Monday 10th of October 2016 06:38:24 PM
Pacific Specialty has wrongfully denied my claim. I have never written an article or a blog before, but there is always a first time for everything. This is my first time dealing with Pacific Specialty over my water damage claim. We had a clog in the master bathroom standing shower upstairs on a Sunday. However the rest of the master bathrooms, downstairs bathrooms, kitchen and toilets were functioning properly within the house. The use of washing machine upstairs caused a sudden and accidental discharge of water due to the stoppage on the residence premises.I have been a customer for Pacific Specialty Insurance company for over 7 years, with a history of zero claims and have always paid them for an entire year of policy coverage. I am not happy with Pacific Specialty, as they have wrongfully denied and are constantly misconstruing the facts of my claim. The company did not follow proper protocols when handling my claim. A claims adjuster, a person professionally trained to assess the damage to your property, did not visit us. We did not receive a "proof of loss" form to fill out and were denied a copy of the filed claim by the company. Our insurance agent (third party) contacted PSI on our behalf after the accident and we have no clue what paperwork was filled. The claim was denied on the same day it was filed without the plumber's written report which contained important information relating to the overflow.They are denying my claim on the basis of the provision that "water backed up from a sewer or drain" and from multiple fixtures in the house. The water only overflowed from the standing master bathroom shower and no other fixture in the entire home. The rest of the plumbing system in the house including bathrooms, kitchen and outside the home premises were working perfectly. There was a no backup on and off my home premises. As an average consumer, what am I do if my insurance company denies my claim? You can file a consumer complaint form with the California Board of Insurance. It's a simple online process, where you create an account and upload all the necessary documents. If your case is valid a case representative will be assigned to your case and will follow up with your insurance company. California Board of Insurance main goal is to protect consumer rights and can hold companies accountable. My case is currently open and I am hoping that they hold PSI accountable.You can file a complaint with NBC Bay Area consumer complaint and Michael Finney Contact 7 on your side. I have received a response from NBC asking for further correspondence relating to my case. Social media links like Linkedin, Facebook, and other blogging websites can be used to voice your story. A letter of complaint can be filed with the senior management of your insurance company. Public adjusters can help you with your claim, however only show interest if the damage amount is high. I spoke to several public adjusters and insurance agents during my research phase who advised me that our claim was being denied on the wrong basis. An inexpensive legal way to resolve your claim would be filing a complaint against the company in the Small claims court, where lawsuits can be filed by individuals for $10,000 or less, and where no one is allowed to have a lawyer.I would not recommend Pacific Specialty to any Bay Area consumer after my experience with this Palo Alto based company. Company performance and comparison date from the California Board of Insurance shows that they received 117 complaints in 2015 and 144 in 2014. Their complaint ratio is about 3 times higher than the industry average. Throughout our claim process, PSI has shown bad faith and poor business practices.It's very important for the consumer to do research on insurance company records prior to trusting their homes and car coverage in their hands. Companies like Pacific Specialty do not care about their consumers and families. For them it's all about reducing the cost of doing business. As homeowners, we rely on our insurance companies to stand by us and provide coverage against sudden accidents. It's unacceptable for insurance companies to deny claims wrongly and stick the consumer with the bill.