Complaints

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• Initial Complaint

  Date:09/13/2022

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  After discovering serious roof damage at my home, I attempted to contact my insurance agent. My husband called the agent directly, and was told that a small patch would likely be covered, but to call him back in a few days after recieving a quote. We recieved a quote and called the agent, but the agent did not pick up, so we left a voicemail. Each of us attempted to call the agent several times in the next few weeks, and left several voicemails, but never recieved an answer. We started trying the front desk instead of the agent, and again were forced to leave voice mails. Neither of us recieved any return calls. When I finally did get an administrative assistant, the assistant told me that she did not know how to help me, then gave me a phone call for another assitant. The second assistant told me they could not help me as she did not know if it would be covered, but to call the insurance main company. She gave me their number, but they did not pick up. I left a voicemail. They never called me back. The main company continued to not respond, so I went to the agency building in person. Here I was told that I must contact the main company, and that the agency cannot file claims. On calling the main company, I was told they cannot file claims as it is the job of the agent to file them.

  Business Response

  Date: 09/15/2022

  First off, I would like to apologize for any confusion
  regarding the claim and how it needs to be handled.Below is a summary of the contacts from the client and/or our
  office in reference to the claim in question:8/14/2022 – email received over the weekend from the insured to our office.  This was the initial contact from the insured advising they have a potential roof leak looking for direction on how to handle with their carrier.8/16/2022 – Our office reached out to the client in response to the email received on 8/14.  No response on call and we left a voicemail for the client asking them to call us back to discuss options.8/18/2022 – Inbound call to our office from the client responding to the voicemail left on 8/14/2022.  Client advised of a roof leak issue.  We advised the client to first get an estimate of the damages/repairs so we can compare the cost of repair to the deductible to be sure it is in the clients’ best interest to file the claim.  Client advised he would be obtaining an estimate on 8/19 and would call that day with the estimate figures.8/22/2022 – inbound call from client leaving a voicemail to one of our employees that the estimate was completed.  He was advised by the contractor that the roof would likely need a full replacement.  He also advised that the portion of the roof in question had patch work done by the prior owner and the work done by that contractor was not good quality which is causing the issues the insured is seeing presently.  From 8/22 to present the representative that was working with the insured was working on an interoffice project for the Agency and had limited access to voicemail and email during that time.  The next contact with the client’s roommate occurred on 08/30/2022.8/26/2022 – Inbound from client to Agent – client did not leave voicemail, so we were unaware of the inbound call with no message left.8/30/2022 – roommate placed call to Agent and left message on machine regarding claim.  The individual that left the message is not listed on the policy or our files.  For privacy purposes we may only discuss the claim or policy specific details with the insured.  No return call made due to this individual not having access to the policy information.9/2/2022 – Inbound to main office line no message left by client.9/2/2022 – Outbound call from our Service Manager to the client to follow up on the claim.  We were advised of faulty craftsmanship being the reason for roof replacement being needed.  Advised of estimate received by the contractor for the roof replacement.  We asked if there was a claim or if it was a maintenance issue that caused the leak.  Client advised there was a windstorm 6 months ago that made the poor patchwork start to deteriorate.  Probing questions asked by Manager, client didn’t know the age of the roof or how/extent of damage to the roof.  Advised our Claims Specialist would call her today to get more details.9/2/2022 – Claims Specialist called out from our office and spoke to roommate.  Did not provide policy specific details due to this person not being listed as authorized on the account but attempted to provide general information to direct them on next steps.  Advised the roommate we cannot guarantee coverage based on the situation and that would be up to the ******* to determine if coverage would be afforded.  We provided contact information for the carrier’s claims department.  Did not hear back from the client until 9/8.9/8/22 – Inbound call to the main office line, chose the option for claims in our prompts which would allow him to speak to anyone in the office that handles claims questions.  All agents were currently on another call and the client got our office’s voicemail advising of this.  Client did not leave a message therefore we did not have a way to know that more follow up was needed.9/8/2022 – Client called the direct line of the Agent he had been working with since 8/14/22.  This was during the time that Agent was limited on access while the office project was being worked on.9/13/2022 – Roommate stopped into our Rochester office to discuss the claim with our Customer Service Manager.  At this time, the information for their carriers claims department was provided to initiate a claim if the client wanted to do so.  9/14/2022 – Agent that had been working with client made an outbound call to follow up on the claim and apologized for the phone tag.  No response to this point from the client.9/14/2022 – the visit was brought to the attention of our claims specialist.  Our Agent provided the following follow up for our client regarding the roof issue:9/14/2022 – Left voicemail for client at the number provided.  Asking the client to call us back so we can take the first notice of loss to get the claim in the system of the carrier.9/14/2022 – Our office took the first notice of loss via an accord application and submitted it directly to the ******* on behalf of the insured.9/14/2022 – Claims Specialist in our office, proactively called the ******* and spoke to the director of claims.  We asked them to put a rush on reviewing this claim to facilitate payment if coverage is afforded so the client can remediate the problem.  Director of claims agreed to put a rush on this claims review.  9/14/2022 – ******* reached out to the client directly.  No answer and left voicemail.9/14/2022 – Claims Specialist also reached out to client to advise of the steps taken that day to get the claim filed and handled efficiently.  No answer.  Left a voicemail for the client letting them know the claim is in with the ******* and we provided the claim number for the client.  Advised client to let us know if anything else is needed during the claims process.That
  is an up-to-date analysis based on all of our call logs and records with this
  particular client.