Complaints

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• Initial Complaint

  Date:03/06/2025

  Type:Service or Repair 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.

  I own a business in a plaza. I was victim of a flood. The water came in through my floor, from the unit next door. They had a pipe burst in their ceiling. As a result, I lost my flooring. A claim against my insurance was made without my consent. A man ***** ****** ******** showed up and told me he was handling my case. He *** ********* ******** *** *** submitted a ****** ******** report, to which I have not been allowed to see. Despite multiple, constant attempts to resolve this issue, ****** will not acknowledge anything of value. * ** ********* ***** ** ***** ***** ***

  Business Response

  Date: 19/06/2025

  File Summary:
  As stated, this is an insurance claim matter.  The insured, ***** ****** ********** ** *** ***** a salon in London reported
  damage resulting from water ingress that originated from a neighboring unit due
  to a pipe burst. ****** was assigned to assess the claim ***** **** ****************. Upon inspection, he noted the damage to insured contents and
  tenant improvements, primarily flooring, and began coordination with the
  third-party adjuster representing the building insurer (**********).
  
  Scope and Valuation:
  The valuation range of $80,000–$90,000 referenced in communication with ***** ****** was not an estimate of the damages but rather a preliminary
  approximation of the value of tenant improvements (Contents of Every
  Description - COED), calculated based on typical construction rates ($75–$80
  per sq. ft.) for a salon of approximately 1,200 sq. ft. This was shared to help
  assess potential co-insurance implications and not to represent a claim for
  indemnity at this stage as no statement of value was submitted by insured or
  their broker.
  Importantly, the COED value is subject to a 90%
  co-insurance clause. Based on the current policy limit of $10,000 for COED,
  it is evident that a significant co-insurance penalty would apply in the
  event of a full or partial loss. As such, while we anticipate a penalty will be
  imposed, it is critical that we receive a Statement of Values from the
  insured or their broker in order to proceed with accurate co-insurance
  calculations and determine the net settlement amount. ****** has made this request
  and is awaiting a response.
  
  Regarding the complaint:
  Insured has been seeking our adjusting report, which can not be provided.  It is a confidential document sent to his insurer. In order to adjudicate this claim, we need to
  have the statement of values from them or their broker as to how they arrived
  at $10,000 C.O.E.D values. This co-insurance clause will severely affect/ limit
  the outcoming and the amount of claim.
  That said, we have given opportunity to insured to submit
  the statement of value without which we cannot assess or move forward. We are
  simply following the instructions of the claims examiner and following a
  standard procedure.  Anything we do as an independent adjusting firm is under the instructions of the insurer.
  
  
  Please let me know if any other information is needed.

  Customer Answer

  Date: 19/06/2025

  
  
  Complaint: ********
  
  
  
  I am rejecting this response because:

  No statement of values was ever asked for. To this date, june 19th, more than a month after the May 10th incident, no communication has been attempted on behalf of ****** in terms of what is required to move forward. * ***** ******* ********** ***** ********** ** ****** *** ******** *** ** *** ***** 

  To address the statement of values, as per our insured agreement, we have our value set at $10k. As we have grown that could now be upped to closer to $20k but nowhere near $80-90k ****** has been stating.

  ****** *** **** ** ******** **** *** ********* ** *** ******* ************ *** has repeatedly failed to communicate anything, let alone in a timely manner.

  He has failed to communicate with myself about any of this process and has proceeded when I repeatedly, in writing, asked for him to stop.

  I want him removed from this case.
  
  
  
  Sincerely,
  
  
  
  ***** ******

  Business Response

  Date: 14/07/2025

  Hello, As stated earlier, we are an independent adjusting firm that "take instructions from this complainant's insurer".  We have since closed our file per their instructions.  They will be submitting the denial directly.  I have reviewed this file in it's entirety and ****** not only didn't do anything wrong, but is work was exemplary.  Below is a synopsis of his efforts through to closing and specific reference to the complainants comments.  We will not be responding further.  Warm regards, ****** ******** VP Eastern Canada
  
  As requested, please find below a comprehensive timeline and
  factual summary of my handling of the above-referenced claim, specifically
  addressing the allegations made by the insured in the BBB complaint. ****** **** **** **** * **** ******** *** ****** **** **** ***** ********** ****

  Email from claims
  manager – That there is nothing wrong with our services and our handling
  of the file. They took the file in-house as this is a strategic move to alleviate the Insured’s perceived conflict
  Confirmation of decision from
  Claims examiner – received on 09th- 11th June 2025
  confirming that there would be a steep co-insurance penalty and it will
  apply here.
  
  
  I would like to begin by stating unequivocally that the
  insured’s claim — that “no
  Statement of Values was ever asked for” and that “no communication has been attempted on
  behalf of ******” — is false *** ************ ** ********** ************** *** **** *****
  
  
  Timeline of Communication and Key File Activity
  
  Here is a timeline of my communication with insured and
  requests including a request for the Statement of Values:
  
         • May 12, 2025: Upon
  assignment, I established first contact with the insured and dispatched a
  "Claims Process Letter". I also sent a formal acknowledgment email to
  ***** ****** and ****** ******, outlining my role, confirming the initial
  inspection, and explaining the next steps in the claims process.
  
         • May 14, 2025: Following
  the site inspection, I met with the insured, ***** ******. During this meeting,
  I provided an overview of our findings, explained the claims process, and
  specifically requested that any relevant documentation, such as service
  reports, receipts, or maintenance records, be shared. I also followed up with
  emails to the contractor (******) and the landlord, copying the broker and
  insured, requesting reports to assist in the assessment. I also had multiple
  calls with the insured regarding next steps and repairs.
  May 14, 2025:Telephonic
  conversation with the broker – Updating them that we need to know who the value for
  C.O.E.D was decided as $10,000 and if statement of value was ever
  prepared. To which he responded he never prepared any before binding the
  risk
  
  May 20th 2025- Preliminary Report sent
  to examiner seeking approval for next steps and claims process also
  seeking directions on co-insurance and if there would be implications
  related to co-insurance .
  
  May 29,2025
  Contact with Broker: I
  contacted the broker, ***** *********** ****** **********, by phone and left a
  voicemail explicitly requesting the Statement of Values (SOV) for the
  insured’s contents and tenant improvements. STILL
  AWAING COVERAGE APPROVAL FROM CLAIMS EXAMINER
  
  June 3, 2025
  Follow-up Email to
  Broker & Insured:
  I sent a detailed email advising of the co-insurance implications and
  again requested the SOV. I clearly stated that without this, we would not
  be able to complete an accurate co-insurance review. STILL AWAING COVERAGE APPROVAL FROM CLAIMS EXAMINER
  Broker Responded asking if I had
  a template for the SOV — confirming that they were aware of the
  requirement but had not prepared one.
  Insured (*****) replied that the valuation was
  inflated and asked for a copy of my report, which I advised I could not
  provide, as per standard protocol.
  I explained, in writing, that the
  $80–90K estimate was not the claim amount but a replacement cost
  estimate used solely for the purpose of applying the co-insurance
  clause — which is required under the policy. STILL
  AWAING COVERAGE APPROVAL FROM CLAIMS EXAMINER
  
  June
  4–June 24, 2025
  
  I continued to follow
  up with the broker by phone and email. On several occasions, voicemails
  were left and no response was received.
  I had multiple phone
  conversations with the insured, including both ***** and ******, in which
  I reiterated the need for the SOV and explained the importance for
  coverage assessment. STILL AWAING COVERAGE
  APPROVAL FROM CLAIMS EXAMINER
  
  June 09,
  2025
  Final coverage decision from
  claims examiner – Informing me of the next steps and next to inform insured
  that there would be co-insurance penalty and the percentage would only be
  calculated after receipt of statement of value.
  June 25,
  2025
  Due to continued
  inaction by the broker, I personally provided the
  insured and broker with a blank SOV template, along with detailed
  instructions and itemized examples specific to a salon. This email was
  sent to all parties and is on record.
  The broker did not
  respond further and stopped participating in the file. The insured
  subsequently changed brokers.
  
  June 30,
  2025
  The insured (******) submitted
  the completed SOV directly to me using the template I had provided —
  again confirming that the request for the SOV had been made and that they
  acted upon it.
  The SOV valued the
  contents and improvements at $62,033, which is significantly higher
  than the $10,000 COED limit — clearly supporting my position that a
  co-insurance penalty applies.
  
  July 2,
  2025
  I inspected and
  documented the SOV and forwarded it to the examiner, noting that the
  broker never submitted it despite repeated requests and that the insured’s
  values confirm material underinsurance.
  
  
  ? Facts Contradicting Insured’s Allegations
  
  “No SOV was ever asked
  for” –
  Incorrect. The SOV was first requested on May 14 via phone to the
  broker (who updated that he never prepared one before binding the risk),
  again on June 3 via email, followed by multiple reminders. The
  broker even requested a template — proving acknowledgment of the request-
  We are proving a Statement of value template when its broker’s job to have
  it at their disposal when they are binding the risk
  
  “No communication
  attempted” – Completely false. The file notes reflect dozens of calls, emails, and
  follow-ups with both insured and broker from late May through July. In
  fact, the insured’s own responses prove active engagement.
  
  
  “Value set at $10K under
  insured agreement” – Even if this were believed to be sufficient by the insured, the presence
  of a 90% co-insurance clause in the policy makes this limit
  problematic. The SOV submitted by the insured confirms actual values of
  over $62,000, which supports my caution regarding underinsurance from
  the outset.
  
  ******* *** ******** *** ********* ******* ********** * ** ** ***** *** * *** ******* ******** ** ******* *** ********** ********* ***** ************* *** ******** ** ****** ******** *** ****** ******** **** ********** *** **** ************ **** *** ** **** *** **** ******* ****** ******** *********** ***** ******** *** ****
  
  ?? Final Notes
  The Statement of
  Values was not only requested repeatedly, but ultimately completed
  by the insured using my template — highlighting the broker’s failure in preparing this
  crucial document at the time of underwriting.
  All communications were
  documented and professional, and the tone of the complaint seems emotionally
  charged rather than grounded in fact.
  This file was eventually
  reassigned as a courtesy to address the insured’s perception, not because
  of any deficiency in file handling.
  
  Part 5: Remarks from Claims Manager Regarding
  Reassignment
  On July
  3, 2025, I received an email from ***** *****, Claims Manager at ***** ******, confirming the following:
  “This
  is a strategic move to alleviate the insured’s perceived conflict… We typically
  do not like to reassign files unless the insured has a strong opinion on the
  matter… This is not related to your abilities as an IA.”
  This clearly reflects that the file was reassigned not due
  to any service deficiency, but purely as a customer satisfaction measure for
  the insurer to personally manage the denial conclusion.
  
  Let me know if more information
  is required
  
  
  Thanks &
  Regards,
  
  **