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following the underwriting guidelines, a HO3 was written in our office. the policy included over 70 000 in schedule personal property. appraisals were submitted in lieu of receipts ( following guidelines) pictures were also submitted. a theft occur in the house in late october of 2009. adjusters are now requesting receipts and will deny claim if not submitted. Does our client have grounds to sue or to take to insurance department for review?

2 Thoughts on homeowners policy with scheduled personal property in california?
  1. Reply
    mbrcatz
    July 25, 2011 at 10:52 pm

    Yes.

    The property existance and value was established at the time the office issued the policy, via appraisals. The claims adjusters request receipts, to establish existance and value – which the underwriting department already ACCEPTED.

    If the documents were good enough for the underwriting department to accept, they have to be good enough for the claims department to accept. Slam dunk, bad faith claim, in my opinion.

  2. Reply
    MSAD
    July 25, 2011 at 11:34 pm

    I know you want whats best for your client…..but there is probably a whole lot more to this story that you don’t know.

    A $ 70K is a huge theft. If the client is claiming all this stuff was stolen….claims is going to take a very close look at that.

    If underwriting was OK with photos and estimates…..and claims is now asking for receipts….that’s a good sign that there is probably more to this loss than you think. If the loss is believed to be fraudlent…yes, they may ask for receipts.

    It’s possible that this claim is being investigated by the SIU department. And if it is, claims may not tell you that and they certainly won’t tell you any details of the investigation.

    I know you mean well……but you don’t need to advise your client to sue your insurance company. Your best bet is to refer the client to the adjuster handling the claim and the adjusters manager. You should not get involved in this loss nor should you tell your client to sue or give your client any type of legal advice.

    If you want….put in a call to the adjuster. When I’ve got an agent calling me about a suspicious claim… I don’t tell them anything other than “you don’t want to get involved in this one…just refer the client to me”. My agents know that is not my normal response and take my advice.

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