Claim Number 55-06c6-44x STATE FARM DENIAL LETTERS
ANALYSES AS MANIFESTATIONS OF BAD FAITH
JULY 2, 2020
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
STATE FARM DENIAL LETTERS ANALYSES
AS MANIFESTATIONS OF BAD FAITH
Dear Mr. Liu:
1. May you please consider the following comments and observations before you write your third denial letter to the claim I filed in your office.
A. ON DENIAL LETTER DATED MAY 6, 2020
ON PAR.2 May 6, 2020You wrote,
As discussed, based on the virtual inspection through my computer on May 5, 2020,the visible damages were viewed, photographed and confirmed. The virtual inspection showed a live stream through the plumber's cell phone and the pipe break was documented.
COMMENTS:
1. You wrote,
virtual inspection through my computer on May 5, 2020,
How would you be able to do your investigation diligently in just staying in the comfort of your office? You should have come to the site as soon as possible where the event actually happened to have a thorough study of this claim and correspondingly respond to your customers needs. You failed miserably on this aspect and I believe this is a violation of the covenant of good faith and fair dealing between us.
2. You wrote,
the pipe break was documented
John Titouah did not see the pipe break. Hence, he can not make a documentation of an event he did not see. It is us who saw the pipe break and had the pipe break documented.
ON PAR.3 May 6, 2020
You wrote,
All Express Plumbing identified through leak detection the location of the break by picking up "heat signature" of the broken pipe and confirmed the break to be on the hot copper pipe under the Hallway concrete slab more than twelve inches down. The plumber indicated after digging down approximately ten inches that he would not dig any further as the home warranty firm does not cover any further digging and recommended to abandon this old run of water lines under the slab and to re-route the line above the slab. COMMENTS:
1.You wrote,
confirmed the break to be on the hot copper pipe under the Hallway concrete slab more than twelve inches down
John said the break under the Hallway concrete slab was more than twelve inches down without actually reaching that depth but he missed out the break at the depth of six inches which he had actually reached. How would you believe that statement by John that the break is down below 12 inches where the break is just 6 inches down he failed to see?
2.You wrote,
John recommended to abandon this old run of water lines under the slab and to re-route the line above the slab.
STATE FARM and you believe John Titouah but First American and I did not.
ON PAR.4 May 6, 2020 You wrote,
Through the live video stream, the area exposed and dug out clearly shows the break below the sill plate of the wall framing, no breaks in the riser portion of the water lines and more than twelve inches below the floor level in a location which the pipe can only be "located" below the concrete foundation within the native soil.
COMMENTS:
You wrote,
no breaks in the riser portion of the water lines
How would you be able to believe him that of a break located more than 12 inches below the concrete foundation within the native soil but the break in the riser portion just 6 inches deep he had failed to see?
This manifestation clearly shows that you failed to thoroughly study the claim presented before you. I believe this is a violation of the covenant of good faith and fair dealing between us.
ON PAR.5 May 6, 2020 You wrote, Due to the fact that all potential causes of the break to the pipe would be excluded, never a large volume of water into the interior of the home, and the access and confirmation of the location of the break by the plumber, the predominant cause of the water damages would be wear, tear, deterioration, corrosion, or latent defect of the copper water pipe under the slab. COMMENTS: You wrote, the predominant cause of the water damages would be wear, tear, deterioration, corrosion, or latent defect of the copper water pipe under the slab. Your statement as a conclusion of a fact not supported by pertinent investigation. Are you able to see, examine the pipe if in fact there is wear, tear, deterioration, corrosion, or latent defect of the copper water pipe under the slab? You did not even bother to see our house and just let John Totouah do the adjusting work for you. You did not make a comprehensive, thorough investigation of this event and make your decision on just one side of the story favorable to you and you did not verify if those information fed to you are actually true and not made out lies webbed by your informant. This, I believe, is a violation of the covenant of good faith and fair dealing between us. ON PAR.6 May 6, 2020 The plumber has confirmed verbally three times to me that the location of the pipe is located under the foundation. COMMENT: You wrote, confirmed verbally three times to me He may confirm to you a lie a million times but that does not change the fact that the break as we discovered it, is on the pipe encased in the slab not on the line located under the foundation. This manifestation clearly shows that you failed to thoroughly study the claim presented before you. I believe this is a violation of the covenant of good faith and fair dealing between us. ON PAR.7 May 6, 2020 You wrote, Unfortunately, this type of water is defined as "water below the surface of the ground" and the manner of the discharge was a continuous and repeated leak over a period of time. Both of these causes are specifically excluded under your policy. COMMENTS: You wrote, "water below the surface of the ground" Assuming without agreeing that there is water below the surface of the ground but that can not invalidate the fact there is a pipe break we discovered above the surface of the ground, on the riser of the hot water line in particular, which caused the sudden outburst of water in the hallway. Hence, it is a pipe break not below the surface of the ground and therefore, should be covered by the policy. B. ON DENIAL LETTER DATED JUNE 12, 2020 ON PAR.2 June 12, 2020
You wrote,
As outlined in our May 6, 2020 declination letter, the predominant cause of the water damages was wear, tear, and deterioration to the forty one year old "hot" side copper water line located under the concrete foundation which resulted in a continuous and repeated seepage of water below the foundation, eventually migrated upwards and manifested itself on the date of the discovery to the interior of the home. My virtual inspection on May 5, 2020, the photographs of the excavating of the pipe, multiple discussions with All Express Plumbing, his written report and a detailed follow up conversation with the plumber, John Titouah on June 5, 2020 confirmed all the original facts of the loss. COMMENTS:
You wrote
the predominant cause of the water damages was wear, tear, and deterioration to the forty one year old "hot" side copper water line located under the concrete foundation
This is a conclusion based only on conjectures not supported by scientific study, research, experiments and observations. You should have first presented a study about the subject then based on that information which you have gathered and presented it is only then that you could make conclusions of fact related to it. But, you have to take a sample of the pipe, the adjacent materials adhered to it, etc. and ask an expert in that kind of endeavor to analyze it and draw conclusions for you. In fact, if you just did simple research, GOOGLE has a quick answer for you.
This manifestation clearly shows that you failed to thoroughly study the claim presented before you. I believe this is a violation of the covenant of good faith and fair dealing between us.
ON PAR.3 June 12, 2020
You wrote,
The original leak detection was performed and the approximate location of the broken pipe was pin-pointed with a heat signature which plumbers utilize to locate slab leaks. The accuracy when it is a hot water pipe is within one foot on the either side of the break. The virtual inspection and photographs clearly show that the plumber had already dug down eight to nine inches from the floor level, your concrete foundation was very thick and difficult to excavate, and at that point, the most prudent method of repair would be to cap and abandon the leaky run of pipes and re-route it above the concrete slab foundation. The location of the break on the hot side is definitive at this point as there are no vertical risers or manifolds in the middle of the floor and the plumber has substantiated beyond a doubt the location of the broken pipe and the fact is it was below the concrete foundation.
COMMENTS:
1. You wrote,
eight to nine inchesThe excavation depth now tapered down to eight to nine inches compared to ten inches on PAR.3 of May 6, 2020 DENIAL LETTER. inconsistent statements.
ACTUAL DEPTH MEASUREMENT IS 4 TO 6 INCHES ONLY.
This manifestation clearly shows that you failed to thoroughly study the claim presented before you. I believe this is a violation of the covenant of good faith and fair dealing between us.
2. You wrote,
there are no vertical risers or manifolds in the middle of the floor
True, there are no vertical risers or manifolds in the middle of the floor. How will you find vertical risers or manifolds in the middle of the floor? Why would the architect place the vertical risers and manifolds in the middle of the floor? This is the problem of doing adjusting work in your office table only.
This manifestation clearly shows that you failed to thoroughly study the claim presented before you. I believe this is a violation of the covenant of good faith and fair dealing between us.
ON PAR.4 June 12, 2020
You wrote,
As far as State Farm's relationship with All Express Plumbing and John Titouah, all insurance carriers after a water loss has been immediately contacts and discusses causation and location of pipe breaks. It does not matter which plumber is called, who they worked for, and what they charge, the only way to confirm the Predominant cause of water losses is to contact and discuss the facts of the discharge directly with the plumber who discovered, located, and repaired the leak. In regards to the costs of a re-route, that would be up to the discretion of the Insured.
1. You wrote,
what they charge meaning, in other words, plumber John charges fees and you paid him in return for his rigged live video presentation and fraudulent statements. How much did he charge you and the amount you paid him?
2. You wrote,
to contact and discuss the facts of the discharge directly with the plumber who discovered, located, and repaired the leak.
Why talk to John Titouah extensively and rely heavily on his statements?
John Titouah, Yes he is a plumber. But he is not the one who discovered the leak. It is us. He is not the one who located the leak, It is us; and he is not the one who repaired the leak. Hence, John Titouah is not the right person to talk to but us. So talk to us not John.
This a manifestation of a biased, partial and improper investigation of the case presented to you. I believe this is a violation of the covenant of good faith and fair dealing between us.
ON PAR.5 June 12, 2020
You wrote,
Slab pipes after a certain age will begin to degrade and eventually start leaking slowly under the foundation. Some people will access the pipe below their foundations, jackhammer the concrete, cut out the section of broken piping, spot repair it, solder a new piece of copper back, and backfill the concrete.This method chosen by a lot of people would not remedy the problem long term as once the a certain section of copper below the foundation breaks it is more likely another section in the same run will also go bad. The alternative for a long term fix is to re-route the lines out of the slab and into the walls.
You wrote,
The alternative for a long term fix is to re-route the lines out of the slab and into the walls. If you happened to be a First American Home Warranty claim specialist you are on the right track. You have a lot of good points to consider and those points are laudable. But you need to realize that you are a State Farm Home Insurance not First American claim specialist and being one you must concentrate on issues basically on the matter pertinent to my claim presented to you. You are in fact meddling issues and your actions as we see them are intentionally committed, confusing us to delay the proceedings. It is worthwhile to note that there is a pending issue of our complaint against John Titouah which we think you need to resolve as soon as possible but here you are consuming your precious time and ours too, delving into matters beyond your jurisdiction. AND, NUMBER 1, YOUR FAILURE TO SHOW ME POSITIVE ACTIONS TO HELP ME TO SECURE JUSTICE AGAINST JOHN TITOUAH'S FRAUDULENT ACTIONS TO BOTH OF US OR TO US, IS A BLATANT MANIFESTATION OF THE VIOLATION OF THE COVENANT OF GOOD FAITH AND FAIR DEALING BETWEEN US. AND NUMBER 2, IT MAY ALSO BE INFERRED AS YOU MIGHT BE A PARTY TO HIS CRIME FOR YOUR DELIBERATE HESITATION TO PROSECUTE HIM FOR NOT SHOWING US ACTIONS GEARED TOWARD HIS CONVICTION. WORSE, YOUR ACTS AND OMISSIONS TENDS TO SHOW EFFORTS TO EXONERATE HIM. AND NUMBER 3. AS AN INSURANCE COMPANY YOU HAVE THE DUTY TO STOP INSURANCE FRAUD AND JOHN TITOUAH'S FRAUDULENT ACTS VICTIMIZED BOTH OF US. IN MY PART I HAVE REPORTED HIS CRIME TO CONCERNED POLICE AGENCY AND FILED THE NECESSARY COMPLAINT FOR THEM TO START POLICE INVESTIGATION BUT IN YOUR PART YOU HAVE FAILED TO SHOW ME CONCRETE EFFORT TO PIN DOWN JOHN TITOUAH OR AT LEAST REPORT HIS CRIME TO THE POLICE FOR IMMEDIATE INVESTIGATION. I believe these are violations of the covenant of good faith and fair dealing between us. ON PAR.6 June 12, 2020
You wrote,
As far as the statements made in paragraphs #12 and #18 of your Email, I have no facts indicating those actions were taken. If you wish to pursue a criminal action against the plumber or First American Home Warranty, that would be your decision.The facts of the location of the pipe and the manner of the water discharge in relation to your Condominion Unitowners Policy, FP-5956CA are clear and unfortunately would not be covered. COMMENTS:
You wrote, If you wish to pursue a criminal action against the plumber or First American Home Warranty, that would be your decision.
Misplaced assertion. It should be you, State Farm and me against John Titouah. BECAUSE WE ARE THE VICTIMS OF HIS FRAUDULENT ACTS. State Farm and you did adverse actions against us due to his rigged fraudulent live video presentation, pictures and statements which you relied on to deny our insurance claim. However, though John Titouah might have shown the same live video footage, pictures and statements to First American Home Warranty, but they did not show manifestations that they were persuaded by him unlike you. In fact, First American sent us a message that John Titouah's scope of work to be done is to access the pipe in the concrete slab and repair pipe.
I believe this is a violation of the covenant of good faith and fair dealing between us.
ON PAR.7 June 12, 2020
You wrote,
Please refer to our May 6, 2020 correspondence and specifically the one year suit conditions begins to run again as of the date of this letter.
COMMENTS:
You wrote,
the one year suit conditions begins to run again as of the date of this letter.
This letter is dated June 12, 2020. THANKS FOR THE REMINDER.
END OF OBSERVATION AND COMMENTS TO DENIAL LETTERS DATED MAY 6, 2020 AND JUNE 12, 2020 RESPECTIVELY AS MANIFESTATIONS OF BAD FAITH BY STATE FARM HOME INSURANCE. I RESERVE MY RIGHT TO SHOW MORE IN DUE TIME.
I would like to thank you for your patience for effort reading my comments and observations.
Yours faithfully,
Antonio L. Buensuceso
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