INAPPROPRIATE RESPONSE 53
RESPONSE TO EMAIL:
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.
DENIALS AND ASSERTIONS NEEDED TO BE
SUBSTANTIATED, OTHERWISE, CRIMINALS MERE
SAYING EMPTY WORDS OF DENIAL AND STATEMENTS
WOULD NEVER BE CONVICTED.
NOTE : INAPPROPRIATE CONFUSING RE, MR. GUENIOT AS USUAL, A LAZY RESPONSE RESPONDING ONCE TO MULTIPLE EMAILS WITH DIFFERENT SUBJECT MATTERS AND DISCUSSING ISSUES OUT OF THE SUBJECT BEING RESPONDED TO, A DELIBERATE AND WILLFUL AND WANTON AND INTENTIONAL VIOLATION OF SECTION 2695.5(b), NOTHING HAD BEEN DISCUSSED AND CLEARLY EXPLAINED. HE DID NOT EVEN SHOW IN THE PAGES 1 TO 45 OF THE POLICY BOOKLET WHERE THOSE INFORMATION CAN BE SEEN. AND WORSE, HE CONTINUES TO MISLEAD US ABOUT "ONE YEAR SUIT AGAINST US" PROVISION IN THE CONTRACT.
Section 2695.5. Duties upon Receipt of Communications(b) Upon receiving any communication from a claimant, regarding a claim, that reasonably suggests that a response is expected, every licensee shall immediately, but in no event more than fifteen (15) calendar days after receipt of that communication, furnish the claimant with a complete response based on the facts as then known by the licensee. This subsection shall not apply to require communication with a claimant subsequent to receipt by the licensee of a notice of legal action by that claimant.
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 CONTINUING MISREPRESENTATION, BAD FAITH
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.
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