HELP: Commonwealth Insurance denying coverage

[polar01]

Pinapahirap ninyo kaso pag claim eh since you have comprehensive insurance, kung na involved kayo sa accident whether it's your fault or not just claim it sa insursnce ninyo and let them handle everything.

Gumugulo kasi bakit pa ninyo gusi ipasagot doon sa nakabangga yun participation ninyo saka bakit kailangan pang meron additonal na allowance?


Never ako humingi ng participation pay sa nakabangga sa akin and I don't care kung meron siya insurance or wala. Bahala siya makipagusap sa insurance ko basta papasok ko na sa casa as soon as possible para magawa na.

Kung wala siya insurancd the it's not my fault hinde ko na rin entertain kung nakikiusap kung pwede na siya na lang magbayad ng deductible pero papalabasin na hit or run or something.





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+1 here. Straight forward. Dapat ganito natin i-appreciate yung compre coverage natin. Let the insurance companies do their job.

Palagay ko sa case ng TS is malaki yung claim then insurance company found out na may areglohan pa including damages.

Baka nga dito nag usap din nung insurance company ng nakabangga to just deny the claim base on the agreement between TS and yung nakabangga.


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[shadow]

+1 here. Straight forward. Dapat ganito natin i-appreciate yung compre coverage natin. Let the insurance companies do their job.

Palagay ko sa case ng TS is malaki yung claim then insurance company found out na may areglohan pa including damages.

Baka nga dito nag usap din nung insurance company ng nakabangga to just deny the claim base on the agreement between TS and yung nakabangga.


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Eh kasi nga sa katiting na halaga ₱10k+₱3k nawala tuloy yun ₱400k+

Kung wala naman kasi nasaktan huwag na kayo makipagusap doon sa nakabangga n ninyo kuha na kayo ng police report then claim na agad. Sigurado ayaw din naman ninyo sa insurwncd ng nakabangga ipagawa dahil mas lalo kayo walang control.

Kung kayo ang may kasalanan naman hinde na rin kayo dapat makipagusap sa kabilang side. Let your insurwnxd do the work for you. Kaya nga kayo nagbabayad ng napakamahal na premium para wala na kayo iisipin.

Huwag na kayo makinig sa kesyo madami hinihingi na documents na reklamo ng kanilang side. Problema na nila yun kung ayaw nila mag submit eh di mas matatagalan sila maka claim. As long as sasagutin ng insursnce ninyo dahil kayo at fault yun lang ang ibinigay ang ibibigay nito wala ng traspo allowencd na kung ano-ano pa.


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[cast_no_shadow]

Agree with Shadow pero may stages naman talaga na ganyan sa car owners, probably first time ma-experince to add napayuhan / nakwentuhan ng ibang tao on what to do in case such occurrences.

Now ganyan na din stand ko, kasalanan ko or kasalanan mo gamitin ko insurance ko.

Laking bagay talaga may comprehensive insurance.

If mag offer sagutin ang participation/deductibles then fine. If not wag mo na pasakitin ulo mo.

Kay TS general term kasi yang Own Damage, paano niyo ba stated? Sa report/affidavit? As is pa din ba? Binangga ka? Paano niyo nilagay na OD?

Laki ng damage kaya talagang pitpitan ang laban ng insurance dyan.

Ako before na-denied din claim, hindi ko din alam na may prescribed time for reporting a claim. Naging transparent din ako sa affidavit, ayun denied due to late reporting hindi ko na lang nilaban.


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[dubidubidapdap]

This is well noted. We might set a meeting with them next week to get their advise for our next steps. Thanks!!

Just to add, ang kakampi mo dito ay si Commonwealth Insurance pa rin. Malaking halaga ang Php 400-500k for a repair so you really have to ask them for considerations into your favor. Kasi as far as I know, if things went smoothly into your favor, i.e., there's a loophole on your written agreement favoring your case, the other party's Insurance Company will cover the damages upto Php 200k as per their policy. Then the Commonwealth Insurance will cover the remaining cost of repair which is around Php 200-300k, right?

Then hopefully Commonwealth Insurance will go after the other party na and wala silang magagawa since its on their end na for getting a comprehensive insurance with only just Php 200k maximum third party property damage coverage. Hindi porket may comprehensive insurance ay safe na from liabilities. It still depends sa coverage and policies ng insurance since there are limits lalo na kung mura lang ang kuha sa comprehensive insurance. Good luck, OP.

[babkalakal]

Just to add, ang kakampi mo dito ay si Commonwealth Insurance pa rin. Malaking halaga ang Php 400-500k for a repair so you really have to ask them for considerations into your favor. Kasi as far as I know, if things went smoothly into your favor, i.e., there's a loophole on your written agreement favoring your case, the other party's Insurance Company will cover the damages upto Php 200k as per their policy. Then the Commonwealth Insurance will cover the remaining cost of repair which is around Php 200-300k, right?

Then hopefully Commonwealth Insurance will go after the other party na and wala silang magagawa since its on their end na for getting a comprehensive insurance with only just Php 200k maximum third party property damage coverage. Hindi porket may comprehensive insurance ay safe na from liabilities. It still depends sa coverage and policies ng insurance since there are limits lalo na kung mura lang ang kuha sa comprehensive insurance. Good luck, OP.

agree po na dapat Commonwealth should be your kakampi. talk to them about specifics I'm sure ok naman sa kanila yun. clarify ko lang din at medyo magulo sa akin isip. bakit po kayo Third party? hindi ba sasakyan ninyo mismo ang nabangga? may nasaktan ba po iba?

also insurance companies do from time to time what they term as "loss recovery" which is singilin ang party at fault para sa nagastos nila. I can only guess that there is something in your written agreement that is not in accordance.

[shadow]

Kasi parang niloko nila insurance nila. OD pero reported na accident and meron involved


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[aNthraxx]

Eh kasi nga sa katiting na halaga ₱10k+₱3k nawala tuloy yun ₱400k+

Kung wala naman kasi nasaktan huwag na kayo makipagusap doon sa nakabangga n ninyo kuha na kayo ng police report then claim na agad. Sigurado ayaw din naman ninyo sa insurwncd ng nakabangga ipagawa dahil mas lalo kayo walang control.

Kung kayo ang may kasalanan naman hinde na rin kayo dapat makipagusap sa kabilang side. Let your insurwnxd do the work for you. Kaya nga kayo nagbabayad ng napakamahal na premium para wala na kayo iisipin.

Huwag na kayo makinig sa kesyo madami hinihingi na documents na reklamo ng kanilang side. Problema na nila yun kung ayaw nila mag submit eh di mas matatagalan sila maka claim. As long as sasagutin ng insursnce ninyo dahil kayo at fault yun lang ang ibinigay ang ibibigay nito wala ng traspo allowencd na kung ano-ano pa.


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Yes correct, kung ikaw may kasalanan just tell them to talk to your insurance. Insurance na din bahala dun. For me kung ako may kasalanan the most that i could do is talk to the insurance kung anu na status and maybe prod them to be faster if ever.

Pero by experience, Commonwealth is pretty spot on sa claims, reason all my vehicles are insured with them. After all your requirements casa na tatawag sau when ka naka schedule. So this letter agreement of the TS maybe the real reason for the denial. This companies have audit departments din eh, baka ma technical sila pag ina approve tapos andun sa report na may agreement pala.

[maxpedition]

Yes correct, kung ikaw may kasalanan just tell them to talk to your insurance. Insurance na din bahala dun. For me kung ako may kasalanan the most that i could do is talk to the insurance kung anu na status and maybe prod them to be faster if ever.

Pero by experience, Commonwealth is pretty spot on sa claims, reason all my vehicles are insured with them. After all your requirements casa na tatawag sau when ka naka schedule. So this letter agreement of the TS maybe the real reason for the denial. This companies have audit departments din eh, baka ma technical sila pag ina approve tapos andun sa report na may agreement pala.

Did you experience a 400k + insurance claim on commonwealth?

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[dubidubidapdap]

agree po na dapat Commonwealth should be your kakampi. talk to them about specifics I'm sure ok naman sa kanila yun. clarify ko lang din at medyo magulo sa akin isip. bakit po kayo Third party? hindi ba sasakyan ninyo mismo ang nabangga? may nasaktan ba po iba?

also insurance companies do from time to time what they term as "loss recovery" which is singilin ang party at fault para sa nagastos nila. I can only guess that there is something in your written agreement that is not in accordance.

Hindi yan yung CTPL Insurance Coverage.

Most call it just Liability Coverage, Property Damage Coverage or yung VTPL - Property Damage.
Yan yung policy na magco-cover sa mga damage on someone else's property. i.e. somebody else's car.

In OP's case, kung ginamit nila yung Insurance nung nakabangga sa kanya, First Party ang tawag sa nakabangga sa kanya. Second Party naman ang tawag sa Insurance Company ng nakabangga sa kanya. Kaya Third Party ang tawag kay OP. Hehe.

Iba rin ito dun sa First Car / Second Car na nasa Police Report. Kaya wag malito. Hehe.

[babkalakal]

Thanks mga bro! maliwanag na. gets na hehe

[aNthraxx]

Did you experience a 400k + insurance claim on commonwealth?

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The claim was for 175K.

[SidCoronel]

Hi guys! New member here and this is my first thread.

Need your help and advise. Our car was hit while parked last Dec. 27, 2018 along Dr. A. Santos Ave. and 4 cars kaming affected sa bilis ng takbo nung nakabangga. Total repair estimate nung sa car namin is over 500k. Kung gagamitin namin yung insurance nung nakabangga, 200k lang ang maximum na third party liability. So we decided and agreed na ung own car insurance namin ung gagamitin namin (Commonwealth Insurance). In return, we asked for 3800 and 10k for the participation fee and damages (Transpo expenses while our car is being repaired). As proof na nareceive namin yung money, we signed an agreement.

Then we filed an "Own Damage" claim sa Commonwealth. We provided all the information and requirements. They asked if we had a settlement with the third party and if we asked for any amount. Since we do not want to lie, we tell them about the agreement we had and the exact amount we asked for. We even provided them with the signed agreement.

We were informed by the daughter nung nakabangga, that Commonwealth is directly contacting them and asked them to pay 500k. Both parties were shocked since we are expecting that it will be an insurance to insurance discussion. They replied to the call and letter they received declining to pay the 500k. Sino ba naman kasi magbabayad ng ganito kalaki knowing na pareho kameng may comprehensive insurance.

After a couple of weeks, Commonwealth gets back to us and informed us that our claim is being denied due to the agreement we signed. We did not know that such internal agreement will cause our insurance coverage. Now, our insurance agent advised us to talk with their boss in Makati so we can talk to them, explained what happened in person and to be able to discuss what can be done.

Is it advisable to go directly to Insurance Commission and file a complaint against Commonwealth Insurance? Mas may chance ba kame na macover with the help of Insurance Commission or baka malagyan sila? (Found a forum somewhere na nung 2nd meeting nila, nagbago daw yung stand nung IC mediator supporting the insurance company) Any legal advise will be highly appreciated.

Thanks in advance!

A 500k lesson for you

You saved participation fee naman.

[shadow]

Did you experience a 400k + insurance claim on commonwealth?

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Doesn't matter kung magkano ang claim dahil bloated naman talaga price ng casa sa mga repairs.


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[cdl]

dapat nag ka sundo lang kayo ng other party na sasagutin nila yun gastos pero walang exact amount tsaka dapat hinde pinapakita sa insurance mo. gentlemans agreement lang ba, kung tinakbuhan ka then no choice you pay the participation fee. kaso siningil mo na agad may allowance pa to cover your travel expense during nasa casa yun sasakyan. so parang quit claim na yun tapos sinabi mo pa sa insurance mo.

you know naman insurance companies sa pinas they will find way para malusutan nila liability nila, being honest is not that bad pero kasi insurance kausap mo eh. you should know how it works.

gano kalaki damage sa oto mo? care to post some pic? ok lang kung ayaw mo bro.

good luck sana maayos

Oo nga.. I shouldn't have told them about the agreement, mahirap din talaga maging honest and mabait dito saten.. Total Repair Estimate is 566k+. For total loss na sya and yes malaki, kaya siguro tinetechnical nila.. We're just waiting don sa last say ng agent. So far ito ang next steps namin:
1. Talk to insurance (managers daw) para malaman ano pwede namin gawin for them to cover it
2. File a complaint to Insurance Commission

Thanks ulit sa mga nagrepy. Highly appreciated.

[17Sphynx17]

Oo nga.. I shouldn't have told them about the agreement, mahirap din talaga maging honest and mabait dito saten.. Total Repair Estimate is 566k+. For total loss na sya and yes malaki, kaya siguro tinetechnical nila.. We're just waiting don sa last say ng agent. So far ito ang next steps namin:
1. Talk to insurance (managers daw) para malaman ano pwede namin gawin for them to cover it
2. File a complaint to Insurance Commission

Thanks ulit sa mga nagrepy. Highly appreciated.

I don't know how you making a complaint to the Insurance Commission would help your case though.

What your initial claim (that the company denied) was basically tantamount to insurance fraud correct?

I would suggest you try to work it out with your insurance company and just talk it out.

Ikaw na nabangga, nagkamali ka lang sa desisyon mo ng pirmahan sa areglo sa nakabangga sa iyo. Hindi mo masisi yung insurance ngayon sa pagkakamali mo din, diba?

I don't understand why you would have signed though, but I'm assuming inexperience. This would just have to be treated as a really expensive lesson in what not do. What you can try to work out with your insurance company is how you can lessen the blow to your wallet na lang.

Playing hard ball with them when you know you did something you shouldn't have might make things worse. They have the documentation you signed and know it was a false claim already.

Hindi ka tinetechnical ng insurance lang din, dahil kasi may signed agreement ka with other party, tinali mo kamay nila diba? Kasi pag naghabol sila sa kabila, di din nila kaya dahil may dokumento mapapakita yung kabila na pinirmahan mo. Ikaw nagpahirap sa claim ng insurance mo din kahit anu subukan nila.

You signed without consultation, kaya for me, medyo mali din na sabihin mo na iniisahan ka ng insurance company mo.

[cdl]

Agree with Shadow pero may stages naman talaga na ganyan sa car owners, probably first time ma-experince to add napayuhan / nakwentuhan ng ibang tao on what to do in case such occurrences.

Now ganyan na din stand ko, kasalanan ko or kasalanan mo gamitin ko insurance ko.

Laking bagay talaga may comprehensive insurance.

If mag offer sagutin ang participation/deductibles then fine. If not wag mo na pasakitin ulo mo.

Kay TS general term kasi yang Own Damage, paano niyo ba stated? Sa report/affidavit? As is pa din ba? Binangga ka? Paano niyo nilagay na OD?

Laki ng damage kaya talagang pitpitan ang laban ng insurance dyan.

Ako before na-denied din claim, hindi ko din alam na may prescribed time for reporting a claim. Naging transparent din ako sa affidavit, ayun denied due to late reporting hindi ko na lang nilaban.


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Yes, this is the first time nangyari samen tong ganito kalala. We used our own insurance para less hassle and in all honesty, para mas malaki ang coverage. Praktikal lang as we always have the option to choose kung kaninong insurance ang gusto natin gamitin.

Declared sya as Own Damage and they used the Police Report for other details like "binangga" kame. Any advise pano dapat namin i-file?

[cast_no_shadow]

Yes, this is the first time nangyari samen tong ganito kalala. We used our own insurance para less hassle and in all honesty, para mas malaki ang coverage. Praktikal lang as we always have the option to choose kung kaninong insurance ang gusto natin gamitin.

Declared sya as Own Damage and they used the Police Report for other details like "binangga" kame. Any advise pano dapat namin i-file?

Hindi dapat “own damage” since ikaw nga ang binangga.

File mo as is including the police report. Kung walang pambayad hindi na dapat kayo nag areglo nung bumangga, file mo and si insurance mo na lang humabol sa kanila

I understand mas madali i-claim as own damage, kaso ang insurance hindi rin basta basta magbabayad yan lalo ma at malaki ang damage na inabot, sabi mo nga declared total loss lalo na.

Talo ka talaga dun sa signed agreement mo sa nakabangga sayo, technically hindi own damage eh in paper you are defrauding your insurance. Outright denied yan pag ganyan. Konting butas talagang yare ka.






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[cdl]

Just to add, ang kakampi mo dito ay si Commonwealth Insurance pa rin. Malaking halaga ang Php 400-500k for a repair so you really have to ask them for considerations into your favor. Kasi as far as I know, if things went smoothly into your favor, i.e., there's a loophole on your written agreement favoring your case, the other party's Insurance Company will cover the damages upto Php 200k as per their policy. Then the Commonwealth Insurance will cover the remaining cost of repair which is around Php 200-300k, right?

Then hopefully Commonwealth Insurance will go after the other party na and wala silang magagawa since its on their end na for getting a comprehensive insurance with only just Php 200k maximum third party property damage coverage. Hindi porket may comprehensive insurance ay safe na from liabilities. It still depends sa coverage and policies ng insurance since there are limits lalo na kung mura lang ang kuha sa comprehensive insurance. Good luck, OP.

Noted. Big thanks!!!

[cdl]

I don't know how you making a complaint to the Insurance Commission would help your case though.

What your initial claim (that the company denied) was basically tantamount to insurance fraud correct?

I would suggest you try to work it out with your insurance company and just talk it out.

Ikaw na nabangga, nagkamali ka lang sa desisyon mo ng pirmahan sa areglo sa nakabangga sa iyo. Hindi mo masisi yung insurance ngayon sa pagkakamali mo din, diba?

I don't understand why you would have signed though, but I'm assuming inexperience. This would just have to be treated as a really expensive lesson in what not do. What you can try to work out with your insurance company is how you can lessen the blow to your wallet na lang.

Playing hard ball with them when you know you did something you shouldn't have might make things worse. They have the documentation you signed and know it was a false claim already.

Hindi ka tinetechnical ng insurance lang din, dahil kasi may signed agreement ka with other party, tinali mo kamay nila diba? Kasi pag naghabol sila sa kabila, di din nila kaya dahil may dokumento mapapakita yung kabila na pinirmahan mo. Ikaw nagpahirap sa claim ng insurance mo din kahit anu subukan nila.

You signed without consultation, kaya for me, medyo mali din na sabihin mo na iniisahan ka ng insurance company mo.

Well noted. This is really the worst first time for us!!!!!! Pinadali namin ung buhay nung nakabangga. Naawa din kasi kame sa kanya. FYI he's 74 years old. Ayun, dinaan sa katandaan at experience. Kame na ang tumulong, naisahan pa nila..

[cdl]

Hindi dapat “own damage” since ikaw nga ang binangga.

File mo as is including the police report. Kung walang pambayad hindi na dapat kayo nag areglo nung bumangga, file mo and si insurance mo na lang humabol sa kanila

I understand mas madali i-claim as own damage, kaso ang insurance hindi rin basta basta magbabayad yan lalo ma at malaki ang damage na inabot, sabi mo nga declared total loss lalo na.

Talo ka talaga dun sa signed agreement mo sa nakabangga sayo, technically hindi own damage eh in paper you are defrauding your insurance. Outright denied yan pag ganyan. Konting butas talagang yare ka.

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Will update you guys kung ano man kahantungan nito.. Thanks ulit sa mga advise, feedback and comments.