In this second part of my dispute with an insurance company, relative to damage of household furnishings as the result of a severe storm back in May, I’m going to describe terms of the policy, my interpretation and theirs.

The policy begins with policy declarations, stating: “WE Agree to provide insurance described in this policy,” –1- “based on your payment of premiums for coverage you chose”- 2- “based on your compliance with all applicable provisions of this policy and in reliance on your statements in those declarations plus you will pay premiums when due & comply with the provisions of the policy.” It further states: “this policy contains all of the agreements between you us and any of our agents” plus, “property damage, means physical damage to or destruction of tangible property, including loss of use of this Property.” Stating, “residence premises’ means the one, two, three or four family dwelling other structures and grounds.”

Under Section 1-Losses insured, it states: “Windstorm or Hail, This peril does not include loss to property contained in a building caused by rain, snow, sand or dust. THAT LIMITATION does not apply when the direct force of wind or hail damages the building causing an opening in a roof or wall and the rain snow sleet sand or dust enters through this opening.”

Because the policy states coverage of grounds, and because I took every precaution to cover all items with heavy plastic tarps weighted down by bricks, I maintained the same principle applied when the wind blew coverings off, leaving an opening for the wind and rain damage, as the limitation clause states when the wind and rain caused damage from the opening caused in the same manner as when roof is blown off the structure.

Let’s say a windstorm blew a hole in the roof, but did not rain, the following day it rained and because the opening was still there damage to property was caused by the rain. The structure itself becomes irrelevant, it is the opening caused by wind, which allowed rain damage, is the cause. Consequently, the same principle of cause of damage applied by the coverings being blown off with resulting damage.

Because three different employees of the insurance company had denied my claim, I estimated at $3,000, I wrote a letter to the Georgia State Insurance Agency, and asked them for their interpretation of the language of the policy. An agent of that office, instead of responding to my request to interpret, contacted the insurance company. And as a result, another agent of the company called and informed me they would not pay the claim, which meant four different persons had denied my claim.

The investigating state agent sent me a letter he received from the company, with a version of events that were simply not true. I in turn responded to the untrue statements to the investigating agent of State Insurance office.

Here it is now the end of September and the storm occurred in May. I think it was a couple of weeks ago I received a call from the insurance office, informing me they had decided to pay the claim. And sent me claim forms. I listed some of the items, but had no recollection of items I had discarded in the garbage. They requested a list of original cost of items and replacement cost. Because I have no specific knowledge of original cost, I did not return a guessing amount and told them I estimated total cost of $3,000. I could not list the items discarded in the garbage. When I had not received payment they promised, I contacted my attorney, who is reviewing the case.

In the meantime, a few days ago I received a settlement check from the insurance company for less than $100.00. In my opinion an insult to loss and just a token payment.

Continued in Part Three

Let Freedom Ring
Just me AC

E-mail: annecleveland@bellsouth.net

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