Insurance scam

[MrBMG]

Jurisdiction

Nevada

Hello,

My wife and I are newlyweds who moved to Las Vegas from California a couple weeks ago. We purchased our first home together to start a new life in Las Vegas and begin our family.

On 6/29 we closed escrow and along with our home we purchased a home warranty through National Home Warranty (who are located in Las Vegas)to cover our appliances that came with the home. I was issued a policy number and the policy became effective close of escrow (the policy was originally ordered on 6/21).

We moved in on 6/30 and found that the refrigerator was not working. Of course I called NHW to file a claim, they took my claim, issued me a claim number, began processing and sent a service technician to my home to investigate the fridge. On 7/3 the technician arrived, determined the fridge was a total loss and recommended to NHW that it needed to be replaced.

Once NHW found out that the refrigerator needed to be replaced they claimed I never had a policy and would not cover it. They claim that even though payment was made to them via escrow on 6/29 and even though they took and processed my claim that they didn't actually receive payment until 7/5 and therefore I don't have a claim. I even received an email, which I still have, from their insurance agent stating that if the repair had been inexpensive they would have covered it but since it's a total loss they are choosing to not honor my policy. How is that ethical or legal? By taking and servicing my claim aren't they making the policy binding or implying coverage?

If I didn't have a policy why would they have issued me a policy number, taken my claim, issued a claim number, and paid a technician to come to my home investigate what repairs were needed? It's only when they realized when they were going to have to replace the fridge that they decided to not cover it. I looked into their reviews and it seems they have a long history of unethical behavior.

Please help! This is fraud and insurance bad faith.

 

[army judge]

Please help! This is fraud and insurance bad faith.

You can speak with a lawyer about this matter.

Frankly, buying a new refrigerator is going to be cheaper and quicker than a lawsuit.

There are no magic words, magic dance, incarnation, get right song, or anything anyone can do, except sue the insurer; which is probably prohibited by your insurance policy anyway.

You could use the mediation explained in the policy, but that would take months to be resolved with you losing again.

The rip off isn't the NO you received, its the crooked home warranty scam you bought.

 

[hrforme]

and the fact that the previous homeowners sold you a house in which the frig was probably already having issues. Around here, you take your frig with you. So that also could be the insurance company's perspective since it died possibly prior to closing or day off....coincidence would be a bit odd.... Usually those policies are meant for things that die within the first year, not that are dead on the first day.

 

[adjusterjack]

This is fraud and insurance bad faith.

People frequently come here and say fraud and bad faith like it's some sort of magic incantation that automatically brings divine punishment down on the perpetrator, when more often than not it's a simple breach of contract issue (if there was a contract). An allegation of fraud requires proof of intent to defraud and breach of contract requires only that there was a contract and that it was breached and that there where damages from the breach.

If you want to go the fraud and bad faith route you will need a lawyer and regular court. The lawyer will want a nice retainer and $300 per hour.

If you want to go the breach of contract route you can do it in small claims court for the price of the refrigerator and without a lawyer.

I suggest suing both the company and the agent that wrote you that email.

 

[army judge]

I suggest suing both the company and the agent that wrote you that email.

Usually an insured agrees NOT to sue the insurer for a dispute.
The insured agrees (revealed & hidden in the policy) to go to mediation, which is usually not cheap, nor quick, nor rewarding.

 

[adjusterjack]

Usually an insured agrees NOT to sue the insurer for a dispute.
The insured agrees (revealed & hidden in the policy) to go to mediation, which is usually not cheap, nor quick, nor rewarding.

Your right. My bad. I should have looked for a sample policy before sticking my foot in my mouth.

However , I do appear to be vindicated as I found a sample policy on the company's website and here's what it says:

K. ARBITRATION
By entering into this Agreement the parties agree that all disputes in excess of applicable small claims court jurisdictional limit shall be arbitrated by the American Arbitration Association in accordance with its rules for consumer disputes. The parties further agree that they are giving up the right to a jury trial, or any other legal action. All disputes or claims between the parties arising out of the agreement or the parties' relationship shall be settled as follows:
1. Small claims court; for claims within the applicable small claims court jurisdictional limit, or
2. Final and binding arbitration held in the county of the covered property address (or other location mutually agreed upon by both parties) for claims in excess of the Small Claims Court jurisdictional limit.

http://www.nhwusa.com/images/07-2017-NV-HOMEOWNER-SAMPLE-CONTRACT.pdf

OP does have the option of suing in small claims court if the amount is within the small claims limit which is $10,000 in Nevada.

Unfortunately, I also found this in the policy:

B. COVERAGE PERIOD
COVERAGE IS EFFECTIVE 30 DAYS FOLLOWING RECEIPT OF PAYMENT BY NHW. The term of this contract as defined in Section C, subject to the provisions of Sections F, G, H, I and J, and specified on the Declaration of Coverage (document entitled "Declaration of Coverage" NHW sends to the Holder after receipt of payment of the Premium, which is incorporated herein and a part hereof). The Service Contract term (effective and expiration) dates will be confirmed and indicated on the Declaration of Coverage, mailed to you upon our receipt of payment.

OP will have to read his policy to determine the actual effective date shown on the declarations page.

 

[army judge]

OP will have to read his policy to determine the actual effective date shown on the declarations page.

As you have said a time or two, answers are to be found by reading the policy.