Letter of Representation

[fejee]

What is the name of your state? CA

My niece mailed a letter to her insurance company naming me as the person authorized to handle her UMBI claim to conclusion. I submitted all the medical records to my niece's carrier and they made me an offer which my niece rejected.

Just last week my niece called her insurance company to get a status on her pending claim. The adjuster of the insurance company began to discuss settlement with my niece and offered her $13k. My niece asked the adjuster to send her the release but has not signed the release as yet.

Does the adjuster have the right to discuss settlement with my niece, knowing well she had sent them a letter authorizing me to settle her claim.

Thank you for any advice in this matter dear forum posters.

 

[testedmonkey]

If your niece is the named insured on the policy, why shouldn't they talk to her? Is there a specific reason you are handling the claim instead of your niece?

 

[racer72]

This person has already asked this question mulitple times and has recieved answers, because she does not like the answers, she keeps asking the same question. Guess what, the answers are not going to change.

 

[fejee]

TestedMonkey, the reason I am handling her claim is coz she felt as a claims adjuster, I might have been able to solicit an offer which she was not getting. After I got involved, they made an offer of $3k, then raised it to $6k and the last offer was $13k(made to my niece and not me, the designated rep per a letter she faxed to her carrier). My question was in reference to California Code Regulations, Title 10, Subchapter 8, section 2695.2(c) and 2695.5(c). Thank you much for your comments, oh wise one.

BTW-She is not the policyholder but a driver listed on her husband's policy.


Racer72 Wrote
"This person has already asked this question mulitple times and has recieved answers, because she does not like the answers, she keeps asking the same question. Guess what, the answers are not going to change".

No, I have just asked this question twice(the 2nd time round was an edited one of the same ?). And FYI, the poster is a "he", not a "she", like u indicate, Ms.Busty72 sorry Rusty72. Perhaps u can show the forum members the multiple postings I submited in this forum. And what answers may I ask u refer to, Ms. Tootsie72 sorry Tasty72. Did u understand the question? I can post it again in your language if English is a little too difficult to comprehend, Ms. Dumber sorry Bummer? Have a good one, if u can manage, that is.

 

[tammy8]

Ummm I thought that a spouse was always a named insured....

 

[K2sweet2000]

It would depend on the verbiage in your letter that you sent in. However, you are not an attorney that has been hired to represent her. Therefore, no laws have been broken by them speaking with her regarding settlement. This is ultimately her claim so she should be the one to settle. She can "authorize" them to speak with you about it in writing, but if she called and agreed to speak with them and settle that's on her. The only way the insurance company would be legally bound to speak with you is if you had power of attorney. Otherwise, I can't see that they have done anything wrong.

What is the name of your state? CA

My niece mailed a letter to her insurance company naming me as the person authorized to handle her UMBI claim to conclusion. I submitted all the medical records to my niece's carrier and they made me an offer which my niece rejected.

Just last week my niece called her insurance company to get a status on her pending claim. The adjuster of the insurance company began to discuss settlement with my niece and offered her $13k. My niece asked the adjuster to send her the release but has not signed the release as yet.

Does the adjuster have the right to discuss settlement with my niece, knowing well she had sent them a letter authorizing me to settle her claim.

Thank you for any advice in this matter dear forum posters.

 

[fejee]

K2sweet2000,
Thanx a lot for yr comments, much appreciated. Perhaps the following published by the CA State Dept of Insurance, may help clarify my stand. My interpretation of this Section of the CA Code of Regs, tells me that the person designated by a claimant to handle her claim does not necessarily have to be an attorney. It could be an adjuster or even a family member of the claimant(as in my case). If that be the case, the person the claimant's designates, must have the same authority as an attorney representing a claimant
has. Otherwise what is the intent of this Sub-Sections that I quote.

The following are taken verbatim from the Fair Claims Settlement Practices Regulations
California Code of Regulations, Title 10, Chapter 5, Subchapter 7.5


(RH-399: Effective October 4, 2004)
Section 2695.2 Definitions
As used in these regulations:


Section 2695.2(c) states;

"Claimant" means a first or third party claimant as defined in these regulations, any person who asserts a right of recovery under a surety bond, an attorney, any person authorized by operation of law to represent the claimant, or any of the following persons properly designated by the claimant in the manner specified in subsection 2695.5(c): an insurance adjuster, a public adjuster, or any member of the claimant's family.



Section 2695.5
Duties Upon Receipt of Communications

Section 2695(c) Reads:

The designation specified in subsection 2695.2(c) shall be in writing, signed and dated by the claimant, and shall indicate that the designated person is authorized to handle the claim. All designations shall be transmitted to the insurer and shall be valid from the date of execution until the claim is settled or the designation is revoked. A designation may be revoked by a writing transmitted to the insurer, signed and dated by the claimant, indicating that the designation is to be revoked and the effective date of the revocation".


PS. I sincerely like to apologize for my comments of yesterday directed to Racer72. It was certainly uncalled for and for which I ask to be pardoned, Racer72. Thank you, very much.

 

[MandyD]

What's the matter fejee? Are you upset that she was able to negotiate a better settlement than you, the insurance adjuster? What difference does it make now? They made an offer that she wants to accept. It would still be the same if they made the offer to you.

 

[fejee]

What's the matter fejee? Are you upset that she was able to negotiate a better settlement than you, the insurance adjuster? What difference does it make now? They made an offer that she wants to accept. It would still be the same if they made the offer to you.

Quiet to the contrary, my dear MandyD. I would have been very much elated by her triumph in effectuating a better settlement than the one I am comtemplating.
And I don't believe we have a settlement agreement as yet. A signed release is required to conclude settlement of this claim and that has not happened.

My niece now understands the $13k offer is far less than the $23k in special damages($8k meds and $15k lost wages)we have submitted when making our demand.

Remind me to send u a pm when I finally resolve my niece's claim for the $30k policy limts, MandyD.

 

[JusticeSeeker1]

Shoot for the policy limit. In the meantime, file a complaint with the insurance Comissioner.

 

[fejee]

BEFORE:

WHAT WUD U DO IF I SUED U 4 BAD FAITH
WUD U STILL LOW BALL AND SCREW AROUND WITH ME
LEND ME YOUR EARS AND I'LL SING U HOW 2 SETTLE A CLAIM
I WILL TRY NOT TO SQUEEZE MORE THAN 30K
OH, MERCURY I GET BY WITH A LITTLE HELP FROM MY FRIENDS
BY WITH A LITTLE HELP FROM MY DEPT OF INS AND FORUM FRIENDS.

"ask n u shall receive", is what my subconscious mind whispered into my unconscious but subliminal mind. that was some 7 months ago, when i lay in bed consciously, thinking how to handle my niece's claim from here-on.

AFTER:

"we have a deal", is what the Mercury adjuster barked when he called me this afternoon, in his full conscious state of mind. barked to say they will offer the $30k limits to settle my niece's UMBI claim. subject to her signing a release which says she will not sue mercury for bad faith.

i relied heavily on the wordings in the Fair Claims Settlement Practices Regulations, under Section 2695(c) which states;
"A designation may be revoked by a writing transmitted to the insurer,
signed and dated by the claimant, indicating that the designation is to be
revoked and the effective date of the revocation".

and my argument was that since my niece never sent a written transmittal to the carrier saying my designation was to be revoked, the carrier had no right to discuss the claim directly with my niece. the sad thing is that it took mercury 7 months to figure out whether i had a valid argument. had they prolonged it to 9 months, it may have given birth to a newly born bad faith claim.

don't u just luv claims, esp them simple ones the insurance company beset with all sorts of complexities.

ok, for policy limits who can guess which tv series had this song as its theme song;

Come and knock on our door
We've been waiting for you
Where the kisses are hers and hers and his
??????? ???????, too!

 

[luvbskts]

BEFORE:

WHAT WUD U DO IF I SUED U 4 BAD FAITH
WUD U STILL LOW BALL AND SCREW AROUND WITH ME
LEND ME YOUR EARS AND I'LL SING U HOW 2 SETTLE A CLAIM
I WILL TRY NOT TO SQUEEZE MORE THAN 30K
OH, MERCURY I GET BY WITH A LITTLE HELP FROM MY FRIENDS
BY WITH A LITTLE HELP FROM MY DEPT OF INS AND FORUM FRIENDS.

"ask n u shall receive", is what my subconscious mind whispered into my unconscious but subliminal mind. that was some 7 months ago, when i lay in bed consciously, thinking how to handle my niece's claim from here-on.

AFTER:

"we have a deal", is what the Mercury adjuster barked when he called me this afternoon, in his full conscious state of mind. barked to say they will offer the $30k limits to settle my niece's UMBI claim. subject to her signing a release which says she will not sue mercury for bad faith.

i relied heavily on the wordings in the Fair Claims Settlement Practices Regulations, under Section 2695(c) which states;
"A designation may be revoked by a writing transmitted to the insurer,
signed and dated by the claimant, indicating that the designation is to be
revoked and the effective date of the revocation".

and my argument was that since my niece never sent a written transmittal to the carrier saying my designation was to be revoked, the carrier had no right to discuss the claim directly with my niece. the sad thing is that it took mercury 7 months to figure out whether i had a valid argument. had they prolonged it to 9 months, it may have given birth to a newly born bad faith claim.

don't u just luv claims, esp them simple ones the insurance company beset with all sorts of complexities.

ok, for policy limits who can guess which tv series had this song as its theme song;

Come and knock on our door
We've been waiting for you
Where the kisses are hers and hers and his
??????? ???????, too!

are you sane?

 

[fejee]

luvbskts wrote:
"are you sane"?


no, i m a fijian.

wat bout u, basketcase?

 

[luvbskts]

luvbskts wrote:
"are you sane"?


no, i m a fijian.

wat bout u, basketcase?

I only ask because of your rambling and quoting of old sitcom theme songs. That just seems a little odd to me

Last time I checked, my sanity is in check...thanks for checking though.

 

[fejee]

no offense but that's just how i act when i feel a little elated. have a great valentines day, oh sane one.