benefits  case studies  

 

 
• An owner of an insurance agency refused to take a claim stating that the property was no longer insured immediately upon becoming vacant. Superior reported the incident to the Department of Insurance. The Department of Insurance sent a letter to the owner of the insurance agency requesting a response within 10 days. His response was that he gave Superior the phone number for the insurance company so Superior could file a claim,which wasn’t truthful. Upon receipt of this information Superior filed a claim with the insurance company and the agent himself was the one to inspect the damaged property and he was made to do so immediately because of his initial delay in taking a claim. Superior received a settlement quickly after reporting him to the Department of Insurance.

• A Superior associate was told by a claim examiner that a claim would be denied because the property was vacant when the damage occurred. Superior in turn sent a letter to the manager and received settlement within 2 days.

• Superior Associates have had a new claim examiners stall on settling a claim because they weren’t sure what documents they would need in order to settle. After explaining why they wouldn’t need any further documents they released settlement the same day.

• A denial was overturned by providing a signed affidavit from the maintenance company inspector. The affidavit stated that damages occurred within the policy period. Settlements have increased by providing to the adjuster scanned photos, and sometimes just a list of additional insurable damage discovered by Superior’s field reps that were not included on the scope.

• A fire damage claim was denied by the standard line carrier, stating that the fire was caused by vandalism. The claim was denied under the vacancy clause because the property was vacant for over 30 days. Superior was able to overturn this denial based on 2 issues 1. the clients knowledge of vacancy did NOT exceed 30 days before discovery of fire and 2. the client forwarded change in risk to the insurance company notifying the insurance company of the vacancy. The client had requested coverage for another client on a vacant property. The Insurance company reversed denial and the client received full policy limit, $85K.


• This client normally does not allow Superior to handle their insurance claims; however, they had no luck getting this claim settled, so as a last resort they forwarded the file to Superior. The insurance company was requesting excessive documentation and unwilling to budge regarding certain discrepancies in the maintenance company reports. After many attempts to work with the insurance company, Superior filed a hostile proof of loss on behalf of the client. Still no calls were returned by the insurance company, so Superior filed a complaint with the local department of insurance on behalf of the client. The claim was settled for $23K, which was used to do the repairs.


• An Insurance company refused to pay for some stolen items since these particular items were not on the original police report that was filed. Superior fought and received payment for these additional items ($472.09)


• An Insurer denied a claim due to a no policy in force at date of discovery of damage. Superior filed with the force placed carrier requesting backdating of the policy. The force placed carrier denied the claim because it happened during coverage. Superior went back to the insurer to refile the claim which was denied due to the 30-day vacancy clause. Superior then filed the claim with the forced place carrier again to get coverage under the blanket vandalism endorsement. With continued persistence by Superior Associates, Superior produced $8070.18 in insurance proceeds for the client.


• A major mortgage servicer sent a file to Superior asking for a CCE, stating that their hazard insurance department waited too long to follow up on a claim that was denied on the MORTGAGOR’S behalf (about a year). The insurer wouldn’t accept the claim . Superior would not accept the insurer refusing a claim. After a couple of phone calls to the insurer, the mortgage servicer received a check for over $40K, representing their payoff.