HELP: Commonwealth Insurance denying coverage

[cdl]

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!

[Sleepcare]

^Denied talaga yung coverage kasi nagkaroon kayo ng agreement nung isang party. Worse is nagkaroon pa pala ng signed agreement. Foul kasi para sakanila yung ginawa niyo kaya grounds for denial automatically.

I know kasi same case tayo but ako naman yung nakabangga. Had a written agreement with the other party and paid for her car repair without the insurance company knowing. But was told by the insurance company na pwede nila ako i-deny ng claim based on what i did. But turns out hindi na din naghabol yung nakabangga ko kaya pinalagpas nalang nila and told me to not do it again (pay the other party for damages).

[12vdc]

Insurance clause does not indicate if you can't collect for collateral damages.

The insurance company only Insures the cost of the property/car & not the collateral damages/abala/lost opportunities from other party. Your insurance company won't pay you with your leave of absence in the office while your car is being repaired, hence you are collecting that cost from the other party.

You may consult with Insurance commission or file a complaint if your claim was denied.

[dubidubidapdap]

Made-deny talaga yan since you opt for an Own Damage Claim in the first place when its actually not.
Ang lumabas kasi, you agreed with the other party na si Insurance nyo ang magsuffer instead of the other party's Insurance Company. That is basically what you agreed upon when signing yung written agreement nyo.

I think you should have filed for the basic Property Damage Claim instead since di kayo magkasundo ng other party and their insurance. Because the way I see it, kung Php200,000.00 lang ang maximum Third-Party Property Damage Claim ni other party, problema na nila yun kung saan nila kukunin yung remaining Php300,000.00 for repair and not your Insurance Company.

Edit. Depende sa nakasulat sa agreement nyo ni other party, there could be a chance na hindi ma i-honor yun if it was properly and carefully worded like.. you agree to use your insurance pero kapag nadeny eh babayaran ka ng full Php500,000.00. ganyan. hehe. Talk to your Insurance muna. They have lawyers and will surely help you out than the other party or their Insurance Company. hehe

[EQAddict]

Made-deny talaga yan since you opt for an Own Damage Claim in the first place when its actually not.
Ang lumabas kasi, you agreed with the other party na si Insurance nyo ang magsuffer instead of the other party's Insurance Company. That is basically what you agreed upon when signing yung written agreement nyo.

I think you should have filed for the basic Property Damage Claim instead since di kayo magkasundo ng other party and their insurance. Because the way I see it, kung Php200,000.00 lang ang maximum Third-Party Property Damage Claim ni other party, problema na nila yun kung saan nila kukunin yung remaining Php300,000.00 for repair and not your Insurance Company.

Edit. Depende sa nakasulat sa agreement nyo ni other party, there could be a chance na hindi ma i-honor yun if it was properly and carefully worded like.. you agree to use your insurance pero kapag nadeny eh babayaran ka ng full Php500,000.00. ganyan. hehe. Talk to your Insurance muna. They have lawyers and will surely help you out than the other party or their Insurance Company. hehe

I agree. It seems --- no, it is clear - - - you wanted to defraud your own insurance company by claiming own damage when it was never own damage.

The insurance company lawyers will have an easy case on this one. And they have written proof. I think you will get no claim from your insurance company. Sad part is.. Since you signed a quit claim with the other party... You will not be able to claim from them yourself. Masakit but it is what it is.


You should have consulted your insurance company before signing any agreement to begin with.



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[A121]

I agree. It seems --- no, it is clear - - - you wanted to defraud your own insurance company by claiming own damage when it was never own damage.

The insurance company lawyers will have an easy case on this one. And they have written proof. I think you will get no claim from your insurance company. Sad part is.. Since you signed a quit claim with the other party... You will not be able to claim from them yourself. Masakit but it is what it is.


You should have consulted your insurance company before signing any agreement to begin with.



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Agree with this. TS may want to read the insurance contract. Kay prudential kasi ganyan.

Since, the TS is deep in the rabbit hole already, now may be the only time to reach out to their insurance.

[cdl]

I agree. It seems --- no, it is clear - - - you wanted to defraud your own insurance company by claiming own damage when it was never own damage.

The insurance company lawyers will have an easy case on this one. And they have written proof. I think you will get no claim from your insurance company. Sad part is.. Since you signed a quit claim with the other party... You will not be able to claim from them yourself. Masakit but it is what it is.


You should have consulted your insurance company before signing any agreement to begin with.



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Thanks for the feedback. But based on personal and friends' experiences, we can always choose kung kaninong insurance ang gusto mo gamitin. We had the same issue before where yung nakabangga ay walang insurance dahil luma na yung car nya. It's stated din sa police report na we settled and agreed na we will use our own insurance and he will just pay for the participation fee. And they covered it. Maybe malaki lang kasi talaga yung bangga ngayon kaya tinetechnical nila kame.

[cdl]

Made-deny talaga yan since you opt for an Own Damage Claim in the first place when its actually not.
Ang lumabas kasi, you agreed with the other party na si Insurance nyo ang magsuffer instead of the other party's Insurance Company. That is basically what you agreed upon when signing yung written agreement nyo.

I think you should have filed for the basic Property Damage Claim instead since di kayo magkasundo ng other party and their insurance. Because the way I see it, kung Php200,000.00 lang ang maximum Third-Party Property Damage Claim ni other party, problema na nila yun kung saan nila kukunin yung remaining Php300,000.00 for repair and not your Insurance Company.

Edit. Depende sa nakasulat sa agreement nyo ni other party, there could be a chance na hindi ma i-honor yun if it was properly and carefully worded like.. you agree to use your insurance pero kapag nadeny eh babayaran ka ng full Php500,000.00. ganyan. hehe. Talk to your Insurance muna. They have lawyers and will surely help you out than the other party or their Insurance Company. hehe

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

[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.

[cdl]

Insurance clause does not indicate if you can't collect for collateral damages.

The insurance company only Insures the cost of the property/car & not the collateral damages/abala/lost opportunities from other party. Your insurance company won't pay you with your leave of absence in the office while your car is being repaired, hence you are collecting that cost from the other party.

You may consult with Insurance commission or file a complaint if your claim was denied.

I agree.. As per our sales agent, it's ok lang naman daw to ask for damages/danyos. Worst case ko dito is, baka malagyan nila yung mediator sa IC. But yes, it seems na ito na talaga ang route namin. Thanks!!!

[cdl]

Insurance clause does not indicate if you can't collect for collateral damages.

The insurance company only Insures the cost of the property/car & not the collateral damages/abala/lost opportunities from other party. Your insurance company won't pay you with your leave of absence in the office while your car is being repaired, hence you are collecting that cost from the other party.

You may consult with Insurance commission or file a complaint if your claim was denied.

Hello! While waiting, ask ko lang ko kung may personal experience na kayo with Insurance Commission? Thanks!

[cdl]

^Denied talaga yung coverage kasi nagkaroon kayo ng agreement nung isang party. Worse is nagkaroon pa pala ng signed agreement. Foul kasi para sakanila yung ginawa niyo kaya grounds for denial automatically.

I know kasi same case tayo but ako naman yung nakabangga. Had a written agreement with the other party and paid for her car repair without the insurance company knowing. But was told by the insurance company na pwede nila ako i-deny ng claim based on what i did. But turns out hindi na din naghabol yung nakabangga ko kaya pinalagpas nalang nila and told me to not do it again (pay the other party for damages).

It's not foul naman kasi kame ang naabala. I explained naman ng maayos don sa nakabangga why I'm asking for it and they agreed din naman. We have three kids, youngest is 2 years old. Nung time na nabangga nila kame, we have a scheduled family travel (Cavite and Batangas lang naman). But still, the fact na gagastos ako ng mas malaki, by renting a car/van, compared na gas and toll lang, masyado naman na kaming lugi.

Re-commonwealth, we were very transparent sa lahat. We did not fabricate or lie sa kahit anong angle. From the very beginning we mentioned na may settlement na nangyari and we asked for a very reasonable amount don sa nakabangga. They asked for a copy, we gave it right-away even if it is an agreement between us lang excluding them (the insurance company).

[yebo]

Bottom line is, you lied on your claim that it was "own damage" when it was not. That is insurance fraud.

You should have
1. Told it straight that your vehicle was hit by another and that his insurance could not cover the damage. Your insurance would then collect from the other party the difference. It will be a legal battle between your insurance vs the other guy's insurance and the other guy.
2. Or claim ot under the offensing party's insurance then sue the other guy for the balance of 300k.

You lied. Worse, you conspired to defraud your own insurance. They have all the right to deny your claim.

[Archerfish]

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

Yes please, as this will serve as good information later.

Bottom line is, you lied on your claim that it was "own damage" when it was not. That is insurance fraud.

You should have
1. Told it straight that your vehicle was hit by another and that his insurance could not cover the damage. Your insurance would then collect from the other party the difference. It will be a legal battle between your insurance vs the other guy's insurance and the other guy.
2. Or claim ot under the offensing party's insurance then sue the other guy for the balance of 300k.

You lied. Worse, you conspired to defraud your own insurance. They have all the right to deny your claim.

It may be said that "he lied technically". However, he mentioned that he didn't want to lie that he even told everything to the insurance company and showed the signed agreement.

So I would like to interpret it this way: he didn't lie and has no intention of lying but to avoid the hassle, he filed "own damage". Technically, it can be said that he lied.

This makes me think, who among us has never lied?

In my own words, I'd rather say, "you made a mistake when you filed it that way". I might have done the same thing out of ignorance and even out of exasperation "just to go over it".

Let all of us learn from this situation, call your lawyer or your insurance agent before signing any documents.

Of course, make sure you have sufficient load at all times.
[emoji3]

[cdl]

Yes please, as this will serve as good information later.

It may be said that "he lied technically". However, he mentioned that he didn't want to lie that he even told everything to the insurance company and showed the signed agreement.

So I would like to interpret it this way: he didn't lie and has no intention of lying but to avoid the hassle, he filed "own damage". Technically, it can be said that he lied.

This makes me think, who among us has never lied?

In my own words, I'd rather say, "you made a mistake when you filed it that way". I might have done the same thing out of ignorance and even out of exasperation "just to go over it".

Let all of us learn from this situation, call your lawyer or your insurance agent before signing any documents.

Of course, make sure you have sufficient load at all times.
[emoji3]

This is totally what happened. Ignorance took a toll on me. Thank you for clearing it out *Archerfish. Again guys, we did not deny/lie anything from our insurance. From Day1, we mentioned everything and the very reason why we will be using our insurance. Again, in all honesty and practicality, we used our insurance para less hassle and for bigger coverage. But then again, the mistake was signing the agreement.

Will not comment on those assuming/negative/reproachful feedbacks as the main purpose of this thread, of any threads I supposed, is to seek advise/help/guidance. Let's help each other guys by providing helpful comments. Not just for TS but for everyone reading the thread/s.

Thanks again for all your comments and suggestions. Will provide any valuable updates. Good day!

[shadow]

Yan kasi ang hinde ko maintindihan bakit kailangan pa makipag areglo, you have a comprehensive insurwncd dapat nag claim ka na lang and sila na nakipag-usap.

For what? Para hinde ka magbayad ng participation mo?

Isa pa yan sa hinde ko maintindihan bakit kailangan ipasa sa nakabangga yun participation eh ikaw nama talaga Dapat magbayad nun either ikaw nakabangga or ikaw nabangga

Then alam na meron involved na iba tapos paanong naging OD ang claim Ninyo?

Cough up the repair cost for your car.

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[sirkosero]

Ginusto mo yan eh. Legally, wala ka na habol sa insurance or sa bumangga. May quit claim ka na that basically waives your claim

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[dct]

Malabo ata to. Ano bang lumabas sa police report mo? Yung other party ang mali? Sasagutin lang yan ng insurance kung ikaw ang may mali sa accident.

Default is, babayaran ka ng insurance. Pero sisingilin si other party kung sya ang mali. Pero dahil nag sign ka na, pano pa nila sisingilin si other party?

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[aNthraxx]

As far as i know you can claim OD if the other party cant pay for it. Done it several times na commonwealth din insurer ko but we dont have written agreements like yours.

Sabi ko di kaya bayaran then siningil lang ako ng participation fee which sinigil ko din dun sa naka banga.

Now they said hahabolin nila yung naka bangga i dont know the insurance din nun or the owner mismo and they would give back my participation fee if they paid.

Key thing is i told them the offending party cannot pay so i claimed sa OD minus any written agreement or a suggestion of any agreement.

There was this other case na i refused to claim from my OD and insisted the offending party to pay for the damage of my other car kasi na inis ako dun sa naka bangga. I was stationary and he rear ended me so careless talaga.

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[shadow]

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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