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  1. Join Date
    Aug 2008
    Posts
    766
    #21
    di ba dapat covered parin kahit own damage? yung kilala ko nasa report nakatulog pero yun nereplace parin ng bago since total wreck.

    yung isa pa kilala ko reported din nakabangga kahit wala pa lisensya kahit student. pero kinover din.

  2. Join Date
    Aug 2010
    Posts
    3,527
    #22
    Yep. Dapat covered parin kahit own damage. As shadow stated earlier, even theft is covered. The point here is that the threadstarter has no good evidence of the case that's why the insurance company does not like to pay off the damage and assumes that it is of fraud.

    Personally, I think it's time to get some help with a lawyer. However, put suing the insurance company as your last card since we all know how long the process goes.

    As people here said, get 3 friends or so that can prove that it was a hit-and-run case. Get their stories and affidavit and I'd say that insurance denial seems pretty weak now. At the same time, it wouldn't hurt for us to flame them in the forum.

    For what it's worth, 3 times na ako nabanga in 2011 with total damages costing 150k. Still, binayaran parin ng insurance ko (since they're been our insurance for a long time now).

  3. Join Date
    Jul 2010
    Posts
    353
    #23
    kung in-house ang insurance mo dapat alalayan ka ng sales agent / dealer mo unless sarili mo ang insurance (not in-house). worst case try to get in touch with insurance commission kasi kahit wala police report basta may notarized affidavit acceptable na yan

  4. Join Date
    Feb 2011
    Posts
    5
    #24
    Salamat sa lahat ng nagreply.

    First- Hindi sya inhouse, Apparently the agent got an insurance from Peoples instead.
    Second- It should have been covered,kasi comprehensive sya and I submitted all docs. I also submitted the pictures of the Car with the damage, in fact, asa casa na and my dealer forwarded the estimate to them,

    As far as the advise goes, these is what I have gathered:

    -Seek the help of the attorney
    -Get at least 3 witness to submit an affidavit to prove that we were there
    -Submit my response to them

    Gano katagal bago maprocess yun? Mas matagal ba? And if ever I loose, hahaba pa ba ang usapan and will they file a criminal case? Ganon ba talaga kahassel to?

  5. Join Date
    Apr 2010
    Posts
    235
    #25
    Seeking the help of an attorney should only be your last recourse. Mapapagastos ka lang niyan. Its better to just report it to the insurance commission. First of all, this is definitely claimable, so siguradong panalo ka sa insurance commission, if ever na umabot dun. Unfortunately you got your insurance from Peoples Gen, which is very very very notorious in the insurance industry.. Meron pa nga siyang thread dedicated just to it!, as indicated by another forumer here. Do you know your agent personally? Bakit niya ipinasok dun?? Mas malaki nga ang commission ng agent dun pero if magkaibigan nga kayo, he shouldnt have put your car's insurance there. Kaya nga normally naka tie-up ang peoples sa mga casa kasi walang iniintindi naman ang mga dealer sa claim ng ganung magnitude. You should push your agent to help you.

    A notarized affidavit should have been good enough, since there were no third parties involved. Yes, meron ngang mga ganung racket of big claims para mareplace daw mga parts. Especially if the unit is already old. What you have going for you though is that the unit is relatively new, so there should be no reason why you should do that. Obviously what peoples is doing to you is plain harassment.

    Normally, kung ganung kalaking damages, it could take mga 1-2 weeks for the insurance to issue an LOA. Depende na rin yan sa parts availability.

    Why do you think you will lose? May masama ka bang ginawa? In fact, kahit may masamang intention ka, if they have no proof to show, they will still have to pay you. There is simply no reason how you can lose this case.

    No, normally hindi ganung kahassle mag claim.Hassle lang schedule mo kasi you cant use your car.

    Next year, do not get from peoples. You know who to look for. Im just here.

  6. Join Date
    Sep 2005
    Posts
    15,326
    #26
    yang LOA depende sa insurance company yan eh.. merong iba sobrang tagal maglabas.. yung kaibigan ko nung pasko lang nagaway sila nang misis nya binangga nya yung car sa poste.. wasak.. dec. 24 yun.. dec. 27 may LOA na..

  7. Join Date
    Oct 2002
    Posts
    17,340
    #27
    Quote Originally Posted by _Qwerty_ View Post
    yang LOA depende sa insurance company yan eh.. merong iba sobrang tagal maglabas.. yung kaibigan ko nung pasko lang nagaway sila nang misis nya binangga nya yung car sa poste.. wasak.. dec. 24 yun.. dec. 27 may LOA na..
    In my case, with Malayan Insurance a couple of years ago. Since the shop i brought my car in for the bumper repair was accredited, they did not wait for the LOA anymore and got the go signal to proceed with the repairs.

    I always course my insurance purchase through a reputable insurance brokerage, and not just mga ahente. I usually have more prompt service.

    Go ahead and consult your lawyer as he can legally guide you on how to reply to the insurance company; hindi yan aabot sa kasuhan once they get a reply from you that is properly worded and has good legal basis to the contract you have with them in your insurance policy. And yes, own damage na labas nyan; it's a new car and you had the policy since day one since it's mortgaged to the Bank so why the hell would they surmise that you would want to bump your car and defraud them? Usually suspicion will arise if the case was you never had comprehensive coverage for quite sometime already and then you suddenly avail of insurance coverage then claim a large, own damage soon after.

  8. Join Date
    Oct 2002
    Posts
    40,038
    #28
    hinde ko talaga maintindihan kung bakit meron fraudulent claim? whether it's a hit and run or the TS intentionally destroyed his car. eh dapat bayaran ng insurance niya, as long as he will pay for the participation.

    my insurance company ang LOA withing 1 hour binibigayan na ako as soon as na submit ko yun documents. lagi naman own damage ang na claim ko sa kanila...notarized affidavit, photos and quotation from casa, pag submit ko...intay lang ako for them to prepare the LOA nakukuha ko agad...

    kahit yun isang time nabangga ako ng taxi, I told them not to collect or call the taxi company until I got the payment from them to covered my deductible and they obliged aftet ko makuha yun pera. sabi ko padalhan na nila ng letter at singilin...doble tuloy gastos ng taxi compant dahil sabi ko ako na mag claim ng own damage sa insurance ko bayaran nila sa akin participation ko pumayag sila then wala naman silang pinapirma sa akin na settled na kami...after ko makuha submit ko lahat ng police report and photos sa insuranc eko ang lumalabas na kasalanan ng taxi..kaya siningil pa rin sila ng insurance...

    ewan ko kung kaya mabilis dahil katabing building lang namin office namin yun office ng insurance company ko kaya open palang sila andoon na ako I can wait all day kung papatagilin nila...I can just go back to the office and eat my lunch then balik na ako ulit sa insurance company...alam kasi nila na katabi lang kaya siguro binibigay na sa akin para umalis na ako at hinde na magtambay sa kanila... kung gusto nila pwede pa nga ako magpa dala sa messenger ng pagkain para hinde na ako lumabas...

  9. Join Date
    Sep 2005
    Posts
    15,326
    #29
    based sa story kasi nang TS.. nagsagawa din nang investigation ang insurance company and wala siguro makapag sabi na may nangyari ngang hit and run or may nakakita nung sasakyan kasi madaling araw na nga.. baka inalis kasi agad that same time.. so obviously walang alam yung mga nakatira don.. so negative yung investigation so they jumped to a conclusion na may FRAUD.. at pag may FRAUD... deny talaga ang insurance claim..

    parang sa theft.. matagal ang investigation kasi they make sure hindi kagagawan lang nang owner yung theft.. pwede kasi setup lang yung theft.. para mapalitan yung car.. so pag may nakita silang kahit katiting na suspicion.. or may mali sa story.. yan.. FRAUD din.. so deny din ang claim..

    pareho din yan pag mag claim ka nang damage.. sa isang panel.. tapos sabihin mo kasama yung isang panel.. pag kapani paniwala yung story or affidavit.. usually approve yan.. pero pag malabo or medyo kahina hinala ang story.. isang panel lang ni a approve nila... yung isang panel.. denied..
    Last edited by _Qwerty_; January 12th, 2012 at 10:33 AM.

  10. Join Date
    Feb 2011
    Posts
    5
    #30
    yung police report qunequestion nila.. Kasi parang malabo at hindi malinaw nakastate sa ploice report. january 4 ko nakuha letter and d pa ko nakakarespond kasi nacocunsult ako ng tulong. Ill get a sworn statement with affidavit from the witness that I have and send it back.

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Denied Insurance Claim- Help!