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Richard
Richard, Attorney
Category: Legal
Satisfied Customers: 46022
Experience:  Attorney with 29 years of experience.
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Hi I have a situation that I do not know how to handle. I reside

Customer Question

Hi I have a situation that I do not know how to handle. I reside in Michigan. I was in very secretive a relationship with a woman (I am also married to a man 20 yrs) and before she died she gifted some jewelry to me. She passed away in July 2012. I insured the jewelry in December 2012 because there had been multiple break ins in my community. At the time that I insured the jewelry I was asked to get appraisals and I was also asked to bring two of the five items into the insurance office because of their value. The insurance agent took pictures and a policy was started to insure my items. At the time I also told the agent that these Items were a gift to me because she had asked if one of the items was my wedding rings. I told her no. Fast forward a few months later and I was doing spring cleaning and I donated some items to the Salvation Army and realized a few days later that mistakenly one of the handbags that I used to store my jewelry was donated. I immediately phoned Salvation Army and they were unable to assist me. I called my insurance company and started a claim on March 7, 2013. My adjuster called back and told me that my claim was pretty cut and dry after she took an account of the details of my claim. She told me that I would be going to a local jewelry store to work with one of their reputable jewelers and she would call me back the following day. Since that time, I had not heard from her and I have constantly had to call to find out the status of my claim. The adjuster wanted me to provide proof that my lover was deceased and I provided a copy of her death certificate and I also was asked to provide a detailed description of the events that led to my loss via affadavidt, a receipt from my Donation to the Salvation Army, and Facebook posting of loved ones wishing my lover and her family condolences, all which I have provided. I called the insurance company again yesterday to follow up as I had not heard from the adjuster since I sent these items in (weeks ago). The adjuster told me that she would call me back today with an answer after she spoke with her supervisor. Today the adjuster called as promised and I am now being told that I need to prove that my lover owned these items and also the face that she gifted them to me. I am unable to do this because my lover is deceased (and the insurance company knows this) and I only know one person that was dear to her. I do not want to open up a can of worms within my own marraige because my husband is sick. He has a pacemaker and a defibulator. I was in the process of leaving my husband and then he fell ill and I maintained a secret life with my lover until she moved away to another state for a job opportunity (a few years ago). Our relationship was not a public one and it is a very private aspect of my life. I am upset to learn that the insurance company is giving me the run around and that my agent is fabricating the truth because I learned that she (the agent) supposedly told the insurance investigator that I told her that the jewelry belonged to my husband which I never told her. My daughter was also present at the agent's office when I insured the items. What can I do to help my claim and to get a fair outcome from this terrible situation? The adjuster told me that she has never run into so many roadblocks before in a case and she refuses to let me speak to her superior. I realize that I mad a terrible mistake but I cannot undo it. Please help me and how am I supposed to provide proof that my dear friend/lover owned these items, where she purchased from, and that she gave them to me. The adjuster told me that my case will remain open until June 18 and will be closed at that time if I cannot produce what they are asking for. I told her that I provided the jewelry and appraisals at the time of inception of the policy and I was never told that I had to prove that these items were gifted to me and whom gave them to me. If this was a stipulation of the policy and the insurance company insuring me then I would have not chosen to insure them with their company because I knew then and now that this is something that I cannot produce. Please help me.
Submitted: 1 year ago.
Category: Legal
Expert:  Richard replied 1 year ago.
Welcome! My goal is to do my very best to understand your situation and to provide a full and complete answer for you.

Good morning. The insurance company insured these items and is responsible for paying the claim. Had they had an issue regarding ownership, they should have cleared that up when they agreed to issue the policy. Since they issued the policy, they cannot now hide behind these excuses now that there is a claim filed. What you want to do here is raise the stakes on them. Write the insurance company a certified, return receipt requested letter and demand that they settle this claim pursuant to their policy within a short specified period of time or you will have no choice but to file a claim against them. I would be sure to mention you intend to file this claim as not only a breach of contract claim, but also as a failure to reasonably settle, which will entitle me not only to actual damages, but additional damages multiple times the amount of your actual damages as punitive damages. This is typically all you need to get this settled; but if not, file your suit.



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Richard, Attorney
Category: Legal
Satisfied Customers: 46022
Experience: Attorney with 29 years of experience.
Richard and 18 other Legal Specialists are ready to help you
Customer: replied 1 year ago.


Can you tell me if this is a common practice with the insurance company and why they are asking me to produce something that they have been aware of from the beginning of the claim that I cannot provide? Also can you tell me if I will be responsible for paying an attorney because I cannot afford to do so and if you are able to reccommend a lawyer in the michigan area greater Detroit) that is willing to get paid from the settlement or is this uncommon?

Expert:  Richard replied 1 year ago.
Thanks so much for following up. This would not be common practice, but the state insurance codes are in place to provide very punitive provisions for insurance companies that act in this manner. It's not uncommon, however, to deny claims because once denied so many insured's simply give up. You should never do that; those that are persistent usually always prevail because of the potential for punitive damages...it's cheaper for insurance companies to settle these and to avoid the bad publicity. You would recover your lawyer fees as part of your damages, but it would be a bit unusual for one to take this on a contingent basis. Under my terms of service with JustAnswer, I'm not allowed to make a specific recommendation, but I can give you direction. You would want to either contact the state bar association or your nearest law school for a referral. I prefer the latter because they take great pride in their graduates and will take a more personal interest in making sure your referral is a good one because it will be a reflection of the school.
Expert:  Richard replied 1 year ago.
Thank you so much for the positive rating! I appreciate having had the opportunity to serve you! If I can be of assistance to you in the future, just look me up and I will be happy to help!
Customer: replied 1 year ago.


Hi Mr. LegalBeacon,


 


I received a letter from State Farm that Stated the following:


 


There is a question as to whether State Farm Fire and Casualty Company is obligated to idemnify you under the policy for loss which is alleged to have occurred on or about March 6, 2013 at...(my address), because:


 


There is a question as to whether you have concealed or misrepresented any fact material to this insurance, whether before or after a loss.


 


For this reason(s) and for any other reasons which may become known, you are hereby notified that any action taken by State Farm Fire and Casualty Company or it's authorized representatives to investigate the cause of loss, determine the amount of loss or damage, or attempt to adjust any claim arising out of the alleged loss shall not waive any of the terms or conditions of the policy of insurance described above, nor shall such action waive any of your rights under the policy. If we do not hear from you to the contrary, we will assume that it is acceptable for us t continue handling the case on these terms.


 


The company does not intend by this letter, to waiave any polocy defense in addition to those stated above, but specifically reserves its right to assert such additional polocy defenses at any time.


 


Can you please explain what this letter is? I had a converstion with my adjuster the last time that we spoke and told her not to pursue my deceased lover's family because it was a private relationship and I would not want to open up something about their loved one that they were not privvy to prior to her death. This letter would have reached me before I put the letter in the mail that you advised me of. I thank you for helping me thusfar. Please help me to understand this. Again, their agent told them that at the beginning of the policy I supposedly said that the jewelry belonged to my husband. If that were the case I think it would have been easier to have my husband to vouch for the jewelry as opposed to a deceased woman.

Expert:  Richard replied 1 year ago.
Good morning. This is a letter explaining they have a right to investigate the claim. They only have a right to explain the loss, but not the ownership. They had an obligation to investigate your ownership when they issued the insurance. At this point, they only have the right to investigate the circumstances of the loss.
Customer: replied 1 year ago.


Thank you for your reply. So at this point what do I do just sit back and wait? I mailed them their certified letter this past Saturday asking for resolution of claim by May 7,2013. Even if State Farm talks to my deceased lover's family and they have no knowledge of our relationship or any other details would this be a cause for them to deny my claim?


Also please explain what you mean when you say : They only have a right to explain the loss, but not the ownership.


 


Thank you again.

Expert:  Richard replied 1 year ago.
You're welcome. Yes, I would. At this point, they can only deny your claim if there is some kind of fraud in the loss of these items...i.e., the circumstances under which the items came to be lost; They cannot challenge now the fact that you own the insured items or how you came into ownership.

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