Complaint Category: Sales presentation did not disclose key conditions of the offer
Complaint: Agent failed to inform me that the policy did not cover theft.
On May 6, 2013 I reported a claim to the insurance company. Received a call back from them on the 8th of May telling me I was not covered for theft, but that I was covered for everything else. Shocked by this I asked how this could be and received no reasonable answer or explanation. I called back into the insurance company as a new customer making inquiries' regarding their policy procedures then came right out and asked them if their homeowner policies covered theft and what would cause for it not to? I was told that yes they would cover theft unless otherwise instructed by policy holder not to. I then confessed that I was a policy holder and explained my situation. After being put on hold and transferred to a supervisor I still could not get an answer or explanation as to why my policy would have ever been written not to cover theft. Instead I was told that over three years' time that they have new and better policies and would be more than happy to have it added now.
The declaration page I received when we got the policy does not state it does not cover theft. Since dealing with this situation other questions have me concerned as well. Starting with the date the policy went into effect. Declaration states policy went into effect on 4/21/2011, we did not even close on our house until 5/24/2011. Then there is the matter of things we had to comply with before we could be insured. Communications going back and forth up till the beginning of July.
Now I am being told that our policy covers everything but theft? And that it did not cover vandalism until a year later. We were never told or asked for vandalism to be added, I now see that our premium went up and other adjustment to the policy were made as well. Had I know I was paying for a policy that did not cover theft I would not of understood the need or reason to pay for it to cover vandalism. Another disturbing factor is when I requested for a copy of the policy to be sent to me at the address that is being insured I was told that I would have to send in a written request to have it sent to that address, but yet when Peter called and requested for the same thing to be done it got done without such request.
The next step I took was trying to contact the insurance agent that worked with us in getting the policy. I called TWG Insurance and asked for the agent by name and was connected to Mr. Clay, I briefly explained my situation to him and he informed me that he no longer worked for TWG and that he would need a minute to pull my policy and get up to date regarding it. I politely asked if I could count on hearing back from him that same day in which he answered "yes I would". I have yet to receive a call back from Mr. Clay and have left him at least 2 other messages asking for a return call regarding the matter.
I then proceeded to contact TWG and asked to be connected to a supervisor and have been communicating with Amber regarding the situation but getting nowhere except for a lot of he said she said. I am being told that due to the fact of being an owner of a Rottweiler dog is why we were given the policy that we were??? When the policy was being considered we were at one point told that the reasons why being insured by National Lloyed rather than a company better know was due to a liability issue regarding the dog. The agent recommended that we go with said company, "they offered the best coverage for the price". We were never told that they policy did not cover theft and for that matter what does theft coverage have to do in regards to owning a Rottweiler anyways? That's not a liability issue.
Business' Initial Response
According to our records, Peter Driscoll (first named insured), spouse of the complainant, called TWG Insurance on 4/5/2011 indicating that he was looking for an insurance policy for less than $100 per month. As the TWG agent, John-Clay Harter, was reviewing his insurance needs it was discovered that ************ had a Rottweiler. Many insurance carriers will not insure a home in which a Rottweiler resides due to increased liability concerns with a breed of dog that is deemed vicious. As such, ************ had a limited number of options. Ultimately, through mutual discussion, it was determined that the best option for ************ was an owner-occupied dwelling policy through National Lloyds. One disadvantage of this policy type is that it does not cover losses resulting from theft and TWG records clearly indicate that this drawback was discussed directly between the agent (Mr. Harter) and the insured (************). TWG records do not indicate that Ms. ****** was ever involved in the direct purchasing discussion, and as such, TWG would not have known about her concern regarding lack of theft coverage under this policy.
Consumer's Final Response
The language from the policy documents provided does not mention theft to be covered as a perils nor as an exclusion. TWG claims that their documentation from April 2011 states that the first named insured was aware that the policy he was purchasing did not cover losses from theft then why won't they provide this proof, they also state that conversations are recorded so they should have no problem providing that recorded conversation.
Business' Final Response
Copied below is the language from the policy documents provided to the named insureds directly from National Lloyds explaining the perils covered by the policy. At the time of purchase, the first named insured, Peter ******** also signed the policy disclosure explaining the responsibility of the insured to read the policy language to determine the coverage(s) provided and coverage(s) available. Our documentation from April 2011 states that the first named insured was aware that the policy he was purchasing did not cover losses from theft.
PERILS INSURED AGAINST
We insure for direct physical loss to the covered property caused by a peril listed below unless the loss is excluded in the General Exclusions.
1. Fire and Lightning
2. Sudden and Accidental Damage from Smoke
This peril does not include loss caused by smog or by smoke from industrial or agricultural operations.
3. Windstorm, Hurricane and Hail.
a. Unless specifically insured on the Miscellaneous Property Schedule endorsement, this peril does not include:
(1) loss to cloth awnings, greenhouses and their contents, buildings or structures located wholly or partially over water and their contents; or
(2) loss to radio and television towers, outside satellite dishes, masts and antennas, including lead-in wiring, wind chargers and windmills.
b. We do not cover loss caused by windstorm, hurricane, or hail to the inside of a building or
personal property contained in a building unless direct force of wind or hail makes an opening in a roof or wall and rain, snow, sand or dust enters through this opening and causes the damage.
5. Aircraft and Vehicles.
Loss must result from actual physical contact of a vehicle with covered property or with the building containing the covered property
6. Riot and Civil Commotion.
7. Vandalism and Malicious Mischief.
8. Sudden and Accidental Discharge, Leakage, Overflow or Release of Water or Steam
within any portion of a plumbing or automatic fire protective sprinkler system that is above the surface of the ground, or from within any portion of a heating or air conditioning system that is above the surface of the ground, or from within a household appliance. This peril does not cover loss to the system or appliance from which the water or steam was discharged, leaked, overflowed or was released. However, if the sudden and accidental discharge, leakage, overflow or release was caused by freezing of any portion of a plumbing or automatic fire protective sprinkler system that is above the surface of the ground, of any heating or air conditioning system that is above the surface of the ground, or of a household appliance, we will also cover the loss to any of these systems or appliances if:
a. the dwelling is occupied, not vacant and not being constructed; or
b. the dwelling is vacant, unoccupied or being constructed, but you have used reasonable care to:(1) maintain heat in the building; or (2) shut off the water supply and drain the system and
appliance or water.
A loss resulting from this peril includes the cost of tearing out and replacing that part of the dwelling structure, excluding the slab or the foundation, necessary to repair or replace the system or appliance from which the water or steam was discharged, leaked, overflowed or was released.
We do not cover sudden and accidental discharge, leakage, overflow or release of water or steam:
a. from within any portion of a plumbing or automatic fire protective sprinkler system that is either:
(1) below the surface of the ground; or
(2) within or below the slab or foundation; or
b. from within any portion of a heating or air conditioning system that is either:
(1) below the surface of the ground; or
(2) within or below the slab or foundation.
We do not cover loss caused by constant, repeated or intermittent discharge, seepage, leakage,
overflow or release of water or steam.
Our total LIMIT OF LIABILITY for loss(es) for this coverage during the policy period stated on the declarations page of this policy is $10,000 , and is the most we will pay for the sum of all losses caused by this peril regardless of the number of losses that occur during the policy period stated on the declarations page. Each payment for a loss for this peril during the policy period will reduce this limit of liability by the amount of each such payment for the remainder of the policy period.
This is not additional insurance and does not increase the COVERAGE A (DWELLING) or
COVERAGE B (PERSONAL PROPERTY) limit of liability.
9. Fall of trees or limbs, including felling, topping or trimming.
10. Objects falling from the weight of ice, snow or sleet.
11. Collapse of building or any part of the building.
We do not cover loss either consisting of, or caused directly or indirectly by:
a. earthquake, earth movement, landslide, subsidence or earth sinking, or the rising, shifting,
expansion, contraction, settling or movement of surface or subsurface soils.
b. insects, vermin, wet or dry rot, wear and tear, inherent vice, decay, deterioration, or any quality in property that causes it to damage or destroy itself.
12. Breakage of glass which is part of the building including glass in storm doors and storm windows.
Complaint Resolution: BBB determined that while the company addressed the complaint issues, the complainant was dissatisfied and the matter was outside BBB Rules of Arbitration.