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Author Topic: Insurance claim experience on Insurance Companies  (Read 1229 times)

Offline nanashi

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Insurance claim experience on Insurance Companies
« on: Aug 19, 2012, 04:21 PM »
Share your experience on your insurance companies when you are claiming your claims,
I'm on a bit deciphering good insurance companies locally and I want to know which of them has the best customer service in terms of paying their clients claims.

When i was gonna snoop around I found a news about a US insurance company "Progressive" gave their policyholders a nightmare in collecting their claims despite the death of their family member due to a car accident. They "insurance company" even defended the killer of their family member in court.

http://www.cbsnews.com/8301-505263_162-57494354/internet-outrage-grows-around-progressive-insurance/

Quote
This week, Internet outrage has mounted against Progressive insurance. Many Progressive customers are taking to social networking sites to declare that they will cancel their policies after a blogger accused the insurance company of defending a driver who killed one of its policyholders.

The blog was posted by the brother of Kaitlynn Fisher, who was 24 when she died in a Baltimore car crash. Matt Fisher said he was shocked to learn that a lawyer for Progressive was in court attempting to convince a jury that his sister was to blame for the crash.

A witness at the scene of the 2010 crash said the driver of a black SUV sped past him, ran a red light, and crashed into Fisher's car, killing her almost instantly. The SUV driver was insured for $25,000. Fisher had a $100,000 policy with Progressive, however Progressive refused to pay the claim because according to the company, "There were conflicting eyewitness accounts as to who was at fault."

When the trial began, the Fishers say they were surprsied to see a Progressive lawyer in court requesting that the company be included as a defendant. CBS News correspondent Elaine Quijano spoke to the Fisher family and Progressive in a report that aired Thursday on "CBS This Morning."

"The guy who...killed my sister had more than one attorney. He had two attorneys," Matt Fisher told Quijano, "One of them identified himself at the beginning of the case as an attorney at Progressive."

Progressive disputes that allegation and notes that the other driver was represented by an attorney for his insurer, Nationwide Insurance.

The jury sided with the Fisher family at the end of the three-day trial, awarding them $760,000 in damages. Progressive is responsible for paying only what it owes under Kaitlynn Fisher's insurance policy -- $75,000 -- and the defendant is responsible for the remaining damages.

Yet Matt Fisher continues to feel betrayed by Progressive, and in his blog post earlier this week claimed; "If you are insured by Progressive, and they owe you money, they will defend your killer in court in order to not pay you your policy."

In response, Progressive issued an official statement and told CBS News:

There has been considerable interest in the case of Kaitlynn Fisher, and while we are limited in what we can say at this time, we can explain Progressive's role in the trial.
Ms. Fisher held a policy with Progressive that included Uninsured/Underinsured Motorist coverage, which protects drivers in the event they're struck by an at-fault driver who's either uninsured or doesn't have enough coverage. Under Maryland law, in order to receive the benefits of an underinsured driver claim, the other driver must be at fault. Sometimes this can be proven without the need for a trial, but in Ms. Fisher's case, there were conflicting eyewitness accounts as to who was at fault.

A trial was necessary so that a jury could review all of the evidence and come to a decision. In those circumstances, under Maryland law, the insurance company providing the Underinsured Motorist coverage is considered a defendant. As a defendant in this case, Progressive participated in the trial procedures on our own behalf while Nationwide represented the other driver. On Thursday, August 9, a jury determined that the other driver was at fault in Ms. Fisher's accident. In accordance with that decision, Progressive is actively working with the Fisher family and their legal representative to resolve the claim.

This was a tragic accident and our sympathies go out to the Fisher family.


Offline pmtmember

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Re: Insurance claim experience on Insurance Companies
« Reply #1 on: Aug 19, 2012, 08:19 PM »
i hope we will hear from our brothers here. I also want to know what their experiences are
Take risks: if you win, you will be happy; if you lose, you will be wise. Trader's Logbook

Offline kithe

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Re: Insurance claim experience on Insurance Companies
« Reply #2 on: Aug 19, 2012, 10:23 PM »
In my own experience, I have 3 death claims already;
my first client died August 2001 from car accident, he's only 28 y/o, he got his policy October 2000, his insurance coverage is 200,000.00 since it is an accident it is a double indemnity claim, his family got 400,000 plus the unused premium..
Second is my servicing client, age 72, her insurance coverage is only 20,000 which she got wayback 1970's, but her family got 50,000.00 cash value and face amount..
Third is my group life account in PICC employees, it is only a group life insurance coverage for employees, he is only 38 y/o, died due to heart attack last 2006,  his family got 400,000.00..

Yun pa lang naman, siyempre gusto natin huwag mamatay ng maaga ang clients, pero sabi nga ni benjamin franklin, two things lang ang certain Death and Taxes..

Meron po talaga na hindi nababayaran na claims, like yung mga cases na may sakit pala pero hindi sinabi intentionally sa agent or doctor.
May existing sakit pala hindi sinabi sa agent, may mga tanong po kasi sa application form, na dapat sabihin ang iyong history ng previous consultations..
Dapat po talaga with honesty ang pagsagot sa form, kung meron man sakit at may medications, they will approve naman yun, its either standard or rated..

Siyempre po may insurance adjuster po na mag investigate, di po sila connected sa insurance company, it is a separate company na ang trabaho ay imbestigahan ang insurance claims,
interviewing the claimant and witnesses, consulting police and hospital records, and inspecting property damage to determine the extent of the company's liability..

GOD LOVES YOU
For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.

Online mxherr5

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Re: Insurance claim experience on Insurance Companies
« Reply #3 on: Aug 20, 2012, 04:28 AM »
Personal experience ko ay yung sa uncle ko.
Mabilis lang kinuha ang proceeds ng insurance.

Meron nga pala tayo online records ng mga supreme court
cases.
At gaya ng sabi ni kithe, sa life insurance halos lahat ng kaso
ay dahil nalaman na nagsinungaling sa application.

Pero 2 years lang naman ang contestability period.
Yun nga ok sa life insurance eh,after 2 years, just pay kung
may nangyari lol


Ibang usapan ang non life insurance tulad ng news article mo nanashi,
Grabe, feeling ko parang lahat ng claims, nilalabanan nila.
I think may isa pa ngang thread d2 na na ondoy na binarat rin ng insurance company nya sa home insurance nya. tsk

Offline pmtmember

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Re: Insurance claim experience on Insurance Companies
« Reply #4 on: Aug 20, 2012, 10:26 AM »
In my own experience, I have 3 death claims already;
my first client died August 2001 from car accident, he's only 28 y/o, he got his policy October 2000, his insurance coverage is 200,000.00 since it is an accident it is a double indemnity claim, his family got 400,000 plus the unused premium..
Second is my servicing client, age 72, her insurance coverage is only 20,000 which she got wayback 1970's, but her family got 50,000.00 cash value and face amount..
Third is my group life account in PICC employees, it is only a group life insurance coverage for employees, he is only 38 y/o, died due to heart attack last 2006,  his family got 400,000.00..

Yun pa lang naman, siyempre gusto natin huwag mamatay ng maaga ang clients, pero sabi nga ni benjamin franklin, two things lang ang certain Death and Taxes..

Meron po talaga na hindi nababayaran na claims, like yung mga cases na may sakit pala pero hindi sinabi intentionally sa agent or doctor.
May existing sakit pala hindi sinabi sa agent, may mga tanong po kasi sa application form, na dapat sabihin ang iyong history ng previous consultations..
Dapat po talaga with honesty ang pagsagot sa form, kung meron man sakit at may medications, they will approve naman yun, its either standard or rated..

Siyempre po may insurance adjuster po na mag investigate, di po sila connected sa insurance company, it is a separate company na ang trabaho ay imbestigahan ang insurance claims,
interviewing the claimant and witnesses, consulting police and hospital records, and inspecting property damage to determine the extent of the company's liability..



ms. kithe d ba may tanong din tungkol sa health ng parents? For example in my case meron akong insurance sa prulife. May mga tanong doon regarding sa father ko na namatay na. Kaso d ko masyado alam ano talaga sakit niya kasi complicated yon so parang generalize nlang nakalagay. Will that affect in the event na mag claim ako. To what extent ba na pwede i-contest ng insurance company ang mga butas doon sa application form mo? At pwede ba na as early as now ipapa re-check mo yong application mo para at least naman you will not be shocked when time comes? TIA
Take risks: if you win, you will be happy; if you lose, you will be wise. Trader's Logbook

Offline yllor

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Re: Insurance claim experience on Insurance Companies
« Reply #5 on: Aug 20, 2012, 01:17 PM »
This is nice thread and hope ms kithe will discuss also the overview procedure in claiming insurance especially life. :D
there is always an opportunity - as winners and losers

Offline kithe

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Re: Insurance claim experience on Insurance Companies
« Reply #6 on: Aug 20, 2012, 08:41 PM »
ms. kithe d ba may tanong din tungkol sa health ng parents? For example in my case meron akong insurance sa prulife. May mga tanong doon regarding sa father ko na namatay na. Kaso d ko masyado alam ano talaga sakit niya kasi complicated yon so parang generalize nlang nakalagay. Will that affect in the event na mag claim ako. To what extent ba na pwede i-contest ng insurance company ang mga butas doon sa application form mo? At pwede ba na as early as now ipapa re-check mo yong application mo para at least naman you will not be shocked when time comes? TIA

May questions talaga regarding sa history ng parents kung buhay pa, kung may hereditary disease or patay na, ano cause ng death.. Kung wala naman, okay lang..

If for example, your parents is Diabetic or any other sickness that they have proven that is hereditary and nagkaroon siya before age 60, this means one of the member of your family MIGHT have that kind of sickness..

Yung sa case mo sir pmt, di naman big deal yun kung di mo talaga sure yung cause of death ng father mo..

Since ikaw naman yung insured, at wala ka nman sakit, there will be no problem if in case magkaroon ng claim..

Tingnan niyo po yung policy contract mo, may copy dun ng application form na pinirmahan mo.. :D
GOD LOVES YOU
For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.

Online mxherr5

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Re: Insurance claim experience on Insurance Companies
« Reply #7 on: Aug 21, 2012, 09:51 AM »
^

Paano nalalaman ng agent na wala na client nya?
Err..sorry to be morbid.

Or for example, nka auto debit na bayad mo so
no agent interaction na, tapos umalis na yung agent
sa insurance company.

Then namatay ang client..
What happens then?

Offline kithe

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Re: Insurance claim experience on Insurance Companies
« Reply #8 on: Aug 21, 2012, 03:44 PM »
We advise our clients not to hide sa family members na kumuha sila ng life insurance, and do not put the policy contract in a safety vault, pwede niyo lang ilagay sa ordinary place na alam din ng family members niyo..

Actually, sa Sunlife, kung umalis at nagresigned na yung agent, SOP yun na pinapadalhan ng letter ng Sunlife yung client informing na yung agent ay resigned na, and may iaasigned na new servicing agent..

With regards sa clients management services ng Sunlife, we are always ask to update the information of our clients like mailing address, change of status, etc..
Pero kung talagang wala ng communications ang client at agent, pero lagi naman nagbabayad si client thru bank, they can directly contact the insurance company thru customer service..

What if, may scenario na di alam ng family members na may insurance pala yung namatay, at nalaman lang after 5years, dahil nuon lang nakabalik ng Phils., nag migrate sa ibang country.. They can claim pa rin sa insurance company, as long hindi lapse yung policy at the time of death.. Just present the death certificate and the policy contract, the company will pay whatever the death benefits ( face amount and dividends, if traditional plan.. Less loan or advance from the policy, if any.. Fund value and face amount, if VUL  or kung term insurance, yung face amount..
GOD LOVES YOU
For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.

Online mxherr5

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Re: Insurance claim experience on Insurance Companies
« Reply #9 on: Aug 22, 2012, 03:57 PM »
Very enlightening. Thanks kithe

Offline rinopepito

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Re: Insurance claim experience on Insurance Companies
« Reply #10 on: Aug 22, 2012, 06:12 PM »
way back n d early 90's may claim ako sa isang OFW na namatay, mas nauna pang nakuha ng pamilya yung insurance benefits kaysa katawan ng OFW after makompleto nila ang required documents

recently naman magkasunod na namatay ang father n-law ko (natural death) at half sister ko (accidental death kaya doble nakuha namin sa face value) w/n 1 week time nakuha namin lahat ng insurance benefits

sakin importante sa pagpili ng life insurance or any insurance ay stability @ performance history ng insurance company para d mahirapan sa claims   
biggest risk is that you did not take the risk!

Offline pmtmember

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Re: Insurance claim experience on Insurance Companies
« Reply #11 on: Aug 22, 2012, 09:09 PM »
@rinopepito anong insurance company yan?
Take risks: if you win, you will be happy; if you lose, you will be wise. Trader's Logbook

Offline rinopepito

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Re: Insurance claim experience on Insurance Companies
« Reply #12 on: Aug 23, 2012, 02:24 AM »
 @ pmtmember philam life po, since 1994 pa kami insured, buong family ko. connected kc ako sa kanila b4 bago ako nag abroad. e2 din ang bread & butter ko during my early days.
biggest risk is that you did not take the risk!

 

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