Pacific Specialty Insurance

I had a micro burst in my neighborhood. The insurance company first said that I needed to prove I have my roof repaired. I showed that proof. They then asked for a receipt of repair. I showed that. They then said the roof was over 25 years old, and I had to prove it had been replaced in the last 25 years. I obtained 2 letters from contractors stating it was not 25 years old. They then said I had to make a claim to get coverage, 1 and 1/2 years later, after going to the head of the company. They denied my claim, stating my roof was excluded, and none of the proof was good enough. Everyone else in the neighborhood got new roofs. From the $13,000 I filed for claim, they paid $2,500, depreciated everything else, or excluded from coverage.

A microburst in my neighborhood did extensive damage to many homes knocking down power lines, trees and blowing off roofs. The roof from my neighbor's house was blown off and landed on top of our block fence knocking half of it down. I called PSI and they took the claim report and sent an adjuster after a few days. The adjuster took pictures of the roof laying on top of our wall and the neighbor's house and the damage caused. He stated that it was very obvious that the damage was caused by the roof and that we had a good claim. He promised to send in the report in 4-5 days to PSI, my neighbor's insurance carrier, and he did. My claim was assigned to Larry ** who promised to handle this rapidly. Three weeks passed and he kept putting me off saying that it was being reviewed. I called him back a week later and he said it could be rejected because it wasn't my neighbor's fault that the storm blew his roof into my property. I talked to my neighbor and he said PSI hasn't the hotel where he was staying and hasn't started fixing his house yet.

I received a letter from them 6 weeks later stating that the claim had been rejected because no grounds were established that there was negligence on behalf of my neighbor and that if I wasn't happy with their decision, I could file a complaint with the California Department of Insurance. Better than that, I will file with the Arizona Department of Insurance and the Attorney General's Office. California has no jurisdiction in Arizona. I recommend all claimants file with their State ASAP.

I'm a contractor who has dealt with a a few claims thru PSIC. First, consumers beware if you signed a DP1 policy. This is the biggest scam since Bernard **. As typical with any type of claim, we met the adjuster from PSIC at the property where we measured and compared our views of the damage. At no point did the adjuster indicate this is a non-recoverable depreciation policy. So the claim is turned into our office and put into an industry standard program that calculates measurements and gives current market pricing based on the current petroleum rates. Once this is completed, usually the price is a little higher than the estimate given by the insurance. At this point we contact the insurance company and get approval for these numbers from a claims agent prior to starting any work. At no point did the agent indicate this is a non-recoverable depreciation policy. Once the work is completed, we have it inspected by the city and gather all info on the claim (permits,pics,receipts,notice of inspection,etc.) and forward this information to the claims agent so that they can release the recoverable depreciation to the home owner.

As sure as sin created the devil on a remaining $7,000 job, the home owner receives a check for $323.56. **! Excuse my language but seriously here folks not only do I have to pay the crew that worked the job but the initial check from PSIC barely covered materials and transportation. So after speaking with the home owner and picking up my enormous check, I had my office staff contact PSIC to find out when they would be releasing the remainder of the money. At this point (job totally completed for 3 weeks), the claims agent announces this is a non-recoverable depreciation policy! Huh?

I contacted the home owner who told me that this was the company his mortgage company made him sign up with when he purchased the home & that he had no idea what kind of policy he held. So again, I personally contacted PSIC and asked that the call be escalated to a manager or supervisor, a young lady by the name of Debbie although extremely pleasant, but firmly let me know that nothing can be done to recover this money and basically as a contractor, I should have gotten cheaper materials and hired cheaper labor because she is more than sure that another company could have made the first check work.

Wow! As a small business owner, $7k is a lot of money and to charge this amount back to the home owner would be unfair and ridiculous. I tried contacting DORA to make a complaint but as a contractor, they would not accept my complaint and asked that I have the home owner make the complaint. This is a tedious process that requires time and effort, so to ask my client to take away from their personal time to recover my money also seems unfair to the home owner.

My best advice is stay the hell away from PSIC if you value your belongings and home.

My son Tony ** bought the insurance when he got the motorcycle. He was run off the road and was killed. Specific specialty then call, a William at that time, I sent he all information on the accident 05/28/2009. Claims finally got back to me on September 20th. They wanted me to sign a release form for the 25.000 and have notarized. I did that and faxed them the form. Then I receive the letter that the claim is resolved. I call them and no one will answer in clamed or call me back. Have not received any check.

On June 6, 2010, I had plumbing pipe leading to the sewer backup in my basement. Sewage backed up through the pipe and spilled all over the basement floor. I contacted Pacific to determine my best course of action. They told me to call a plumber to resolve and Serv Pro for the clean up. The clean up company (Serv Pro) was to be paid directly. When submitting for reimbursement for the plumbing, I was careful to separate out the extra work done by the plumber, which was not a result of this event. The clearing of the pipe and clean up were completed within a few days. However, my claim continued to remain open for months.

I asked when he was planning to tell me about this and was met with silence. He then said he would reopen the file and someone would get back to me soon. Nothing for about a month. I called back and left yet another message on Douglass' voicemail. Eventually, I received a phone call from one of Douglass' associates stating that my claim was denied because "water damage resulting from a backup was not covered".

I argued that the cleanup was covered and paid for and that we had a rider covering backup. After a half hour of discussion, this associate consulted with someone and returned to the phone stating that Douglass had not mentioned the rider and that we were, in fact, covered. She said Douglass would call me the next day to discuss the exact figures.

I made it a point to emphasize Douglass is not the most reliable when it comes to call backs and that I would appreciate it if she stressed to Douglass that I am awaiting his phone call. Again, nothing. Tonight (10/13), I called again and left a voicemail for Douglass.

He called back and stated we were not covered. This time, he quoted an exclusions section, which stated, "We do not insure the cost of tearing out, repair and/or replacing any pipes, including concrete slabs enclosing pipe." He insisted that clearing a clog is excluded under the "repair" meaning. When asked if I can speak to an individual who made that determination, he refused to provide me with a name. When I asked if a phone number would be available on the claim rejection letter, he stated he thought so but he wasn't sure. Stay away from this company. They appear to do all they can to not cover a claim. Regardless of what their reasoning is, there does not appear to be recourse for dispute.

$526.43 is the consequence. My daughter starts college next year. We are trying to save money and every dollar makes a difference.

I filed a claim in Feb. 9. It been bad since day one I got a draft I mailed it in to mortgage company. First the insurance company forgot to pay me for the damage to roof. So they had the adjuster come back out again redo the estimate. He blamed them. They blamed him. In the mean time, I have cancer. My kids had been back and forth to hospital with sore throats, sinus problems because mold was setting. My mortgage company adjuster read the paper wrong two times. They have only sent me half of one check $6000.

The insurance comp made another check. I mailed it to them mortgage company. I still haven't got anymore money. I owe contractor. Works done. I also got deducted again for deductible. The mortgage company adjuster keeps messing up. Well, it's June now but I didn't have two ceiling fixture outlets in which there was never none in the first place, outside patio which they have pic. I didn't have. They still have not released my funds to me. I owe people money. What should i do?

I haven't received any money on roof which I had to fix first. Okay update. They sent adjuster out three times. He has changed his report three times. They covered all damaged in the house and carpet, everything. Now they are saying the roof wasn't the cause of it. They gave me three different reports. They messed up on paying me for personal property twice. How can they pay for water damage in side if the wind lifted roof up first to cause damage? They aren't returning my calls. They said claim has been closed. On their last report, they put based on our inspection of the roof. There was no storm related damage to the roof that created an opening. Would account for any water intrusion in the interior. But they paid for damages inside. Don't make any sense. Well due to them not paying for the roof that cause the damage inside, mold came and my kids and I been to doctor more then 10 times each. Can't breathe.

On January 8, 2010, we had a garage fire that spread to the roof, living room, dining room and it destroyed all of the contents in the garage. The adjuster came out that weekend to survey the damage. Since that weekend, there has been no re-construction to the house. PSIC has paid some of the personnel loss items, paid other small items, but still has not moved on the re-build of the house. It has now been 8 months and our living expense allowance is about to run out. Instead of providing what they should be doing, they would rather pay for us to stay in a rental home instead of repairing my home. They do not communicate with my public adjuster, return phone calls or e-mails. If they do not act soon, we will be on the street but still paying a mortgage on a house that has been red tagged and unlivable. If my living expense runs out, I can not afford to pay a mortgage on a burnt house and rent on another. For PSIC not to perform on my claim is unacceptable. I made my insurance payments every year and now they won't do what I paid for.

Had house fire on March 13, 2008 which started in the garage of new property. Had only been in house 90 days. Now house is rebuilt and there were add ons that were necessary by the city of Apple Valley our contractor Thorpe Development had to complete. Now PSIC will not pay for the add ons. We had 13,000 in checks sent to us to give to the contactor. Our mortgage company IndyMac is holding them until we get the new totals from PSIC. No return calls even if paged April A. Just no return calls. Customer service is just terrible.

Now a lien is being place on the house because of the amount owned to the contractor Jeffrey Thorpe Development. It has been one year since we have been in the rebuilt house. Still dealing with PSIC for contractor monies and personnel property still unfinished. I can deal with no more my father died suddenly on July 3, 2009. I cant mourn his death still dealing with PSIC 20 months after fire. We want this resolved. I have contacted Department of Insurance for help also. Any help would be appreciated

We are now told that cost of insurance and premium are not the same and that the cost of insurance has escalated to about $55,000.00 per year. My father has paid in approx. $130,000.00 in premiums to have a policy that is now worth $5000.00 in April and then of course if we do not pay $5000.00 for May it will have no value. My father is very upset because this was not the understanding when he bought the policy. We knew that the cost/premium would increase after my mother's death, but not by this extreme and to have the cash value go down to $0.00.My father's attorney cannot do anything to fight this case.

My father has paid in over $130,000.00 and we should at least get that much money back.

M home was robbed on January 12th. On the 23rd of February I was told by April that a check was being cut for the claim. Nothing showed up. I called on Monday March 2nd and was told that she had to ressubmit the claim for approval and that a check was being cut that day. I called on Friday March 6th. I can't get a straight answer from them on what is going on and what to expect. I can't even talk to a supervisor. They don't return calls.

This has been mentally difficult on my family; especially my children. My daughter is a sophmore in high school and needs her laptop replaced for her schoolwork. My son can't sleep at night because of the robbery and is still upset losing his tv, electronics, play station and games. I would like to meet their needs with replacements, but can't do so until Pacific Specialty processes the claim.