• Report: #1057492

Complaint Review: American Family Insurance

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  • Submitted: Sat, June 08, 2013
  • Updated: Sat, June 08, 2013

  • Reported By: Rhonda H. — Phoenix Arizona
American Family Insurance
6000 American Parkway, Madison, WI 53783 Madison, Wisconsin USA

American Family Insurance UN-AMERICAN FAMILY INSURANCE Madison Wisconsin

*Consumer Comment: State Statue Trumps AMSCAM Policy

*General Comment: Sorry but...

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American Family Insurance ... just cancelled my daughter because she TRIED to file a claim on her roof and air conditioning unit from a horrendous hail storm in AZ that occurred back in 10/2010 - they denied her even after she took them to the Insurance Commission!  The statue of limitations has passed in 12/ 2012 for MOST insurance companies, but American Family refused to honor the claim saying she had gone past "their" limit of a year ... the house was in foreclosure and a home modification was being fought for at the time of the storm, replace the roof when you think you're losing the house ... HELLO?!  ... the modification was obtained, but American Family Insurance kicked my daughter to the curb!  State Farm honored my claim and I obtained a new roof and AC unit in 5/2012, damn near 2 years after the storm! ... I told her to get rid of American Family when the house was purchased ... just take a look at all the blogs from the public regarding their claim denial history ... bunch of LOSERS ... they censor their facebook page and block all  comments that that they do not want the general public to read! ... LOSERS ... they don't have your back ... they're a monkey on it! If you have Un-American Family Insurance get rid of them before you NEED them! 


This report was posted on Ripoff Report on 06/08/2013 09:51 AM and is a permanent record located here: http://www.ripoffreport.com/r/American-Family-Insurance/Madison-Wisconsin-53783/American-Family-Insurance-UN-AMERICAN-FAMILY-INSURANCE-Madison-Wisconsin-1057492. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.

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#1 Consumer Comment

State Statue Trumps AMSCAM Policy

AUTHOR: ClaimAdvocate - ()

AMSCAM has far exceeded the long history of bad claim behaviors of Allstate and State Farm, They make the others look like Saints. Amscam has ill trained and badly trained adjusters and supervisors, this is a direct reflection of upper management, the VP and Training Manager in charge. They have almost overnight become the worst claim operation in the nation with the worst claim idiots around that should be put in jail for defrauding the public in our experience with them. So far they have bought their way out of scuffles with the State Ins Commissioners who have consistantly looked the other way. What are they getting back in return? They may know auto insurance but they practice bad claim protocols in homeowners or business claims. They are the # 1 insurer today in the Hall of Shame. I have not met anyone in multiple States that can talk about their life with AMSCAM with a straight face and look you in the eyes.

In AZ there is a 2 year statue on property claims which trumps any contract that limits your claim to one year to file suit or an action. If your claim was wrongly denied due to the policy one year statue to file suit, it constitutes willful fraud on their part. Its part of the policyholder duty to file suit in 2 yrs if the claim cannot be resolved per the conditions section of all policy or you lose that right forever. If coverage is triggered, then she must proceed to Appraisal before filing suit, its mandatory. During the Appraisal process (2-3 months) the time limitation is extended until after an award is made out of the Appraisal. However you need not file suit to trigger a valid claim. There is no fraud for filing a claim, in fact its your requiremetn whenever there is damages covered otr not covered to file notice with your agent. They use that against your premium at renewal time even if no claim was paid out. Its not your duty to determine if you have a valid claim on an all risk poloicy, that rests soley with the insurer per contract. The State prohibits the cancellation of a poloicy due soley because a claim was filed. If she filed 3 claim in 12 months that may give them a right to "non-renewal" only at the policy expiration date. If she was wrongly "cancelled" after filing a claim (before the expiration date) then the DOI should be notified of this wrongful act. They hav ebeen known to use this tactic before.

She was defrauded by AMSCAM as we have seen occur routinely if the 2 year time period had not lapsed yet. It appears her claim was filed within the time limits.  She would not have needed to file suit, she simply should have hired a Public Adjuster to handle this for her and not listen to want-a-be adjusters, agents, or contractors posing as illegal unlicensed adjusters. In every instance we prevailed when the contracts are in violation with the State Statue. The policy has a liberalization clause that states in part it will conform to any changes required to be in compliance with State Laws.  However, here, AMSCAM has used the contract 1 yr limits knowingly and willfully to falsely deny a claim and  to defruad your daughhter into believing the time has tolled.  Obvioulsy the last responder was duped as well, the same as your daughter. Only AMSCAM has WRONGLY used this approach as a denial of the claim. Always get a second opinion from a Claim Advocate.  

Even if the time limitation has now tolled to file suit, a valid claim may be filed to reopen it  if shown to be wrongly denied and her claim was a valid loss by a covered peril. She simply cannot file suit per se and she never intended to file suit, so the clause becomes a mute point. The AZ Fruad Statue reads in part that anyone who mis represents or uses a deceptive practice to defruad anyone is guilty of a crime. You may still be able to file a valid claim under the theory of breach of contract. I assume the Dept of Insurance was duped too, they do not get involved in judicial issues, but if properly presented to them thru underwriting, loss control and rating perspectives they would have looked further into explaining the facts. However, many DOI adjusters are ill trained in 1st party property losses as they come from the insurers rank and file and you have to educate them sometimes too. As an advocate in many States, I often am forced to prepare and present all the issues, coverage, and claim handling flaws to them that resulted in an adverse outcome before they understand the facts and sanction the carrier.

As long as your daughter had an insurable interest "at the time of loss" and her claim was filed within  the 2 years, she still has a valid claim to pursue even if she lost her home now. However she is probably only helping the lender collect the money and none of it benefits her now. AMSCAM has a duty under the Reasonable Expectation Rule to investigate her claim and the duty to determine the cause of loss.Once coverage is triggered, then the duty to determine and file proof of damages rests back with the policyholder. At the first sign of a denial or trouble, hire a Claim Advocate or Public Adjuster. They only get paid if they make a recovery. No win = no cost to you. They take all the risk for you and may spend thousands of hours to win such a case. They may charge as much as 20% but getting 80% back on a cash out basis to fix it yourself or sub it out for less is better than zero. You will still come out ahead. When you have a low ball or denied claim, always call a local experience Public Adjuster who has worked inside the carriers for decades, its worth the money, but watch out for contractors ad storm chasers posing as Public Adjusters during a storm

The Claim Advocate

 

 

 

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#2 General Comment

Sorry but...

AUTHOR: Tyg - ()

 They appear to be quite clear in thier time limit. If you daughter tried to file a late claim ,they could have taken that as insurance fraud. As such they would have cancelled any policy she has. Just because you were going through a foreclosure and a loan modification at the time of the original incident, is no excuse to not have filed for the roof. YOU may not think that it was appropriate to do at that time, but given there is always a time limit it would have behooved you to file for it anyways. As you were fighting for your house at the time it seems that you would have wanted to get the roof fixed as it would have increased the value of your home. What this sounds like more then anything is your mad at them for not giving you a break or your daughter a break. This really isnt a ripoff, its you just being mad. Stop taking the anger out that you have for yourself and your poor decision on a company that has lived up to its obligations. Its your fault not thiers. Get over it and live with the mistakes that have been made and learn from them.

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