Forum Discussion
Wrong_Lane
Apr 23, 2015Explorer
Sorry and surprised to hear about the denial.
You have the right to a written explanation with full details of the reason for the denial with reference to the specific section of the policy wording that they are relying on. Ask for it.
In the interim, call their head office and ask to speak with the vice-president of claims. Have your policy and claim number available.
In a calm and professional manner explain the loss and your subsequent treatment. Explain that you no longer wish to deal with the original adjuster as he/she refused to accept your photographs and video evidence when it was offered. Explain that it was your impression that the original adjuster had their mind made up before they arrived and were not interested in the facts or giving you a fair hearing.
Explain that all you are asking for is a fair and impartial review by someone with the authority to change the original decision should the review support your point of view.
I wouldn't go down the road of explaining how much premium you have paid, it shouldn't matter as the loss should be covered regardless, but would mention that you have been a loyal customer for many years.
You, as a former member of the law enforcement community you know how easy it is for an investigator to fall into the old trap of deciding the results of the investigation first then gathering only evidence that supports their predetermined conclusion. I suspect that your adjuster did this and probably doesn't even recognize their own mistake.
Good luck. By the way, does your state license Public Adjusters? These are licensed adjusters that work on behalf of claimants and can often assist in this type of situation. The downside is that you have to compensate a public adjuster, however if they can get you paid for the loss it may be worth it.
You have the right to a written explanation with full details of the reason for the denial with reference to the specific section of the policy wording that they are relying on. Ask for it.
In the interim, call their head office and ask to speak with the vice-president of claims. Have your policy and claim number available.
In a calm and professional manner explain the loss and your subsequent treatment. Explain that you no longer wish to deal with the original adjuster as he/she refused to accept your photographs and video evidence when it was offered. Explain that it was your impression that the original adjuster had their mind made up before they arrived and were not interested in the facts or giving you a fair hearing.
Explain that all you are asking for is a fair and impartial review by someone with the authority to change the original decision should the review support your point of view.
I wouldn't go down the road of explaining how much premium you have paid, it shouldn't matter as the loss should be covered regardless, but would mention that you have been a loyal customer for many years.
You, as a former member of the law enforcement community you know how easy it is for an investigator to fall into the old trap of deciding the results of the investigation first then gathering only evidence that supports their predetermined conclusion. I suspect that your adjuster did this and probably doesn't even recognize their own mistake.
Good luck. By the way, does your state license Public Adjusters? These are licensed adjusters that work on behalf of claimants and can often assist in this type of situation. The downside is that you have to compensate a public adjuster, however if they can get you paid for the loss it may be worth it.
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