#2 Consumer Suggestion
AUTHOR: Chris S. - Phoenix (U.S.A.)
SUBMITTED: Tuesday, April 14, 2009
POSTED: Tuesday, April 14, 2009
I have been a First American policy holder since 2002. I have not had any issues with them until recently. A contractor on a call to my house made a comment that FA has changed the way they handle claims.
I am finding this to be true that FA is attempting to skirt its obligations under the policies by relying on vaguely worded exclusions such as “improper installation” or “code violations.” I have made over a dozen claims, and had three claims denied; however, by persistence, I prevailed on all three denials. Here are some tips on how to avoid problems with this Company:
Know the history of your home, when it was built, and when certain systems were installed and by whom. Know this information before the contractor comes to your home. Save every single invoice for work done on your home, by either an FA contractor or someone else. (especially maintenance records for AC and furnaces).
Never, ever, ever, let the contractor work unattended, particularly during the evaluation phase of the call. The contractor usually does an evaluation and then calls the company for clearance. Make sure you watch the contractor do the evaluation and insist on being present when the contractor calls the company. If the contractor is experiencing problems getting coverage, ask to speak to the rep on the spot. Never let the contractor leave your property without speaking to you first. If the contractor leaves your property without speaking to you first, it will be a devil of a time getting the Company to send another. If the contractor wants to leave the property pending FA approval, that means your claims probably is already denied and you should start taking notes, and calling the Company every day.
Ask lots of questions. If the contractor says something is not “up to code” or is “improperly installed,” ask for clarification. For example, if your house was built in 1957, and the Company refuses to fix something “not up to code,” clarify which code – the 1957 building code or the 2008 building code. There is a difference; don't let them use modern standards – which are stricter – to wiggle out of fixing a problem.
Do not hesitate to record your conversations with the contractor or videotape them working but don't be offensive about it; ask for a business card and get the technician's name before they leave the property.
If your claim is denied, you do have recourse. Ask for a second contractor opinion. If your request is denied, keep pushing.
If the line rep says an exclusiion applies, ask to have the exclusion read to you. (I hope you saved the policy they send you every year). If a line rep says your claim is denied or won't do what you want, ask to speak to a supervisor. Get the rep's and supervisor's name and extension; document the time and date of the call. Take notes or record the call. The line reps and their “supervisors” have little authority and will generally give you the run around. Don't give up.
FA uses three tiers. FA has a “claims evaluation” department, which answers to the VP of Operations and has a lot of authority to settle problem claims. The address, phone and fax numbers are not publicized, but try calling 18188924043. Get the department's contact info (I don't have it with me now or I'd share), and fax and mail a letter to them in Van Nuys, California.
Be civil in the letter. Describe the problem, describe what were you were told and by whom and when. State why you think the Company is wrong and you are right. Submit a statement from someone with knowledge, a contractor friend or even a handy man. (I succeeded in getting a new swimming pool filter installed by having my pool cleaning company write a letter for me). Take photos. Look up the building codes if necessary. Make your case clearly. Remember, exclusions in a policy are construed strictly against the Company. If there is any wiggle room in the exclusion, use it to your advantage.
At the end of your letter, state that you expect the claim to be resolved quickly and fairly and state that if it's not, you'll file a complaint against the Company with the state insurance commission, a complaint against the contractor with the contractor regulating authority, or you will have the work performed yourself and file a small claims suit to recoup the cost. (It'll cost the Company more to defend itself in front of the insurance commission or a small claims court than to pay your claim, more often than not). I have done this three times; each time the “claims evaluation” department has promptly given me what I want, and followed up to make sure I was satisfied.
I hope this information helps others who have problems with this company.