Troubleshooter: Insurance denial

December 8, 2008 3:51:22 PM PST
A denied insurance claim left a Sanford woman with a big bill. When she couldn't get the coverage she thought she deserved from her insurance company, she called Troubleshooter Diane Wilson.

You have homeowners insurance for protection when something big happens. So when Janet Bullard's air conditioning unit stopped working she hired an HVAC company to do the repair. While repairing it, she says the HVAC company told her why the unit stopped working. She says, "They found out it got struck by lightning and instructed I call my insurance company which I did immediately."

Janet says a Nationwide agent took the entire old unit and did their own investigation. She adds, "They said it wasn't hit by lightning. So we wanted all the equipment back so we could have it tested to find out if it was hit by lighting or if it wasn't." But Janet says Nationwide didn't return all the parts. She says, "They did not bring the electrical box. They could not find it. No one could find it anywhere."

Meanwhile Janet had to pay in full for her new unit which was a little more than $4,000. A cost she didn't feel she should solely be responsible for since the air conditioning company she hired put in writing they determined the system had been severely damaged by a power surge due to a lighting storm. Janet thought her insurance should cover some of the cost and adds, "I was with Nationwide for 17 years and I don't abuse a claim."

Troubleshooter Diane Wilson got in touch with Nationwide and a rep immediately got in touch with Janet. Janet adds, "He was bending over backwards and he was very, very sorry what I had to go through. Now everything is fine. You made me get my check within days."

Nationwide sent Janet a check for a little more than $3,000, which covers the entire new unit minus her $1,000 deductable. Janet says she's very happy with the outcome.

A Nationwide rep said in a statement, "The customer is always our top priority at Nationwide. Our policy is to settle all claims fairly and quickly. Nationwide is always willing to work with the customer to resolve any concerns regarding a claim. We will re-inspect and re-estimate a claim if there is a policyholder concern over the value of the estimate, which is what happened in this particular case. We urge any customer with a concern to discuss the matter with their Nationwide claims professional."


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