INAPPROPRIATE RESPONSE 69 INAPPROPRIATE RESPONSE TO EMAIL:Claim Number 55-06c6-44x INAPPROPRIATE RESPONSE 68 DATED 25FEB21 10:48PM
NOTES ON IMPROPRIETY : PERTAINING TO INAPPROPRIATE RESPONSE 69 NUMBER 1. MR. GUENIOT, MAY I MOST RESPECTFULLY REMIND YOU THAT YOU ARE AN EDUCATED MAN AND YOU ARE NOT DUMB, PLEASE PARDON ME FOR THE WORD BUT I AM FORCED TO WRITE IT IN ACCOUNT OF YOUR DELIBERATE AND INTENTIONAL IDIOCY AND MALEVOLENCE. THE ASSISTANCE SOUGHT IS, PLEASE PROVIDE ME A CONCISE SUBSTANTIVE DENIAL LETTER ON MY CLAIMS FOR SECONDARY DAMAGES FILED IN JUNE 2020 AND VANDALISM WHICH COVERAGE I DISCOVERED JUST IN NOVEMBER 4, 2020 WHEN YOU BELATEDLY FURNISHED ME WITH THE COPY OF THE POLICY BEYOND ON WHAT IS REQUIRED BY THE REGULATION. TO WIT: FAILURE TO PROVIDE WRITTEN A CLEAR SUBSTANTIVE DENIAL DOCUMENTS CORRESPONDING TO THEM ARE CLEAR VIOLATIONS OF SECTION 2695.5. NUMBER 2. DELIBERATE INTENTION TO SOW CONFUSION. IT IS AN IMPROPER RESPONSE FOR RESPONDING TO AN EMAIL ASKING FOR A CLEAR AND CONCISE DENIAL LETTER LIKE "As I previously communicated to you on November 13, 2020, we have done our best to answer your questions and provide a reasonable explanation for the basis of the denial of the claim based on the policy language. " WHERE IN YOUR EMAIL IN NOVEMBER 13, 2020 YOU DID NOT MENTION OF MY DAMAGES CLAIM FROM VANDALISM COMMITTED BY YOUR INFORMANT PLUMBER TITOUAH? NUMBER 3. YOU ARE SAYING "we have done our best" WHAT EFFORTS HAVE YOU MADE TO EXPLAIN YOUR POSITION? WHAT YOU HAVE WRITTEN ME ARE JUST A TEMPLATE OF EMPTY AND UNSUBSTANTIATED FIVE (5) FEEBLE MINDED OR FEW INSANE SENTENCES, REPEATEDLY ALL OVER AGAIN? WHAT YOU HAVE DONE BEST IS TO SOW MORE AND MORE CONFUSIONS TO DETER ME CONTINUING NEGOTIATIONS WITH YOU AND SUBJECT OUR CLAIM TO FRIVOLOUS DELAYS. BUT I ASSURE YOU, I WILL CONTINUE GOOD FAITH NEGOTIATIONS WITH YOU THOUGH YOU ARE CONTINUALLY DISPLAYING OBVIOUS AND REPREHENSIBLE MANIFESTATIONS OF BAD FAITH AND/OR I WILL EXHAUST ALL ADMINISTRATIVE DISPUTE RESOLUTIONS AVAILABLE BE IT WITHIN THE PREMISES OF STATE FARM, THROUGH MS. TIFFANY WYATT OR THROUGH THE MANAGERS ABOVE YOU OR THROUGH OUR INSURANCE AGENT, MR. EDDIE ATCHLEY OR THROUGH PUBLIC ADJUSTING SERVICES. I WOULD LIKE TO REITERATE THAT I WILL CONTINUE MY GOOD FAITH NEGOTIATIONS WITH YOU AND STATE FARM UNTIL I HAVE EXHAUSTED ALL ADMINISTRATIVE REMEDIES AVAILABLE. NUMBER 4. MR. GUENIOT PLEASE DO NOT DERAIL EFFORTS TO RESOLVE THIS CONFLICT TOWARD A HOLISTIC RESOLUTION. THIS EMAIL WHICH YOU ARE RESPONDING TO IS INTENDED FOR MR. EDDIE ATCHLEY INITIALLY AND NOT FOR YOU TO ANSWER. I FURNISHED YOU A COPY OF IT FOR THE SAKE OF COURTESY JUST TO LET YOU KNOW THAT I AM PRUDENTLY EXPLORING OPTIONS TO NEGOTIATE THESE INSURANCE CLAIMS BETWEEN RESPECTABLE AND HONORABLE MEN. STATE FARM INSURANCE COMPANY DESERVES MEN OF HIGH HONOR AND INTEGRITY IN THE EXACT OPPOSITE OF WHAT YOU ARE SHOWING. PLEASE LET MR. EDDIE ATCHLEY DO WHATEVER HE COULD TO HELP US OUT OF THIS PREDICAMENT. HIGHLIGHTS : CONTINUING REITERATION OF SUBSTANTIVE DENIAL LETTERS ON VANDALISM FILED IN NOVEMBER 2020 AND SECONDARY DAMAGES CLAIM FILED IN JUNE 2020. NUMBER 1. MR. GUENIOT, THE ASSISTANCE SOUGHT IS, PLEASE PROVIDE A CONCISE SUBSTANTIVE DENIAL LETTER ON MY CLAIMS FOR SECONDARY DAMAGES FILED IN JUNE 2020 AND VANDALISM WHICH COVERAGE I DISCOVERED JUST IN NOVEMBER 4, 2020 WHEN YOU BELATEDLY FURNISHED ME WITH THE COPY OF THE POLICY BEYOND ON WHAT IS REQUIRED BY THE REGULATION. WHY YOU NEED TO PROVIDE A CONCISE SUBSTANTIVE DENIAL LETTER? 1. Your denial letter must be accurate and not confusing. State Farm had an affirmed denial letter dated July 17, 2020. On paragraph 3 of this letter, Mr. Gordon Liu wrote the following: "In your request that our correspondences be re-organized and re-written, we respectfully respond that we will not. Please refer to May 6, 2020 correspondence and specifically the one year suit against us paragraph. The one year cited begins again as of the date of this letter." Meaning, according to Mr. Liu, the one year suit begins again as of the date of that letter, July 17, 2020 and not June 12, 2020 as in your responses dated February 11, 2021 and February 25, 2021. Mr. Liu wrote July 17, 2021 and not June 12, 2020. Please read my supporting document for date July 17, 2020 as the beginning of the one year statute of limitations : STATE FARM RESPONSE DATED JULY 29, 2020 WITH ATTACHED AFFIRMED THIRD DENIAL LETTER DATED JULY 17, 2020 . Without prejudice to the continuing violations doctrine which I have invoked, as far as State Farm is concerned the date July 17, 2020 shall prevail over June 12, 2020 because July 17, 2020 is the date specifically mentioned in paragraph 3 of the July 17, 2020 denial letter. If you still insist it to be June 12, 2020, then this is deliberate and intentional misrepresentation, a manifestation of bad faith and futile efforts to sow more confusions. 2. Again, your denial letter must be accurate and not confusing. ON PAR.2 June 12, 2020 DENIAL LETTER, Mr. Liu wrote,
"his written report " This means on the denial letter dated June 12, 2020, Mr. Liu impressed upon us a copy of the written report of JOHN TITOUAH. BUT HOW COME MR. LIU IS DENYING THE EXISTENCE OF JOHN TITOUAH's REPORT ON PAR.3 JULY 31, 2020 DENIAL LETTER TO THE EFFECT THAT THE INFORMATION PROVIDED BY JOHN TITOUAH WAS PROVIDED VERBALLY AND NOT IN WRITTEN FORM. PAR. 3 July 31, 2020 DENIAL LETTER Mr. Liu wrote, "Attached is a copy of the photo media sheet with the photographs obtained during our virtual Claims Xperience inspection which took place on May 5, 2020. The information provided by John Titouah was provided verbally and not in a written form. The information contained in our claim file notes are not considered claim-related documents, as defined by Insurance Code Section 10082.3 and will not be provided." Again, kindly clear the conflicting contrary position. 3. Please write a clear denial letter on my claim on vandalism which coverage I discovered just only on November 4, 2020 when you belatedly furnished me with a copy of the policy which I requested far beyond on what is required by the regulation. 4. Your plumber informant is not authorized to search for pipe break on May 5, 2020. Your contention that huge excavation to search for pipe break on May 5, 2020 is not vandalism is out of order and had no legs to stand on. Your alibi that Titouah did a huge excavation to search for leak is a gross misrepresentation because he had already done the search for the pipe break some four days ago in his leak detection procedure and based on the heat signatures he had taken according to Titouah, assuming without agreeing, the pipe break is located some twelve (12) inches under the foundation. Likewise according to Titouah First American will not allow excavating deeper than ten (10) inches. Since he confirmed that the pipe break is some twelve (12) inches under the foundation and First American does not allow him to dig that depth. Therefore, he should not have come on May 5, 2020 anymore to excavate. The fact is though he is not authorized to do excessive excavation he still did it to satisfy your plan to make that huge excavation to produce a video footage of a huge excavation with a rigged no leak scenario for your benefit, to deny our secondary claim for damages. 5. With regard to the depth of the excavation made by Titouah, it is from four (4) to six (6) inches only. If you would want to dispute it, then please come again to the site and bring with you a ruler. I have preserved the excavation for farther investigation for you. If you refused to come then this dispute on depth measurement shall be resolved according to measurements we have taken invalidating the report of Titouah of eight (8) or nine (9) or ten (10) inches. 6. I vehemently object this paragraph 4 of your response, "Your email contains allegations of misconduct. All such contentions are denied. You should not interpret our silence as any agreement with you, or any waiver of our rights under the policy or law. We reserve all rights under the policy and the law. " Why? Because this paragraph had already been rendered debunked on Wednesday November 13, 2020 where I have proven through substantial evidence that when you feel that you have a valid argument to contradict my contentions you respond in comprehensive details but when you do not have any, you just remain silent and seek refuge on paragraph 4. Next is the email evidence dated November 13, 2020.
7. I am equally objecting to paragraph 2 of your response: "This claim file remains closed. Our position as communicated in our letters and responsive emails are unchanged. All conditions previously quoted still apply." Why? Because there is a pending criminal complaint against your informant that has to be resolved first before you close our claim file. Besides, I am still negotiating in good faith with you, whether you like it or not, although you are showing manifestations of continuing bad faith. TO WIT: FAILURE TO PROVIDE WRITTEN A CLEAR SUBSTANTIVE DENIAL DOCUMENTS CORRESPONDING TO THEM ARE CLEAR VIOLATIONS OF SECTION 2695.5. NUMBER 2. DELIBERATE INTENTION TO SOW CONFUSION. IT IS AN IMPROPER RESPONSE FOR RESPONDING TO EMAILS WITH DIFFERENT SUBJECTS WHICH TEND TO CREATE MORE CONFUSIONS. DENIALS AND ASSERTIONS NEEDED TO BE SUBSTANTIATED, OTHERWISE, CRIMINALS MERE SAYING EMPTY WORDS OF DENIAL AND STATEMENTS WOULD NEVER BE CONVICTED. CLEARER READING BELOW OF THE EMAIL SCREENSHOT ABOVE: Dear Mr. Buensuceso,
The email below has been received.
This claim file remains closed. Our position as communicated in our letters and responsive emails are unchanged. All conditions previously quoted still apply.
The one year “Suit Against Us” time period referred to in the May 6, 2020 letter includes the time period from the date of loss (April 26, 2020) to the date the claim was reported to State Farm (April 29, 2020). The one year time period was tolled during our investigation of this claim (April 29, 2020) to the date the claim was initially denied (May 6, 2020). The one year time period was tolled upon receipt of Antonio Buensuceso Jr.’s email dated May 29, 2020 for additional investigation until the date the denial of the claim was confirm in our June 12, 2020 letter. That one year time period continues to run as of the date of our June 12, 2020 letter.
Your email contains allegations of misconduct. All such contentions are denied. You should not interpret our silence as any agreement with you, or any waiver of our rights under the policy or law. We reserve all rights under the policy and the law.
Sincerely,
Louis
Louis E Gueniot III Claim Team Manager |
Wednesday, March 11, 2020
STATE FARM INAPPROPRIATE RESPONSE 69 DATED 11MAR21 11:42AM
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10 CCR § 2695.5
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