Contract Issues - A failure to honor a contract or agreement Problem: I filed a claim for a sudden burst of water that occurred in my home on 4/30. The insurance company has denied claim number A1191 stating that it is not peril. The incident was a sudden burst/explosion of water from my upstairs bathroom and I prudently turned off the main water supply and reported the incident as soon as possible. I immediately called a restoration company that provided a service to start drying up the water in the ceiling and carpet the night of the incident. I received a denial letter from the insurance company and mailed them a letter as follows: Claim number A1191 Dear Standard US Lloyd's Insurance Agency, I have recently received a letter from you that states that you have denied my insurance claim stating that the adjuster has not determined that the cause of damage was related to a covered peril. According to my policy information section I number 4 lists that a covered peril is explosion. On April 30 at approximately 2230 my wife and I heard a loud explosion while we were sitting on the patio in the back yard. Within 5 minutes we walked into the living room from the back yard and observed water streaming through the kitchen and living room ceiling onto the bar and floor. I immediately tried to find the source of the damage. I went upstairs into the guest bathroom and discovered the lid to the toilet laying on the ground and water on the floor of the bathroom. I observed that a part to the float system was broken in two in what appears to have occurred from a considerable amount of force or pressure. I next went into my front yard and turned off the main water valve to shut of water flow to my house and prevent further damage and then turned on several faucets to drain the water in the system to prevent further damage. I then attempted to call your agency and discovered that you do not have a calling system set up to report claims after normal business hours and therefore had to wait until the next business day to report my claim via the telephone. I later filed a request online with your website. I request: 1.) A complete copy of the inspection report associated with this claim. 2.) A full copy of my policy. (I have only ever received what appears to be a single page face sheet of the policy.) 3.) A copy of the appeals/complaints process with the agency that regulates your business. Please respond within 5 business days. Sincerely,
Justin R Smith
I received another letter stating that my policy will not cover a sudden burst of water. I have been told by multiple people working in the insurance business and in the homes repair business that a "sudden burst of water" should be covered by any policy.
I am currently fighting this issue with the insurance company. For anyone else out there that has been wronged by US Lloyds Standard Insurance Company please report it.
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