STATE FARM RESPONSE ON WATER DAMAGES (VANDALISM) DATED 13NOV20 7:42AM

STATE FARM RESPONSE  DATED 13NOV20 7:42AM EXCAVATING A PORTION OF THE CONCRETE TO SEARCH FOR THE LEAK IN A SUPPLY LINE TO "FIX IT" IS NOT AN ACCIDENT......... RESPONSE TO EMAIL: Claim Number 55-06c6-44x WATER DAMAGES BASIS OF DENIAL DATED 8NOV20 7:57AM WATER DAMAGES BASIS OF DENIAL. PLEASE EXPLAIN IN PLAIN STATEMENTS THAT WE COULD UNDERSTAND THE BASIS OF THE WATER DAMAGES DENIAL AND SHOW WHERE IN PAGES 1 TO 45 OF THE POLICY BOOKLET IT IS WRITTEN. CLEARER READING BELOW OF THE EMAIL SCREENSHOT ABOVE: Dear Mr. Buensuceso,   I’m writing to acknowledge receipt of the email below along with other emails from you since my last response to you on November 4, 2020.   We previously addressed your allegations of misconduct by John Titouah as referenced in your May 29, 2020 email in our June 12, 2020 and July 13, 2020 letters, along with our responsive emails.  Our May 6, 2020 correspondence stated that we insure for accidental direct physical loss to the property described in Coverage A.  The retaining of a plumber to “fix a leak” that results in the plumber, John Titiouah, excavating a portion of the concrete to search for the leak in a supply line to “fix it” is not an accident, and it is not vandalism to personal property as defined in the policy section included in your November 7, 2020 email.     This claim file remains closed.  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.  Our position as communicated in our letters dated May 6, 2020, June 12, 2020, July 13, 2020, July 17, 2020, July 31, 2020 and responsive emails are unchanged.  The May 6, 2020 letter included the applicable policy language.  All conditions previously quoted still apply.    We are required by California Insurance Regulations, Section 2695.7(b)(3), to advise you that if you believe this claim, or any part of this claim, has been wrongfully denied or rejected, you may have the matter reviewed by the California Department of Insurance, Claims Service Bureau, 300 South Spring Street, Los Angeles, California 90013, telephone 800 927 4357.   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 emails contain 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 State Farm General Insurance Company NOTE: ON PARAGRAPH 2, MR. GUENIOT  WROTE ,  We previously addressed your allegations of misconduct by John Titouah as referenced in your May 29, 2020 email in our June 12, 2020 and July 13, 2020 letters, along with our responsive emails.  Our May 6, 2020 correspondence stated that we insure for accidental direct physical loss to the property described in Coverage A.  The retaining of a plumber to “fix a leak” that results in the plumber, John Titiouah, excavating a portion of the concrete to search for the leak in a supply line to “fix it” is not an accident, and it is not vandalism to personal property as defined in the policy section included in your November 7, 2020 email.   SPECIFICALLY: The retaining of a plumber to “fix a leak” that results in the plumber, John Titiouah, excavating a portion of the concrete to search for the leak in a supply line to “fix it” is not an accident, and it is not vandalism to personal property as defined in the policy section included in your November 7, 2020 email.  I AM SORRY, I AM CONFUSED. KINDLY EXPLAIN WHAT  DO MEAN PRECISELY WITH YOUR STATEMENT :  "John Titiouah, excavating a portion of the concrete to search for the leak in a supply line to “fix it” is not an accident, and it is not vandalism to personal property....." I WILL REWRITE THE STATEMENT HERE  FOR CLARITY.  "John Titouah excavating a portion of the concrete to search for the leak in a supply line to "fixit"is not an accident, and is not vandalism to personal property.....",

Claim Number 55-06c6-44x WATER DAMAGES BASIS OF DENIAL DATED 8NOV20 7:57AM

NOVEMBER 8,  2020 LOUIS E. GUENIOT TEAM MANAGER GORDON LIU CLAIM SPECIALIST STATE FARM HOME INSURANCE RE: Claim Number 55-06c6-44x        Policy Number 77-C3-B499-7 DATE OF LOSS: April 26, 2020 WATER DAMAGES BASIS OF DENIAL    Dear Mr. GUENIOT: MAY I MOST RESPECTFULLY REFER YOU TO : 1.Section 2695.5. Duties upon Receipt of Communications (e) (2) (e) Upon receiving notice of claim, every insurer shall immediately, but in no event more than fifteen (15) calendar days later, do the following unless the notice of claim received is a notice of legal action: (2) provide to the claimant necessary forms, instructions and reasonable assistance, including but not limited to, specifying the information the claimant must provide for proof of claim. 2.  FROM PAGES 1 TO 45 OF THE INSURANCE POLICY BOOKLET YOU PROVIDE US WITH ON NOVEMBER 4, 2020 PLEASE KINDLY SHOW US ON WHAT PAGE OR PAGES WHERE THE DENIAL OF OUR CLAIM IS BASED. PLEASE EXPLAIN IT TO US IN PLAIN STATEMENTS THAT WE COULD CLEARLY UNDERSTAND. Please acknowledge receipt of this e-mail and kindly inform me when I should expect a reply to this email AND kindly put back the following reminder to your response which had been missing for quite some time. PLEASE RESTRICT ISSUES AND ANSWERS WITHIN THE CONTEXT OF THE SUBJECT MATTER TO AVOID INAPPROPRIATENESS. Please be reminded that your DENIAL LETTER DATED MAY 6, 2020 was prepared, relayed to us, sent and read by us in just a few minutes. Thank you very much. Yours faithfully, Antonio L. Buensuceso