I've been away for a while....

[namekagon]

Snds like BS to me!
If your coverage wasn't valid why were they taking your premium money....if nothing else I'd fight to get that back....all of it...hopfully for the past 10+ yrs.
And what raw69 said....a home burglary really makes one feel violated....sorry for your losses Shane.

[OttoDita]

I thought it was a bunch of BS. I did what you guys suggested. But, I called my broker first and told him I wanted to speak to the owner of the brokerage. I also called the insurance company themselves and asked to speak with a supervisor. But, the SV can't call me back until sometime tomorrow, and the owner of the brokerage is on vacation.

What pisses me off, is while they take your money, they are all friendly. Like they're our buddies and whatnot. File a claim they don't like and it's like I'm walking around with the plague. I've only been paying for 2 years, but that's close to the time I was "Not insured".

The guy I spoke with at the brokerage told me that I won't get my money back as they'll be keeping it for processing fees etc. Processing of what? Paper, to send me something I wasn't covered for?

A farmer that is close to me, used to be my old landlord, he's a lawyer. I told him about it and he told me he'll look into it if I get nowhere with these phone calls. But he said the same thing everyone here has said. That it's BS. He said they owe me something.

I'll keep everyone updated. Thanks a lot everyone,
Shane

[JohnScott]

Shane -

I was in the claims end of the casualty insurance industry here in the U.S. for twenty nine years. I had some work in Canada since I worked with the company's Toronto and Quebec offices, but the work by those offices that I was reviewing did not involve property claims, such as yours, and it has been a LONG time since I did that kind of work.

Having said that, it would surprise me if the Provinces in Canada do not have regulations similar to what every state in the United States has in the way of regulation and compliance requirements.

My suggestion is that you or your attorney promptly and courteously request a complete and documented explanation of the insurance company's denial of your claim. Politely ask them to point out the specific language in the policy that they relying on to deny your claim.

It may be that they are not relying on the policy language, but on the Conditions of the policy and will suggest that you failed to do your part in disclosing to them the nature of the risk that you were expecting them to insure. If that is the basis of their denial, ask them for a certified copy of the application for the policy that you signed at the time you took out the policy, and an explanation how they are relying on that application to deny the claim.

Ask them if the application specifies under what conditions you must notify them of any change in the potential risk they assume by writing a policy for you. Ask them what constitutes a "business" under the insurance regulations, laws, and court decisions of the Province of Ontario. Ask them if they could please, as a service to one of their premium paying customers, send to you and / or your attorney copies of the legal decisions regarding policy applications, policy Conditions, and / or the policy language they are relying on to deny your claim.

Ask them to be sure that they are sending you the most current and on point legal decisions that are available, so no one will be embarrassed if they send you misleading, irrelevant or out of date explanations for their decision.

Ask them to send you copies of any Unfair Insurance Business Practices regulations that might apply to their conduct in this matter, and copies of any Unfair Claims Practices regulations that might apply. Politely point out to them that as a paying customer you will rely on their good faith to provide these things WHICH CERTAINLY MUST BE IN THEIR IMMEDIATE POSSESSION FOR THEIR REGULAR REVIEW OF THEIR RESPONSIBILITIES in these matters.

Ask them to provide the names, addresses, and phone numbers of any insurance regulatory agencies that might have an interest in how they handle such claims for you and for all their other policyholders.

Finally, remind them - and you can quote me as an insurance consultant and expert witness who was tacitly qualified and approved by the Washington State Courts to appear in insurance litigation in a case involving the good faith handling of a claim by an insurer ( I was on the policyholder's side in that case ) - that "Implicit in every contract of insurance is a mutual covenant of good faith and fair dealing."

You are asking nothing more than that they live up to their end of the covenant of good faith and fair dealing. You have to expect to be asked to cooperate fully with them as they consider your claim, and assure them that you expect to live up to your end of the convenant.

John

You will have my mailing address shortly. If you want me to look over anything the insurance company sends you, send it along and I will look at it as promptly as possible.

I thought about sending this information to you in another PM, but it's clear that there are other members of the BB who might get some milage out of my thoughts on the situation.

It's been fifteen years, but it's kind of like riding a bike or swimming !! Lots more questions to ask, but we got to start with basics.

[Uncle Jesse]

Most insurance is named peril policies, there are other types however, that state you and your possession with possible exclusion are protected against, fire , windstorm, flood, theft, etc., Your agent has been taking your money over the years to provide this protection. If he is an independent agent he should really be on your side, if he works for one company, like State Farm, Allstate, Nationwide, etc., he may not be as pro consumer. I don't have a clue about insurance commissioners in your wonderful socialist country, but there should be a board of arbitration some where to appeal this to. Down here in GA and most of the southern states the Insurance Commissioner is an elected official, but you should know if that is the case in Ontario.

Your agent should know about your home, possessions and business and should get you the correct coverages. He has no exposures collects a nice commission and only has to do what he is paid to do.

Remember "You can fleece a sheep many times, you can only skin him once."

[OttoDita]

John,

Thank you very much for the information and what to ask. I'm going to copy and past it into an email in the morning and send it to my broker. And explain to him that you're my consultant and and I'd like all the information you've stated.

He's aware that I have a lawyer, but doesn't care....Maybe he knows I can't afford to take it to court.

I don't see what the big deal is. I don't run a reptile business, I will be, but not now. I don't even have any reptiles. Not for a couple months. I guess they see it differently.

Thanks again,
Shane

[jcfly]

Shane, I'm with Clay and John on this issue. Don't roll-over and die, fight them and let them know you won't give up. Sorry to hear of your losses.

[OttoDita]

I showed my lawyer what John had said. He called the broker and spoke with whoever was in charge. I recieved a phone call today. Saying that we got off on the wrong start. Apparently, they're in the right, and don't have to replace anything. According to my lawyer. But, they have to refund me money I've been paying in to them. Unfortunately, it won't be enough to cover everything we've lost. But it's still something, and it'll cover some of the larger things that were lost. Such as the TV's.

Thanks to you guys, otherwise I never would have made the calls.

Thanks a lot everyone!
Shane

[Clay]

Shane, here's what I keep thinking and I could be all wet. I think that you insurance company owns you for anything that is missing that is part of your normal home or household things but doesn't owe you for things that were part of the business. Your attorney will know more about these things than I and there is always more to the story than how things seem at first. Glad that you have been making some calls and shaking the tree. Keep shaking things up and see what happens, best to you.

Rick