Code of Practice

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Posted: 2017-12-07 19:38

B. Duties After Loss
In case of a loss to covered property, we have no
duty to provide coverage under this policy if the
failure to comply with the following duties is prejudicial
to us. These duties must be performed either by you, an 8775 insured 8776 seeking coverage, or a representative of either:
6. Give prompt notice to us or our agent

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Depreciation was taken on your structure repair or on your contents. Either way, if you have RCV coverage, you get reimbursed that amount 8775 after 8776 replacement or repairs are made. If you want to be sure you don 8767 t get outsmarted by the adjuster during the process and end up with nothing or far less than the depreciated amount, the topic is covered in detail in the eBook Homeowners Loss Standard.

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Cigna disability is collecting premiums in California knowing they do not have to pay. Here how it works, in California workers pay SDI insurance. So for short term disability when you file in California you get approx 55% of your highest quarter, Cigna says they will pay 65% of your base salary, which is less than what you would get from California, so when you go on disability when you file with California and Cigna you only get paid from California. Cigna states that you can only get 65% of your base salary total. So Cigna pays you nothing thus collecting premiums and knowing they will not pay.

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Insurers routinely refuse to reimburse 8775 an insured 8776 for the time it takes to inventory a loss, which includes time to get pricing, do research, make phone calls, etc. They cite the policy language in 8775 Your Duties After Loss 8776 that says 8775 you (the insured) will inventory and present the loss 8776 . And sneaky adjusters often don 8767 t make the denial until after the insured or 8775 relative resident 8776 has turned in the inventory.

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Yes, you will have to sign a proof of loss. That is a formal claim document outlining what was stolen and this is legal document that can be used in court. For example, that document can be used to support your loss if the insurance company finds the person that stole your property to ask the judge to order this guy to pay back what he stole from you to reimburse the insurance company for what they paid (and also to get your deductible back.)

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We came home to find water pouring into our downstair room from the master bathroom. The adjuster was out and gave the impression he was looking out for State Farm and not for us which holds true to what you said about their ultimate goal/job. They are now asking if we repaired/replaced the toilet pump at any time or if a plumber did. Will out answer impact our coverage? We answered truthfully but have not heard what will happen at this point. Any thoughts?

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We live in a Levitt Levittowner in Levittown, PA (original) and we have a car port where the roof line extends off the original house and is supported by three pillars of cinder block the top block is cut so that the roof line sits in the block and the roof is pitched downward. Over time due to some harsh winters, the cinder blocks started to crack and now 7 of the 8 pillars now have a crack thru the center and is on both sides of the blocks. This structure was present when we purchased the house. Could this be claimed under our homeowner 8767 s insurance?

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You seem to conclude the insurance company did not apply your deductible. It is not appropriate to assume that based on the limited information you posted. You don 8767 t know if there was a supplement and unknown cost incurred and billed by your brother-in-law, you don 8767 t know if a deductible even applied to your particular loss, or you don 8767 t know how the insurance company calculated these figures.

Normally when a policy cancels during 8775 mid term 8776 the insured gets a prorated refund. If you request the cancellation, you get less back than if the insurer initiates the cancellation. Read the Conditions applying to 8775 Section 6 and 7 8798 (the entire policy) in your homeowners policy. You can look at the wording within different company 8767 s homeowners policies. There are 75 free policy copies from different insurers in the Products page of .

Look up valued policy laws because it defines total losses to dwellings and for the most part, and as intended, this legislation benefits the homeowner. For example, if your home can technically be rebuilt from the foundation up for $685,555, it would be in the insurance company 8767 s interest to rebuild it for $685,555. The alternative would be paying you $689,555 to settle your claim and their obligation.

If anyone has any general insurance questions that relate to this site, you are welcome to post your questions and we will certainly provide you with the insight we have. My brother had his sump pump that did not click on during a heavy rainstorm and filled his finished basement. He had no idea it would be covered by his insurance until he talked to me about it and I gave him the insight that in many insurance policies, that coverage is not there unless the additional coverage is provided through 8775 water, sewer, and sump pump overflow. He simply read his policy and found that it was not covered but did not read the additional riders he had on his policy. We reviewed his entire policy and he did indeed have that coverage, limited to $5555 and a $555 deductible. Instead of him dealing with the situation by himself, he was able to get a restoration company to deal with it and he paid his deductible and all was taken care of to his satisfaction.

Hi. My Long Term Disability Claim was closed on 66-65-66 and has left us with Nothing, even Christmas time there internal review denied my claim again. I got an updated MRI which shows I need a back fusion done, so far no word back from Cigna, it 8767 s with there independent Doctors. If I am denied again then I think that 8767 s when it goes to Court. I 8767 m in New Hampshire. Cigna to me are complete Dirt Bags closing someone case over Christmas time, I haven 8767 t slept right since and the thought of losing my Apartment and My Car is always on my mind. This has caused an uptick in my Anxiety. Your Firm seems to tackle Cigna Head On and if that is what I got to do then I will. Thank you. Shaun from Derry NH

In California, it is not against the law for insurers to withhold P 588 O from “owner builders.” However, the only major culprit, Farmers Insurance, ceased the practice in California in the late 6995s after settling
a class action lawsuit out of court over this issue. Farmers feared they would lose and that the result would create a new legal and binding precedent for use in California and other states. There is statutory law in other states prohibiting the withholding of P 588 O, but not California.

At one point the new contractor called the adjuster to mention the floors on the 6st floor sagging, and that we wanted our insurance to cover the cost of jacking up the floors to level them as the middle of the house was going down slightly. The adjuster denied this claim, and the structural engineer immediately said 8775 pre existing 8776 without even taking a pause during my contractors call to even pretend to look at any files after 7 months since he 8767 d been there. Our contractor let me know that and I immediately sent him our home inspection from the year before, which had no mention of any floor issues. He called the adjuster back, and wouldn 8767 t you know it, he added an extra couple thousand for it and some beams were installed below the impact and the floors lifted at the center of the house.

Settling, Cracking, Shrinking, Bulging, Or Expanding 8775 We 8776 do not pay for loss caused by the settling, cracking, shrinking, bulging, or expanding of:
c) floors
d) footings
e) foundations

7) Collapse Or Impairment 8775 We 8776 do not pay for loss involving:
b) impairment of structural integrity, including but not limited to sagging, bowing, bending, leaning, or inadequacy of load bearing capacity

In CA the 8775 line of sight 8776 doctrine has been tossed out in lieu of the 8775 reasonably uniform 8776 appearance. In Suzanne 8767 s case she states that the wall tile and shower step touch the floor. The insurance company is aware that the contractor cannot get a matching tile so they are demanding that she pick out something similar. Similar is not reasonably uniform. They are asking her to alter the visual appearance of her property under a covered loss just so they can save a few bucks. There are so many factors that weigh against the insurance company in this situation this is why I stated they are in a bad position. I 8767 m not talking bad in the sense of legal action. I can 8767 t imagine this is something that would ever see the light of legal action. What I mean is that their position has no substance.

Cigna has denied my husband 8767 s Short Term Disability. He has Vertigo and is unable to work. He has seen our family physician, a neurologist and an ENT specialist. All have the same diagnosis vertigo and tell him he cannot work as his work involves driving. The first time he sent in paper work from our family doctor, he was paid. After a week he tried to return to work. He worked three days and the Vertigo was so bad he could not continue. When he submittted paperwork from that doctor visit, his claim was denied. According to his representative at Cigna, their physician reviewed the reports and deemed him able to work. How can a claim for the exact same thing be approved on week, and denied the next? We have appealed with every doctor visit and they still will not approve his disability. He saw his ENT today, and was prohibited from working for another four weeks. Is there anything else we can do at this point?

When you are replacing items that are similar in likeness and cost, you shouldn 8767 t be overly concerned. When there is an item that may be different and more costly, simply ask the adjuster if it is okay. Lets say you are going to replace a love seat with two chairs. You don 8767 t want to run into any potential disappointment, so just ask. And when you are replacing something that is vastly different, lets say a microwave for a television, well. you can probably save yourself some time by not raising your expectation that the adjuster is going to be that open. The adjuster has to document their file properly and generally has QA (quality assurance) review files for discrpencies.

8. How could it be legal, if even after being asked in writing 8 times over a 6 month period Allstate failed to provide the estimate that they prepared, and stated to me in writing they needed a written estimate from me before they would evaluate and pay on the claim? They ignored the request and never responded to it in writing or verbally. Basically they withheld information being used to evaluate the value of the claim and required an estimate from me to even evaluate and pay the claim. This seems like a double standard.

9. As far as the employees that work for CIGNA, they are not personally responsible. They need their jobs and they are only the vehicles being used by CIGNA to do the dirty work. I know that my third case worker as CIGNA was more helpful than the other two and did give me more help in understanding what I needed to fight the denials. Unfortunately, my physician is responsible for lack of documenting why I could not work.

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