how long to assess a claim??? help please

[c_allen]

i had and accident about 6 weeks ago with a tin of paint, my suite, carpet and tv, i rang my insurance [ A I G ] straight away, they sent a company round to inspect the damage 2 days later, now this visit was to see if the damage could be repaired which it couldn't, they took about 100 photos of the damage, wrote down how the accident happened, measured rooms, took serial numbers ect, he was here for about 2 hours, as he left he told me i should here from the insurance co in a few days, and if i don't, to ring them in about 5 days, great i thought.
6 weeks later and after dozens of phone calls i have JUST been told that they'll be sending an loss adjuster round to look at the damage, when i asked why it's taken so long to reach this stage, when they've had the report from the company THEY sent round, plus the huge amount of photos he took, plus dozens of photos that they requested from me, which i e-mailed to them, had a telephone interview which took 20 mins, and was told 3 weeks ago that they'll reach a decision when they've had a chance look at the photos and reread the report, they said that the floods have delayed things, i said that i understand, but this accident happened 1 week before the floods and i have paid for this insurance, just like the flood victims, so why am i left without any sort of service.

any thoughts on where i stand and what i can do about this????????
i will be complaining to the co involved but is there a regulatary body i can complain to?????

[craigwalton]

Hello,

From my experience of claims I am afraid to tell you that they dont believe your story. It looks like the photographs they have taken shows some inconsistencies with the accident as described by you.

The 20 min call you had - were you being interviewed, or was it a call initiated by you? Did they advise you that the call was being recorded an assessed for fraud prevention? If so they have connected you to a stress detector, which would show if you are deceiving them. This might also be a reason for the delay in the claim

I'm afraid you will have no chance of your claim being settled before the adjuster comes around. Sorry.

However, you can start the ball rolling with the complaint. As you are complaining about the length of time it is taking for the claim, you can go directly to the insurance ombudsman - our complaints procedure and how to complain

[c_allen]

THANX CRAIG, I'D ALREADY GUESSED THAT WAS THE REASON FOR THE DELAY, I'VE NO OBJECTION TO THEM SENDING ANYONE ROUND, AND I'VE TOLD THEM AS MUCH, I ALSO ASKED THAT THE ADJUSTER BE SENT OUT WEEKS AGO, BUT THEY SAID THAT THEY COULD SORT IT WITHOUT THE NEED FOR AN ADJUSTER TO COME OUT, NOW WEEKS LATER THEY'VE CHANGED THEIR MIND.
OH WELL IT'S JUST A WAITING GAME NOW I SUPPOSE, ALTHOUGH I'VE MANAGED TO FORCE THEM TO BRING THE APPOINTMENT FORWARD FOR THE ADJUSTER, AND IF THEY TURN DOWN MY CLAIM THEN THEY'LL HAVE ONE HELL OF A FIGHT ON THEIR HANDS

[c_allen]

hi there, heres a not so quick update;
had the adjuster round for about 2 hours and he took even more photos, sinse then i've kept on at them to come to a decision but no luck even after 4 more weeks, they finally sent all the info they'd gathered to a forensic place, they took over 4 weeks, the report came back about 3 or 4 weeks ago, since then i've been ringing to try to find out WTF is happening with this claim, but they just say that they've nothing on their screen or that i'm ringing the wrong number/dept/office and could i ring this number/dept/office , when i do that they say the same and give more numbers/depts/offices to ring. finally last friday i got through to the right office/dept/number but they have nothing on their screen, but they will get someone (who will be able to help) to ring me back within the hour, 1 hour later no phone call so i rang them again, same thing so i wait another hour, no call, i ring them back, it's now 4.45pm and they tell me that someone will definatley call me within 1 hour, so i asked what time the office shut and they say in 15 mins, i then asked how i'd be getting a call then if there will be no one there??? so they said i'd get the call monday. no call again, so i ring them and they say i've got the wrong number/dept/office . i did some searching on the net and got hold of a number for head office, they didn't really want anything to do with it, but after MUCH complaining and threatening they put me through to a manager, unfortunatley he'd gone home so i left a message on his machine saying whats been happening. 20 mins later had a call from his assistant, he told me i'd got the wrong number/dept/office , i told him i didn't care and if he didn't help me now i'd just keep ringing him every chance i get until he did something , so he took all the details and the epic story so far( which he did agree was disgusting) and said that someone would be ringing me tomorrow for certain,( we'll see).
anyway i still don't know whats going on, but i'm not going to let them off with not paying. i've been told by a independent loss adjuster that if they'd found anything that looked like i've been trying to commit fraud they'd have had the police involved by now, and are just giving me the run around so they can avoid paying me for as long as possible, so this is what i'm thinking of saying when/if they call tomorrow; pay up or prosecute. any thoughts???????

[c_allen]

just to add that this has now been going on for 5 months, it is a genuine accident so i'm not worried about anything they my think or threaten me with, ie fraud, but i would like to here peoples opinions about whether or not to say pay up or prosecute.
BUMP

[craigwalton]

Highly doubtful they will prosecute. I only know of a handful of claims that have gone to court, one involving a coughing bloke and one involving a policeman - both to set examples.

More likely they will decline the claim and void the policy from the date of the claim.

Your best bet is to ask them, in writing, the reasons for the delay in the claim, taking into account they have had an ample amount of time to investigate any "discrepencies".

[majorclanger100]

Hi sorry to hear about this - terrible delay and disgusting behaviour. If it's any consolation part of the delay may just be due to the fact that AIG are bloody awful in terms of service. I work in the industry and even brokers with multi-million pound accounts get rubbish service.

My advice would be to complain to the AIG Customer Complaints division (contact details should be in your policy booklet). If these guys don't get it sorted then you can then head off to the Financial Ombudsman Service. Also threaten them with the FSA.

Best of luck

[c_allen]

well i did recieve a call on tuesday, but it was only to tell me that the manager was in a meeting so wouldn't be able to call me .
i did manage to arrange another call for wednesday, but it never happened , so i will be ringing them again tonight when i finish work. and to rub salt into the wounds my brother insured his empty house 8 weeks ago, 3 weeks later he had a water leak caused by DIY plumbing and claimed, last week he accepted an offer for £9000. i've been insured for 10 years, 3 of those with AIG, and never claimed a single penny, and i get all this crap the first time i claimed.
i will let you know what happens tonight after the call

[Trojan1401]

I agree with majorclanger, AIG claims service leaves a lot to be desired. Most of it is outsourced to TPAs.

[c_allen]

well after much messing i finally got through to the manager that was going to call me, and guess what, the report from forensics was sent to the wrong department . now theres a shock (not). so he's going to ring me tomorrow once he gets hold of the guy that it was sent wrongly to 3 weeks ago, he couldn't get hold of him because he was in a meeting. so nothing new there then.
if he rings tomorrow i'll update then

[c_allen]

well he did ring but the report he received was not the full one so he'll have wait until he's got that, he did admit it didn't look good for us though, so in preperation i've started getting ready for battle, starting with a Subject Access Request;
Data Protection Act 1998
Subject Access Request


Dear Sir/Madam

Policy No:***********. Claim No:**********

Please supply me with a complete history of all dealings either myself or my partner, Mr ************ have had with your organisation, with particular attention to the period of the above claim, which was started around 12 June 2007 and is still ongoing as of todays date.

Would you please ensure that you include ALL reports received by yourselves, whether internal or from outside companys, including the following companys; rainbow, landmark, and also the " forensic lab" you used, also any other companys used.
Also i require any screen notes, internal memos, also copies of any telephone calls made or received in relation to this policy, if that is not possible then I require a complete list of times, dates, and duration of calls made and recieved in relation to this policy with a statement explaining why it has not been possible to provide more detail.

I require information on equipment that your company may have used to analyse stress or any other factors in a voice, and if any such, or similar equipment has been used when I have been in contact with your company. If such equipment has been used I insist on receiving a full copy of the conversations, along with any results/conclusions of the conversations, the official details of the reliablilty of any results/conclusions come to using this equipment/method, in the same format you viewed them, and most importantly how much these results/conclusions may have influenced this claim
I enclose the statutory maximum fee of £10. You have 40 days in which to comply.
If there is specific information which you require in order to satisfy yourself as to my identity, please let me know by return. However, please note that the above address is the one which you normally use to communicate my private business to me and which you have hitherto found to be acceptable.

any thoughts?????

[GoldyR]

That sounds good to me, they can't argue with that!! My only concern though is the forensic evidence, they must feel they have enough forensic evidence to prove that the incident did not happen in the way in which you say it did.

This type of investigation costs insurers alot of money, as they are able to tell which way the paint fell, how long it has been there, how it was applied (i.e. dropped, thrown, painted on). They will not back down on this if they feel they have sufficient evidence, but i'm sure you won't either! They may will void your policy from inception as well, which basically means treating the policy as if it never existed - this will make it very difficult for you to get insurance in the future as you have a duty to disclose to any new potential insurer whether you have had insurance cancelled in the past.

I would be very interested to find out how this turns out for you.

[craigwalton]

If the claim is being investigated for possible aspects of fraud, they do not have to provide the information unfortunately - It is an exemption from the Data Protection Act act 1998.

Try though! If they refuse, at least you know why they are refusing!

[c_allen]

thanx to you both for your input,
GoldyR, i know where your coming from, but the accident really did happen in the way i told them it did, but it also involved a 9 stone bull mastiff, who jumped out of her skin as the paint hit her and went on to drag the dust sheets off everything, spreading the paint all over the place and knocking everything flying, then ran upstairs spreading it further, (i find that quite funny now) and then you've got my attempts to wipe it off everything, spreading it even more, so i don't know how anyone can even guess how paint got where, never mind prove anything, and as for any voice stress analyser evidence, thats well out the window as i'm being treated for anxiety and depression and have been for ages now, which also covers my stupidity in trying to wipe the paint off, but it's a very good point you've raised.
Craig, i'll give it a go if i need to, but i think i'll try the " pay up or prosecute" route first, but either way they'll have to come up with the info, because if the "pay up or prosecute" doesn't work then i'll be taking them to county court, there is no way i'm backing down on this even if it takes years, this is a genuine accident and unless their willing to (attempt to )prove otherwise, i'll force them to.

[c_allen]

quick update, i'd received no call by 2.30 so i rang him, the report had " only just landed" on his desk, and he'd not had time to have a read, so he'd ring me back by 5pm, 4.50 and no call, so i rang him, only to be told that he'd gone home, so i asked to speak to his manager,i only got through to his answer machine, so i very calmly (ok i lost it) told a machine what a bunch of liars they all were and i'm starting proceedings in small claims court against them first thing monday, for breach of contract. after i'd got my wits back i really didn't expect a response, but i just ( 6.50pm on a friday evening, WOW) had a call from them, all very sorry for the delay in getting back to me sooner. and you'll never guess what?.................... .



they want to arrange another visit as there seems to be conflicting evidence, i asked if that would be the bull mastiff, which he did admit it was.

so i'm now feeling like they are asking some serious questions about how this major factor has been ignored by the previous investigation, i get the feeling that they are trying to justify the amount of time this claim has taken. i'm feeling confident that they will pay up eventualy, and let face it they **cking well should the incompetent a***oles, so it seems i'll have to wait even longer, oh well, there goes the christmas party i was supposed to be having

[c_allen]

why is it that just when you think things can't get any worse life decides to prove you wrong.
i'm in the middle of doing up my bath room, last night my o/h was finishing the tiling, when a stop end came of the water pipe ( the sink is being changed so was not plumbed in), water was bouncing of the ceiling, my o/h ran down stairs and turned of the water, 2 minutes later the electric tripped out, water was coming out of the kitchen light fitting, so we had no water or electric last night, which means we also had no heating either, it was -4 last night round here. my o/h has managed to sort it now, but it looks like the ceiling in the kitchen is bulging now.
the reason i'm posting this here is because if this claim is denied them it's very likely that i'm not insured #~*&:@.
oh well moan over