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Home owners claim denied

Posted by James M 
Home owners claim denied
December 12, 2014 10:09PM
I Was encouraged by my agent to file a claim regarding my bathroom that badly needed to be fixed. The adjustor came out took pictures and declined my claim stating it was long term damage to the wall and they would not pay for the mold and tile work. What really happened was there was a slow leak from a pipe from behind the wall and it gradually force the grout to fall out. I had to pay for the entire thing out of my pocket, in the 15 years I have been with Farmers I have never filed a claim never, once my fence blew down and once I had some items stolen and my agent said oh that is too small wait for something bigger, well this was it, and the denied me. I asked for a second opinion and they denied that as well, so I pay and pay and pay and whenever I need them they are not there, I have not filed an auto claim with the exception of a broken windshield claim in the past 20 years. When they say it was long term damage that I ignored they are lying, a leak that I had paid a plumber to fix caused the problem not long term damage, I have filed a complaint with the state of Oregon last summer and still have never heard anything from them either.

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Beware of Farmers Insurance! They will do anything to earn a dollar and not pay a claim: Tell lies, ignore coverage, misrepresent facts, dodge inquires, fail to conduct with integrity a full investigation, and fail to provide clear reason for denial supported by applicable policy provisions.

I filed my first property claim, 5 years paying, under my homeowner’s policy: Section 1, Coverage C Personal Property, “we insure accidental direct physical loss or damage.” Loss or damage means theft or distinct and demonstrable actual physical injury to or destruction of the property." My hand was struck and caught in a pool vent that altered my ring, loosen the diamond and it caused it to fall out. My claim was to reshape band and replace the 2 carat diamond.

Farmers denied the claim, without investigating, examining the ring or photos. In their first denial letter, (Alexandra Arreola), failed to list the "Accidental Coverage Provision," or reason for denial.

Instead, they simply copied from the policy, without explanation, inapplicable exclusions. After they stated that I reported “ring damaged when reaching into a vent,” they immediately proceeded to dishonestly claim that “lost was unknown" and "losing or misplacing items is not a covered loss.”

After questioning their failure to address the “accidental coverage" and misrepresentation of the facts, they finally sent a 2nd denial letter, that included the policy "accidental coverage provision." However, this was done without explanation or reason as to why said coverage did not apply or why they chose to misrepresenting the facts. They pursued this dishonesty by bringing forth different representatives, Michael Hogard, Shaun Jackson, Brititini Girk. & Adam Smith, who made up different versions of the claim facts and lost, dodged questions, told outright lies, and refused to acknowledge “accidental coverage” provision.

After resorting too e-mails, to stop the dishonesty, I finally stated that Farmers were not operating in “good faith,” and would like to verify Farmers' administrators addresses, so I could file a complaint. They responded, we have hired attorney, James Robles, and "all further communication must be directed to him." Interesting, this attorney, sent a letter, identified my claim as a “theft claim, not accidental, and never explained why Farmer had hired him. I had already submitted my complaint to three of Farmers’ administrative officers, Jeff Dailey, Keith Daly and Tim Felks, all failed to respond. The attorney finally responded, “although correspondence was prior to him being retained, Farmers requested that I respond.” Of course he stated that Farmers denies "allegations of bad faith, etc."

I submitted this complaint to the Insurance Commissioner and Better Business Bureau. I am still awaiting a response from the Insurance Commissioner. Farmers responded to the BBB with even more outrageous lies, claiming, that "diamond was lost," "constant wearing of the ring had worn it out and it failed to hold the diamond," too contradictorily stating, I have "not, in fact suffered a loss of the diamond as she is aware of its location." This is sad!

Needless to say, I canceled all three of my policies: home, auto and golf cart, all had endured price increases every year, only to find out that I would not receive a refund on my golf cart. Farmer’s (Agent Kevin Shelton), without asking or informing, had insured the golf cart under a “fully-earned” premium. The insurance co. had immediately earned full payment, regardless of when policy was canceled. No refund. Who does this?

STAY AWAY or RUN FROM FARMERS. We the public, need to let Farmers that we truly know a thing or two about dishonest insurance companies that go to any length, to rip off and con honest people, just to increase their profits. Then hide behind attorneys for egregious acts that they have committed. Shameful and the SWAP must be Drained.

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