ComplaintsforAdjuster Groups LLC

• Initial Complaint

  06/08/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  We are submitting this complaint because we have not been able to get a status or make contact with the adjuster at Adjuster Groups LLC for our claim number ********** with*********** Insurance. On 11/29/2021 we entered into agreement with Adjuster Groups LLC to function as a licensed public insurance adjuster on our behalf for wind and hail loss of our roof. Accompanying them was Restoration First Services and we signed an agreement to tarp the roof. It is now 7 months into the agreement and Adjuster Groups LLC has failed to return our calls and failed to make any verbal contact with us. On 2/1/2022,*********** setup an engineer inspection at our home. It was determined the damage to our roof was caused by wear, tear and deterioration of its life span and that the torn shingles were determined to be caused by mechanical manipulation and not the result of wind or hail damage. Our adjuster at Adjuster Groups LLC, Sixto U******, was copied on the report. We tried to make contact with Sixto to find out if he responded to the*********** and to get a copy of his response. We did not receive a call back nor did we receive a copy of his response. We reviewed the Customer Portal periodically to find status updates. We had no contact from Adjuster Groups LLC until 4/26/2022 when compliance officer Bethzaida R****** (Betzy) called us and said she spoke with the adjuster at*********** who said he is making process with reviewing the claim and should have something in about a week. Betzy said she would contact us in a week but we never heard back from her. On 5/12/2022 we contacted Betzy and requested a status on the claim since we had not heard from her since 4/26/2022 and no one was returning our calls. Betzy said she would submit a claim to Mediation at*********** and there was a status updated in the Customer Portal that this was done. ********** denied and closed the claim on 5/26/2022. We sent an email the Adjuster Groups on 6/6/22 for resolution.

  

  Business response

  09/19/2022

  Business Response /* (1000, 20, 2022/08/02) */ I received this complaint on August 1 2022 and prior to this Mr and Mrs. ******** had advised my staff that they would be placing this complaint but I was unaware that it had actually been placed by them. In response to the complaint Mr. and Mrs. ******** had contacted the office on numerous occasions Their major concern was that they wanted to speak to the adjuster which signed them up. We have advised and told them in many occasions that the office is handling the claims process for them and we advised the Adjuster of their concern to speak with him. We are unable to force the adjuster to address the client but have been diligently working this claim. We informed the ********'s that we have place their claim in mediation and that it would take time for the department of Finance to communicate with us and schedule a time for the mediation. They were also advised that the insurance company maybe showing the claim as closed but that we requested mediation in efforts to to settle the claim as it was a denial for wear and tear. Our office has a call center and customer service center ready and able to assist our clients so Mr. and Mrs. ******** have always been able to communicate with a live person who can provide update and escalate any questions or concerns to the necessary departs in our firm.. Mr. ******** and Mrs. ******** have spoken to on numerous occasions with our customer service department and with our compliance officer Betzy and with our office manager who have both tried to be as diligent as possible in attempting to get the claim settled. Our records indicate how many calls we get and from whom we received them so we have records of calls that where made to the ********'s which are not listed in this complaint and the calls made to our firm which were all answered to as well. Mr and Mrs. ******** have received call backs and have been explained the process many times. I understand that the 5/26 as advised Mr. ******** and Mrs. ******** saw the request submitted to DFS for mediation and advised of the process we also advised them that part of the reason this request was done was because of the denial. I understand that the resolution requested is for us to provide more information on the claim but unfortunetly until we have a date for mediation which is provided by the state not us we don't have much to provide only that we are still pending. Our hopes is to get a date soon and to try to reach a setlement with the carrier as soon as possible. My name is maileny V********* I am the supervising adjuster of the firm I am more than willing to speak to the ********'s and provide any information they are requesting in effort to confirm our service on their claim and to provide them the customer service they need. Consumer Response /* (3000, 22, 2022/08/04) */ (The consumer indicated he/she DID NOT accept the response from the business.) Dear Maillemy V**********: We filed the complaint with BBB on 6/10/2022, which was the same day that BBB notified your business. It is unfortunate that your staff did not pass the complaint along to you until 8/1/2022, which was three days after BBB closed the case Unanswered. BBB made several attempts to get a response from the business--including phone calls and email--starting on 6/10/2022 throughout the time span of 7/29/2022, at which time BBB closed the case due to Unresponsive. All these dates are documented in the complaint. This is indicative of what we have encountered with trying to get our calls returned when we have left messages. If we had known the adjuster assigned to our case would not be involved, we would have hesitated to sign an agreement with the business. Following are prime examples of our working through this claim on our own. On 12/15/2021, your business organized a home visit with the inspector from************ No one from your business came to the home to talk with the inspector but they chose to be on the phone, leaving us to address any questions that the inspector had. On 2/1/2022,************sent an engineering firm out for an inspection. Sixto came but did not stay for the inspection. The engineering firm gave a detailed write-up of their findings and copied Sixto, our adjuster with your business. We tried to reach Sixto or someone else from your business who could tell us if Sixto or anyone responded to the engineer's report. We were told he responded but we have yet to receive a copy of the response that we requested a copy of. From 11/29/2021 until now, this is the type of support we have been receiving from your business. Regarding the mediation requests, we tried to contact Betzy on 5/12/2022 and requested a status of our claim as we had not heard from any one and no one was returning our calls. Rather than get a live person to call us back, we relied on the notes placed in the portal that stated a claim was submitted to Mediation by Betzy on 5/12/2022. On 5/24/2022 we called the business and asked for someone other than Betzy to return our call, as Betzy gave us little confidence that she would call us back since she had not in the past. Deborah Barbosa agreed to intervene and sent a follow-up email to************Claims and explained to us that we should have a mediator by 6/3/2022. She copied us on the formal email letter that she sent to************ On 6/9/2022, another claim was submitted to Mediation, submission #2 per the portal. On 7/11/2022, Betzy sent another claim to Mediation, submission #3, and copied us on this 3rd submission. We are now at 8 months and 1 week into this agreement, which is at a standstill and unacceptable. We have not made contact with the adjuster who assured us that he would be working on this case. Also, Restoration First Services has removed the tarp from our roof and we are now requesting your business to patch the holes and restore our bedroom and garage back to their original condition prior to installing the tarp. We are very disappointed in the service we are receiving. We are being left alone to maneuver through all of this as if we never had an agreement in place with your business. Based on this we are requesting (1) repair the holes in our bedroom and garage and restore these areas to their original state, and (2) cancel this agreement since it has been over 8 months and we have received little representation in getting this claim approved. Attached is a timeline that explains all that has transpired since entering this agreement, along with dates. Business Response /* (4000, 25, 2022/08/15) */ Mr. and Mrs. ******** maybe what I expressed in my response was not clear but when I stated that I did not receive the complaint until 8/1/2022 was not that my staff did not give it to me, I did not receive it from BBB. I checked all my emails and it was not there including spam, I advised****** the BBB Representative of this. That was just for the purpose of clarification as to why a response was not given sooner. As stated before I have a customer service center which you have spoken to on many occasions with and checked the messages they forward to us on all conversations as well and none of them being from BBB. With this said I returned to the office on 7/31/2022 and responded as soon as this complaint was received from another case manager from BBB. I understand that you would have liked better communication with Sixto and all I can say is that as I advised in the previous response our office handles the claim also that we advised Sixto of your concerns and interest to speak with him, in which his response to me was that he spoke with you informed you of the process and advised you that it would be at your best interest to contact our office as we would have the best information to provide. Our office has been diligently working to get a resolution for you on your claims. Unfortunately we work with the Insurance you purchased and the process is based and state guidelines and the requirements that they ask. We have advised you of the processes and the next steps moving forward with the claim. Our office received the engineer inspection you were told and also contacted you and advised you of the findings and what the next steps would be, which would be mediation. All documents are sent to our office not Mr. Sixto as we are the ones who contacted and requested them. I saw many calls and emails with Betzy and both of you, where she continuously advised that she is pending the mediation from the state, We have no control as to when the state will assign a mediator or your carrier a mediation representative. We have submitted all required documents, we have done the estimates we have communicated with you all developments on the claim. I apologize that you feel that you are on your own but we advised, that we did reach a point with your claim where we need to take secondary measures to resolve your claim and provided all alternatives. We do not do any repairs or mitigation and your carrier has denied covering repairs or mitigation to your property. I also received notification from your attorney requesting for us to remove the tarp to your roof as you know we did not install the tarp and we do not do any repairs so we cannot. I suggest that you get someone to do temporary repairs to manage damages to your property in the future. He also states that there has been a lack of communication this also has not happened as we've kept you unto date with the most recent activities from your carrier. We can close your claim in our office as requested if you desire and we will keep your records as required by state law for 5 years, this does not mean we are providing a release only that it as your discretion to continue the claim with another adjuster or attorney. The only delays on this claim have been from your carrier not from us. On our part everything has been submitted on a timely manner and the claim has been handled efficiently in our office. If you would like to speak to me directly please contact my office and ask to speak to me I will be more than glad to answer any further questions or concerns. Consumer Response /* (4200, 27, 2022/08/17) */ (The consumer indicated he/she DID NOT accept the response from the business.) Hello Ms. V*********. I tried to reach you in the office but George said you were not available. I have a question regarding the resolution statement in your latest response. I would like to understand better what is meant by this statement in your response: "We can close your claim in our office as requested if you desire and we will keep your records as required by state law for 5 years, this does not mean we are providing a release only that it as your discretion to continue the claim with another adjuster or attorney." We want to ensure that when we close this claim that with your business that we will be fully released from the agreement. Thank you very much. Business Response /* (4000, 29, 2022/08/23) */ Mrs. ******** I hope I was able to clarify the process and that I was able to address any concerns, through our phone call yesterday. As advised I have sent you a list of options for you to look at as well as providing the information as to how the mediation process is done. I am awaiting your response. We hope to continue servicing your claim so if you have any questions or concerns please do not hesitate to email me. Thank you

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