are to be returned to Farmers Claims Office at 1190 Saratoga Avenue San Jose, Calif 95129.

Now that Mail issue is cleared up, once more, the same p/u from Farmers Claims Office located at 1190 Saratoga Avenue San Jose California 95129 can be done with the check at this point, which should have been issued long ago, certainly by now.

In regards to that issue of payment, it is brought to your attention the following second EUO is yet to be formally requested with a scheduled date. This is the procedure to be implemented for Farmers to have required an additional EUO. As you are aware, also Farmers Counsel has failed to issue such proper and formal notice or proceeded properly as it had in regards to the June 8, 2011 request by assigning a date.

The last 221 days of delay is no different in that Farmers simply needed to proceed as it had with the June 8, 2011 EUO. Would have returned the next week back in June 2011 but actually, Brian said he was done, and discharged me as the last thing he said.

Instead of being, timely with the EUO Farmers embarked upon an elaborate plan in BAD FAITH to send to the wrong address and delay the claim. In addition, for not responding to mail knowingly sent incorrectly Farmers threatened to take adverse actions. As well, Farmers did not just issue the new EUO date after the June 8, 2011 EUO ended. It is hardly reasonable to think now this was even a serious plan on Farmers behalf.





Moreover, Farmers was contacted by the State of California about delays. According to Farmers own response to the State of California, Farmers was aware as early as July 6 2011 the date the State received a response from Farmers on delays. Obviously earlier than that about not being contacted since the June 9 2011 e-mall follow up to the June 8, 2011 EUO. Farmers still waited 12 days more to correct. For a total delay around three weeks. Farmers could have if it choose to send the June 15 2011 letter by e-mail as an attachment it could have easily done so using the second e-mail opportunity when the State informed Farmers by mail. About three weeks earlier than the July 18 2011 response. This is on record with the State of California to provide the letter of June 15 2011. Farmers created about 40 days of delay for that June 15, 2011 letter despite the June 9 2011 e-mails. Asking for the status of the EUO/claim payment. Farmers was instructed to use e-mail or the Online Farmers System on June 8, 2011 and that the use of mail is invalid. Farmers ignored both e-mail options timely and by using, the first option of e-mail on June 15, 2011 would have deducted 33 days of delay on the claim.

I cooperated and agreed on the documents we still possibly needed with Brian McShane and Diana Mausen. That document agreement was offered in June 2011. Instead, Farmers created a massive delay while waiting in Good Faith for Farmers response under the period Esther Matson asked me to wait regarding a claims decision.

The possibility of requiring a second EUO, which will now come at a point in time in this ongoing, claims process where delays have been the mainstay for 452 DAYS. Iniates the issue and argument that Farmers has given up its right to conduct an EUO especially a second EUO so late in the claims process as it is simply not timely. Prompt timely claims adjustment requires and demands this EUO not be required a year and more from the actual claim date. Especially under the factual situation, we have on the claim Farmers has effectively denied the claim and cannot force a EUO with threats of 14-day deadlines or by denying this claim at this point for this reason.

Farmers Insurance Exchange, the insurance carrier cannot casually ask for an exam. The demand must be clear and unequivocal. Nicolai v. Transcont'ntal Ins. Co., 61 Wn.2d 295, 378 P.2d 287 (1963).

Furthermore, Farmers has denied this claim given the facts. There is compliance with all requests that are my duty under the Policy in a substantial and material manner. Given the fact for 452 days Farmers has failed to pay under the policy.

Insurance Claims and Disputes, 139-140. Windt cites dozens of cases for the last example, examination under oath. He also points out that the denial of coverage need not be explicit – an insurer's silence or delay in accepting or rejecting coverage can constitute the equivalent of a denial. Id. at 142.

It is a basic principle of contract law, that once one party to a contract breaches the agreement, the other party is not longer obligated to continue performing his or her own contractual obligation. As a result, once the carrier has denied coverage, an insured is no longer bound by the insurance policy's provisions governing cooperation, proof of loss statement, ... access to books and records, and submission to examination.

Furthermore I have/had an agreement with Mr. Brian McShane which was violated to not schedule an EUO until my claims file in its entirety has been produced or until I get officially notified I am not entitled to my complete file. Agreement was that is/was to come from Esther Matson at the California Department of Insurance. This information from Esther Matson confirmed the claim file is required to be produced. The complete file has not to date been produced. Instead, Farmers bullied me into attending the June 8, 2011 EUO under threat Farmers would deny the claim however wrong that would have been. The claim was fully supported and payable at that point and even earlier than that.

The request for my complete claims file for this claim referenced above came before the file was sent to the Attorney(s) avoiding any claim(s) of Attorney Client Privilege. Despite that agreement, Brian McShane broke our agreement, went ahead, and scheduled a EUO for June 8, 2011. There have been several requested claims files from Farmers that Farmers continues to deny production. In those files there is information requested by Farmers I would like to produce in further support of the fully supported claim. Therefore effectively preventing me from complying with the document production request in a more complete way. Those where the July 2011 theft claim, the October 2011 Vehicle theft claim, and of course this claim file referenced above. None of the requests where complied with. I am entitled to those claims files in full, in complete form. Farmers is in violation of the California Fair Claims Practice laws on this as well as other actions and or inactions Farmers has chosen to take or not take to date.



In any event with my rights under California Law and other rights Farmers has violated, ignored and not respected, nor complied with many if not all my requests. The production of documents request for the June 8, 2011 EUO was under the surprise circumstances of that scheduling. As well, the complete lack of Bonafides. The claim file production request was ignored. This continues to date.

Additionally the June 8, 2011 EUO ended because of the court reporter having to leave early and your office had been told by the stenographer that was a possibility if the EUO went longer than normally expected which apparently it did. In addition, I would follow up with the agreed documents and I would have the decision within the 40 days as required by law.

Is not any concern of mine Farmers could not finish the June 8, EUO because of staff shortages. I should not have suffered any delays nor should this have resulted in any follow-up EUO, any second EUO demands, or any other consequences of such problems with Farmers own EUO process and it is clear there are severe consequences for this inability.

There has been supplemental documents produced to the already substantiatial documents already produced for Farmers that came as reviewed and requested over the last 3 months while awaiting my EUO date to be scheduled.

As well without the additional documents, Farmers was in possession of a substantial amount of documentation as of June 8, 2011. That Farmers requested to begin with, including receipts statements of various kinds, itemized claims list as well as the opportunity of a whole host of documents where brought to Diana Mauasen at the Interview she conducted in concert with Miss AMY Brasseur.

Document Farmers had as of June 8, 2011

1. Purchase and loan document for the van.

2. Documents evidencing the ownership of the stolen Ford van, including loan contracts where presented to Diana Mauasen during the Special Investigation Interview on 11-9-2010. Diana was free look/copy a whole host of documents and did copy documents Diana and Amy choose. Diana and AMY explicitly excluded documents at that appointment.

3. A list of all items stolen from the van on or about October 18, 2010

4. Any and all photographs of the property claimed stolen.

5. E-bay username

6. All invoices, receipts, correspondence, memoranda, contacts, appraisals and any other writings pertaining to my purchase and ownership of any of the property claimed as stolen, To the extent that the purchase of any property clamed was made by a credit or debit card, monthly statements for such credit or debit card showing said purchase.

7. Check Copy from Allied Telesis INC., substantiating the October 2010 income of Four Thousand Three Hundred Fourteen Dollars and Eighty Four Cents for a total income of at least. $12,533 dollars.

Since June 8, 2011, while reviewing and awaiting a second EUO date, documents that where added,

8. Profit and Loss statement.(July through October 2010).

9. Cell phone records for October 2010 with all telephone calls as line items.

10. Check copy from Univar Dated October 27 2010 for Eight Thousand Two Hundred Eighteen Dollars and Sixteen Cents ($8218.16)









However, I made an agreement with Brian Mcshane on which documents where really required during the June 8, 2011 EUO. Since that time I have received many differing descriptions and expansions of that agreement. Creating document production conflicts by Farmers. Farmers has been made aware previously that needs to be resolved with me but Farmers has intentionally delayed, avoided and ignored this matter with me as Farmers continues to implement the ongoing delay, deny and defend strategy that has been employed from day one or two of this claim. Then falsely claimed the EUO had not been scheduled because requested documents have not been produced is false and a red herring.

Obviously, this is something that needs to be worked on in GOOD FAITH by Farmers Insurance. However, please take notice I am in substantial if not complete compliance of all conditions of the policy to date including the document request(s). To threaten me (the policyholder) that if I do not meet a arbitratary imposition of a 14 day deadline or any other deadline by threatening denial of my claim by claiming rights arbitralarialy to documents Farmers does not have rights too, documents I do not have etc and has not made the necessary negotiations on in the course of the claim regarding document production is incorrect and against the law. Ignoring the previous objections and circumstances. Nor worked out the contradictions and vagueness of such requests and the breaking of the agreement of the documents to be produced previously where destructive as this document issue was settled essentially on June 8, 2011. June 9, 2011 I offered the documents if Farmers would confirm they where needed and asked for a status on payment, however Farmers just delayed. Denial of the claim would be outright improper under such circumstances using deadline(s) as blackmail and would continue to build the substantial amount of Bad Faith actions…etc to date!

Indeed, one Court has held that "substantial compliance" is all that is needed because: "the real question is whether there was enough evidence of whatever form and however acquired that it would be unreasonable for the insurance company to refuse to pay the claim." McCormick v. Sentinel Life Ins. Co. (1984) 153 Cal.App.3d 1030, 1046. This claim is fully supported and has been payable for some time.

Any allegations that Famers may be alleging or will allege as to certain document(s) as not being produced does not invent a legal right to avoid scheduling any EUO especially an EUO that is contingent on arbitrary requirements and claims. Farmers claims it wants. That cannot be in Good Faith! This is not provided by the case law. I demand Farmers position on this be made known and available in a prompt response to avoid any misunderstanding between the parties regarding my compliance on this issue above and on any issue, that risen throughout this claim within 15 days.

It is not a right Farmers possess to invent a claim I am not complying in Good Faith or claim I am withholding any documents Farmers claims is required. In fact this recent letter is part of an ongoing intimidation plan and straight out bullying of me (the insured) for reasons not to be in found in Good Faith but clearly it is all Bad Faith, as any reasonable person would acquire from the ongoing delays created with dishonesty…..etc…... and other wrong and illegal actions.

In any event, to claim the failure to provide requested information does not necessarily excuse the insurer's duty to investigate the claim through other channels because the insurer's duty of good faith and fair dealing is not contingent on the policyholder's performance of any policy condition. (Gruenberg v. Aetna Ins. Co. (1973) 9 Cal.3d 566, 577; see also, California Cas. Gen Ins. Co. v. Superior Court (1985) 173 Cal App.3d 274.)

The Court noted that circumstances must excite suspicion so that there is a basis for probing the bonafides of the claim and that the questions asked and documents sought must have point and direction.]; Chavis v. State Farm and Fire Casualty (N.Ca. 1986) 346 S.E.2d 496.

As well there is no arbitrary right created in such an unfounded document production request, too refuse to schedule an EUO because the insurer claims there is not the right amount of documents or is requiring documents exempted by law. Alternatively, as well, that the Insured has not standed on his head before being issued a formal EUO date in advance of issuing the EUO date creating delays beyond all reasonableness. Then using the fact Farmers has not issued an EUO request to deny the claim based on not complying with an EUO, Farmers has not requested properly and/or scheduled failure to produce a document(s) or both while knowingly aware of certain issue(s) and circumstance(s) involved with production of these documents is illegal.

The Bonafides of this Special Investigation Process and EUO aspect of this claim goes without properly coming across any proper or prudent foundation. I have requested Farmers provide the Bonafides of the Special Investigation as of day two of the claim date and for first EUO along with the possible second EUO request. I did this back in January 2011 and at other times since in various communications. I do it now with any past or future EUO requests.



Nick promised an answer on the Bonfires as did Susan Anderson. Amy gave some information that is contradictory, but I have not received the promised outstanding inquiry for reasons that are apparent and in Bad Faith as well as obvious, and apparent. The claim is for real and there is no prudent reason or proper foundation. I will tell you AMY’s version and Susan Anderson’s small amount of detail from Susan’s version differs to begin with, so someone is not truthful.

Even though Farmers Insurance (insurer) has the right to demand documentation from me (policyholder), the demands must be reasonable. As one Court stated, of course, the insurer is limited by a rule of reasonableness and specificity. It may not "roam at will through all of the insured's financial records." [Citation.] "(Stover v. Aetna Casualty and Surety Co. (S.V.W.Va. 1987) 658 F.Sup. 156, 160; see also Happy Hank Action Co. v. Amer. Eagle Fire Ins. Co. (N.Y. 1955) 145 N.Y.S. 2d 206, 211 [Holding that insurers have no license to harass insureds with aimless questions and demands for documents, or with random Shots in the dark. To this end, the paraphrase for Mr. Eichenbaum in that he does not know what questions to ask after the June 8, 2011 EUO without aimless document production on my behalf.

The Court noted that circumstances must excite suspicion so that there is a basis for probing the bonafides of the claim and that the questions asked and documents sought must have point and direction.]; Chavis v. State Farm and Fire Casualty (N.Ca. 1986) 346 S.E.2d 496.

Famers Claims office located at 1190 Saratoga Avenue San Jose, Calif 95129 is the Farmers office where I dealt with Miss Amy and brought the receipts, statements etc along with many major and other documents that are on the request for document list(s).

It is preferred you send whatever it is you are sending to Farmers local claims office at 1190 Saratoga Avenue San Jose, Calif 95129. Richard may suddenly go on a vacation at 3:00 AM and this would cause delay Along with an inventory to be checked against what I will be picking up. Richard stated recently the documents you have relate to another claim that had been asked for. No doubt is another attempt to delay me from the all the information I have rights to have under Law including the claims files. I had been lead to believe this was for what had been given AMY at Farmers claims office at1190 Saratoga Avenue San Jose, Calif 95129 on Friday December 3 2010.

As you know the documents given AMY are among the documents Farmers has requested from me along with the documents I have sent in addition to these requested documents I have sent over the last several months while I was awaiting the EUO date to be scheduled. Whatever the documents are as no one has been definitive they would be only a small and partial amount of documents I have requested from Farmers. In addition, untimely delivery has prejudiced me with this claim. Among these is the June 8, 2011 transcript for the EUO on June 8 2011. Basing a claim denial in a arbitrary manner is, wrong and your 14 day deadline is wrong, unfair and illegal. Basing a denial on a transcript that has not been produced for signature would be improper, going against my legal rights and extremely unfair. I had an agreement to pick my Transcript up on June 8, 2011. This was ignored. I attended the June 8, 2011 EUO as noticed by your attorneys. This all part of the orchestrated delay, deny and defend strategy. No EUO should have been or be scheduled until Farmers responds to all outstanding issue’s I have and rights I have. Moreover, the claim is fully supported and payable so there is no issue(s).

Farmers has abused the mailing of important documents to delay my claim avoiding time frames required under law in adjusting my claim and to prevent Farmers from having to properly pay this claim.

On November 2, 2010, I wrote Farmers and requested Farmers give a list of any things I could do or any questions I could answer, explanations or anything else I could possibly provide that would help settle the claim timely. This is the way Insurance Company operates when matters are in Good Faith and is simple and efficient. Moreover, it prevents any unnecessary delays.

Please pay the full claim within fourteen days and arrange with me the pick up of payment from Farmers Claims Office at 1190 Saratoga Avenue San Jose, Calif 95129.

Insured
Bart Kay
550 Moreland Way Apt # 3116
Santa Clara, California 95054
Address no longer valid as of June 8 2011


Sunday, February 12, 2012


Farmers National Document Center
P.O. Box 268994
Oklahoma City, OK 73126-8994


RE: Claim Number # 1017109697-1-1
Loss Date 10/20/2010

Fire Insurance Exchange v. Kay
Case No.: :N/A - EUO
Your File No. : 11-103908
CSB FILE No. : 5655214

Mr. Cuarsema,

Referring to your January 14, 2012 letter to me you stated, “We will make a determination based on the information we have to date” after your 14 day deadline.

After waiting 14 days since I wrote you back in response, you write me on January 30, 2012 another letter, conflicting with and/or attempting to change retroactively the possible consequences Farmers previously stated in regards to the 14-day deadline that had already passed.

This was a new idea and/or new warning that stated Farmers may decline coverage based upon failure to comply with the policy section of the EUO. That claim to in regards to the policy is false in any event.

Informing me of this change of actions Farmers was now stating on January 30 2012 after your deadline expired was invalid. Your retroactive extension Farmers proposed did not afford me any chance to respond with thought even if the extension was valid as a matter of contract Law and precedent. As well was not valid as common sense matter the average citizen enjoys. Your statement Farmers is extending the 14-day deadline by 4-6 hours on the same Monday January 30, 2012 did not change the fact you informed me of this information and acted upon it after your 14-day deadline. Attempting to make this sound as something extra nice Farmers want to do for me.

I reiterated Farmers co operate and schedule the EUO as requested by the State by re referring you to my January 14, 2012 letter you avoided acknowledging to date. The extension is invalid as a matter of law as well the extension is just too convient to be in my best interest, therefore the extension of the 14-day deadline was self serving to Farmers and against my interests.

Your stated extension did not provide sufficient time to consider or respond since your decision came February 1, 2012 and only after your 14 day deadline. Farmers failed to point out the differences in consequences it might employ. Farmers was obligated to act as it had stated since Farmers deadline had passed. Farmers cannot retro actively inform me of a new consequence and act upon it after Farmers deadline had passed. When the deadline passed Farmers could have paid the claim or denied the claim based upon the information Farmers had to date. There was very little chance I would even see your January 30, 2012 letter that day.

This is a dirty, dirty, dirty, tactic. Farmers mislead me with evil intent in Bad Faith. Farmers has risen to a new standard of misconduct.



Bart Kay