ComplaintsforOhio Mutual Insurance Group

• Initial Complaint

  05/09/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I reached out to get a claim filed regarding significant roof damage and siding (*********). I was never contacted by the adjuster, did not proceed to tell property manager that images needed to be sent via email and told us to reach out via text. I was told adjustment and review would take one week and was never mentioned OMIG would pay for temporary repairs to roof while it was reviewed, and there has been incremental damage due to storms. I called today (5.9.24) and was told it will be an incremental few weeks before any decision has been made. I had a second damaged house at the same time, and the other adjuster was able to walk the property, review and send payment within 24 hours. This is very disappointing there is zero urgency while a roof and siding is damaged.

  Business response

  05/15/2024

  Attached is the response to the complaint.

  Thank you,

  ***********************, SCLA

  Property Unit Manager

  Business response

  05/15/2024

  [BBB Transcription via Attachment]

  Dear *********************************:
  We are in receipt of the Better Business Bureau complaint filed by **** ********, arising from a
  property insurance claim presented for damages to the residence.
  We have confirmed the *************** of Insurance is the proper forum for insurance related
  complaints and resolution of those complaints. We will provide a brief response regarding this
  insurance complaint filed by **** ********.
  An insurance claim was reported, indicating there was storm damage to the property. We contacted
  **** ******** on April 25, 2024; however, the line was disconnected during the call. We then
  received a text message from **** ******** asking that we contact his property manager.
  We reached out to the property manager and left a message requesting photos of the property.
  We have since be in contact with **** ******** and have arranged for an Independent Adjuster to
  meet onsite and complete an inspection of the property. The inspection is being coordinated with
  the property manager.
  **** ******** has been advised to complete any emergency repairs that are required to mitigate
  the property from further damage. He may provide invoices to us for those costs for
  reimbursement.
  The policy of insurance will provide Actual Cash Value coverage for the direct physical damages
  caused by a storm event which occurred on April 24, 2024. 
  There is no coverage for any increase costs associated with the enforcement of any ordinance or
  law.
  We apologize for any confusion or delay in the handling of this claim. 

• Initial Complaint

  04/03/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Please see the attached email communication between ***** and my daughter, along with the attached invoice that was sent to *****. Not only did ***** send a denial letter without fully investigating a claim, she also sent a denial letter and purposely left out the part of the policy that would provide coverage. She was trying to hide where coverage would apply and just blindly deny the claim. The adjuster, ***** needs to be retrained, as she is denying things without actually reviewing the policy. Now she is stating that the "Insured’s have a duty to mitigate their damages, but we (Ohio Mutual Insurance Group) does not owe for that." I have asked twice now for a denial or policy language that states this. I have provided her the policy language where this provides coverage. Please see attached email communication. I still have yet to hear from the manager, ****, regarding any of this. This is absolutely egregious and bad faith at this point.

  Business response

  04/04/2024

  Attached is the response to the complaint.  

  Thank you.

  ***** ***, CPCU

  SIU Manager

  Property Claim Manager 

  Ohio Mutual Insurance Group  

  Business response

  04/04/2024

  [BBB Transcription via Attachment]

  We are in receipt of the Better Business Bureau complaint filed by ****** *******, arising from a
  property insurance claim presented for damages to the residence.
  We have confirmed the Ohio Department of Insurance is the proper forum for insurance related
  complaints and resolution of those complaints. We will provide a brief response regarding this
  insurance complaint filed by ****** *******.
  An insurance claim was reported indicating there was a crack in a plumbing line and they must do
  concrete repairs to repair the plumbing line. A year prior there had been a water back up issue, the
  sump pump now keeps running and a contractor was contacted to identify the cause. A camera was
  run through the plumbing line, a crack was identified in the plumbing line, which was causing the
  water leak.
  An invoice was submitted for the usage of a camera to identify the cause, accessing the plumbing
  line, replacing the plumbing line and the costs to put back the concrete.
  There is coverage for the accessing of the plumbing line, the resulting water damage clean up and
  the repairs to put back the concrete.
  There is no coverage for costs associated with the plumbing line.
  Payment has been issued for the accessing of the plumbing line, resulting clean up of water and the
  costs to put back the concrete.
  A denial letter has been issued for the costs associated with the plumbing system.
  We apologize for any confusion in the handling of this claim.
  Sincerely,
  
  ***** ***, CPCU

  Customer response

  04/04/2024

  
  Complaint: ********
  
  I am rejecting this response because:

  Neither myself, nor my daughter has received communication from ***** or **** regarding the payment. ***** last email, yesterday, to my daughter was “I am not agreeing to pay this”. My daughter requested a denial letter in writing to support this and where in the policy is states there is no coverage for the water clean up.

  I have also received no communication via hi-Mar***, email, or mail that the payment has been issued, nor how much the payment was for. 
  

  I disagree, BBB should be involved as the business practices of this company have been unfair, deceptive, and unethical. 

  
  Sincerely,
  
  ****** *******

  Business response

  04/08/2024

  April 8, 2024
  
  Better Business Bureau
  ATTN:  ******** ********
  BBB Investigator & Dispute Resolution Coordinator
  
  RE:      BBB Complaint Case:            ********
              Insured:                                   **** ******* and ****** *******
              Claim Number:                       **********
              Policy Number:                       ** *******   **
              Date of Loss:                           03/20/2024
              Complainant:                           ****** ******* 
  
  Dear ******** ********:
  
  We are in receipt of the Better Business Bureau complaint follow up filed by ****** *******, arising from a property insurance claim presented for damages to the residence.  
  
  Claims Manager, Peggy Shuster, called and spoke with ****** ******* on Friday, April 5th. ****** was informed by Peggy that all requested payments have been made on the claim and the claim is now closed. ****** ******* indicated that she was satisfied with the current status of the claim and that she will not be pursuing anything further from Ohio Mutual.
  
  We now consider this matter closed.
  
  Sincerely,
  
  ***** ***, CPCU
  SIU Manager
  Property Claim Manager
  Ohio Mutual Insurance Group
  P.O. Box 111
  Bucyrus, OH  44820
  ************
  *************
  
  CC:      **** *******, Vice President, Claims

• Initial Complaint

  06/09/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  Better Business Bureau Re: Ohio Mutual Insurance Group Previous customer: ***** ** ******* Renters insurance policy #HMP ********* I paid $132.00 on the above policy on February 20, 2023 for one year coverage to March 5, 2024. My Dad passed away on April 17, 2023. On April 18th, I called Ohio Mutual to cancel the policy. On 5/3/23 I called again and spoke with ***** to request the premium refund. I told her of my Dad’s passing. She said to cancel the policy and send refund, she needed me to sign a cancellation form which she would send to me. I signed the form and returned it on 5/8/23. There was no response so I called again on 5/26/23 and spoke with ******* who told me a refund was processed on 5/11/23 for $112.00. She transferred me to ***** in billing who told me the check was sent to my Dad at the apartment on Genesis Way. I told her his mail is forwarded to me, but I have not received the check and it would need to be in my name. She said I needed to send her my POA so they can cancel that check and resend it in my name to me. I e-mailed the POA to her on 5/26. There was no response so I called again on 6/8/23 and spoke to ***** again who told me she sent the POA to her boss and has had no response. She said she would check on it and call me back. I received a call back from Pasha?/***** who said the POA is not valid after a person is deceased. I told her I knew that, but that is what ***** had asked for so I sent it. She said they need Executor of estate papers. I told her there is no estate or executor. My Dad lived alone as a widow in an apartment. She said without executor papers, they will not refund the premium. I verified; they will keep rental insurance premiums of deceased who don’t have estates. Even though I paid the premium with my check on mine and my Dad’s account, they only issue the check to the deceased person who can’t cash the check, in other words, they kept my money.

  Business response

  07/03/2023

  Ohio Mutual Insurance Group received a call from ******* and we did send a refund to her in the mail on 6/4/23 in the amount of $112.00. I emailed ******* ******* on 6/9/23 to get a good address to send the refund check. She responded with the address to send. 

  There is nothing more to do in this case as we refunded her the check. However, it is our policy to not send refund checks on policies where the named insured is deceased unless there is an estate and we have documentation showing that. We made an exception in this case to send her the refund after proof that she sent the check for the last payment into Ohio Mutual Insurance Group. 

  Thank you. 

  ******** ******

  Billing Service Center Manager 

  Customer response

  07/03/2023

  
  Better Business Bureau:
  
  I have reviewed the response of refund made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.  With their policy of not refunding persons who live in apartments and have no estate, I would never recommend them to anyone and will be sure to let everyone I come in contact with of this information.
  
  Sincerely,
  
  ******* *******

• Initial Complaint

  03/30/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I am the victim, I am not a policy holder with ohio mutual but the policy holder Ms. ***** of the automobile that caused damage to my truck stop all communication once ohio mutual received the police report and video tape of the accident by my testimony once I filed a claim with her active ohio mutual insurance. This incident happened February 23 2023. someone inside of ms ***** vehicle in the back sit opened there door and struck my side panel of my vehicle while i was passing by. the police was on the seen. the claims coordinator recorded my verbal of the event of the accident and said she was going to send out an adjuster and never did as of today a month later. I am seeking repairs and communication to resolve this issue that associated to the damages. phone #i gave my information to **** 1-***-******** and online #1*************

  Business response

  04/12/2023

  April 12, 2023
  
  ******** ********
  BBB Investigator & Dispute Resolution Coordinator
  *** ************ **** *** ************ ************ ****** ****** *
  *
  ******* ** *****
  
  RE:     BBB ID:                      ********
  Customer:                  ***** ******
  Claim Number:         **********
  Policy Number:         *** *******
  Date of Loss:            02/23/2023
  
  Dear Ms. ********:
  
  This letter is in response to Ms. ******’s complaint regarding the above claim.
  
  Ohio Mutual received the claim on February 23, 2023 which is the same day the loss occurred. Ohio Mutual reached out to our insured to obtain the facts of loss. Our insured was upset that a claim was turned in as she stated she was not at fault for the accident. We told her that we needed to obtain a recorded statement from her going over the details of the accident. She was upset and was not willing to proceed with the statement. Ohio Mutual then reached out to Ms. ******. Ohio Mutual obtained a recorded statement from Ms. ******. Ms. ****** advised that the accident occurred at the beginning of the drive at ****** ******* **** ******. She stated that a student was crossing, and once the student crossed, she pulled in. She said there were two cars to the left of her. She stated she proceeded to go past those cars on the right. She stated she was trying to get to the door of the school. Ms. ****** stated while she was passing the other cars, the right rear door of a car to her left opened and struck her car. Ms. ****** stated the damage to her vehicle is to the left front headlight. Ohio Mutual asked if there was anything between the lanes when she passed the cars. She said not where the incident occurred, but that there were cones further ahead. She said the cones were in front of our insured’s vehicle. She confirmed that our insured wasn’t to the cones yet and was in the middle of the lane. She said that our insured should have pulled up more and to the left. Ms. ****** stated there was an Officer on duty. She stated he was not there for the accident, but that he did come over and mediate between her and our insured. She stated that there is a police report and that Officer ****** has a video of the accident.
  
  On February 27, 2023 our insured sent us an email stating she was frustrated when we contacted her and she was not sure how the process worked. She stated she was not at fault for the accident and not sure why Ms. ****** was filing a claim against her. Our insured stated that she was dropping her daughter off at school, the car door was open, and they were saying their goodbyes. As her daughter was exiting the vehicle a black SUV being driven by Ms. ****** ran into the opened right rear passenger door. Our insured stated the SUV came from behind her car and tried to pass on the right side and was within 6 inches of her car. She stated her daughter had no time to close the door. Our insured also sent in photos of her vehicle and a video she took showing the drop off area at the school. She stated she took this video the day after the accident occurred. She stated the first cone in this video is moved forward closer to the entrance than what it was the day the accident occurred.
  
  On March 2, 2023, we emailed our insured to set up a time to obtain a recorded statement going over the facts of the loss. The recorded statement was scheduled for March 8, 2023.
  
  On March 8, 2023, we secured a recorded statement from our insured. Our insured stated that there is one lane going into the school. She stated that there are cars parked on both sides of the lane and that is where the teachers park. She stated once you get past the parked cars there are some cones. She said once you get to the cones, the one lane splits into two lanes. One lane to the left of the cones and one lane to the right of the cones. She stated that she was still in the one lane area before the cones start. She said the other vehicle was behind her. Our insured states she was stopped for a minute or two and her daughter had already opened the right rear door. She stated that her daughter and her were saying their goodbyes and her daughter then began exiting the vehicle. While her daughter was exiting, Ms. ****** attempted to go around our insured’s vehicle to the right and that is when Ms. ****** struck our insured’s right rear door. Our insured stated during this whole process, the door hit her daughter’s knee. She said luckily her daughter was fine after a few days and so they did not seek treatment. Our insured stated there are police on scene due to school traffic. She said Officer ****** came over and did say that where the accident occurred, it was still one lane. He said there were cones out, but that they were not to that point yet. Our insured stated that while they were talking with Officer ******, they exchanged insurance information. Our insured stated that Ms. ****** stated she had *********** Insurance. Our insured stated she called *********** to turn a claim in and *********** is telling her that there was not an active insurance for Ms. ******. Our insured also stated there was a witness named ******** ******* who is a school employee. The witness told our insured that she saw our insured stopped with the right rear door open and that the Black SUV struck her vehicle.
  
  On April 6, 2023, Ohio Mutual called Ms. ****** to obtain photos of her vehicle.
  
  On April 11, 2023, we cannot locate a police report. We called and Officer ****** and left a voicemail message for a return phone call. We have also reached out to the witness via email in an attempt to obtain her statement.
  
  Today, on April 12, 2023, we received an incident report from The City of ****** ******* Department of Police. It was an in-station crash report that was filled out by Ms. ****** which states her account of the accident.
  
  At this time, we are still trying to gather evidence to see if we can determine who is at fault.
  
  Ohio Mutual believes we are handling this claim appropriately. Please contact me with any additional questions or concerns.
  
  Ohio Mutual Insurance Group
  
  ***** *******
  Claims Unit Manager
  Phone ************ ext.****
  Email: *****************
  
  CC:     **** *******, Vice President Claims
              **** ******, Claims Operation Leader
              ***** ***, Meetings & Events Manager
  
  

• Initial Complaint

  02/27/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I reviewed my Consumer Reports and noticed that i had one collection on an account that i was never late for. Consumer Reporting Agencies have assumed a vital role and have a responsibility to report Consumer information to the best of their ability with maximum Accuracy. I have never been late on payments forth account [OHIO MUTUAL INSURANCE GROUP] PLEASE investigate and provide proof with statements showing that these payments were late. if proof can't be provided I demand these payments be updated to on time as they should be as I was never late.

  Business response

  03/03/2023

  To Whom it May Concern:
  
  Our records indicate that Mr. ****** secured a Personal Auto policy, *** *******, effective October 13, 2017,  with an annual premium of $1979.
  
  We received one payment in the amount of $198 on 10/15/2017. 
  
  This policy cancelled effective December 9, 2017 for nonpayment of premium with $136 earned premium due Ohio Mutual.
  
  Copies of Insurance declaration and billing notices, and final cancellation notice are attached for your review.
  
  Please advise if I may be of further assistance in this matter.
  
  Kind Regards,
  *****
  Sr. Underwriter PL

• Initial Complaint

  02/22/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I was struck in the back of me and my husband's SUV and police report says the lady was at fault. I am currently injured and in speaks with lawyers because neither adjusters, injury adjuster *** or car Adjuster ***** want to resolve the issue that happened on Feb 8th the claim was filed the following day when I got the police report stating there client was at fault. But because no statements was done at the time of the incident, Mr ***** does not want to pay me for the damages until they get a statement from their insured. Which she won't even speak to them and he's been trying to contact her for a couple weeks now and she's avoiding it because she was at fault. And as I told everyone from the cities police department to Ohio mutual insurance I spoke to the gas station that it happened at and it's all on digital cameras,the cop showed up he has a body cam, along with personal photos I took that show a timestamp not long after the incident. He rushed me to get a estimate the very first day I spoke to him actually the only time because both adjusters only want to email which I save all the emails, I took it to the first place i could get into not even the dealership in my home town and the place I took it to is over a half and hour away and I'd have to get a rental. Both adjusters our pushing me to pay for everything out of my insurance company and my medical and I have told them repeatedly No . I saved every email. The injury adjuster won't even speak to me after she screamed at me on the phone the only 2 times I spoke to her which is recorded. All calls through every company is recorded after that I only talked to *** through email so I have everything saved the only offer she made me was $750 when I am dealing with hypertension I can barely sleep I have migraines Non-Stop she said in an email that the reason that she needed records is to see my blood pressure reading prior to the accident I have the email so I sent her exactly what she asked for and it's still not good enough, I have neck problems shoulder problems from a contusion sprain strain and whiplash and she said in good faith the most she could offer me a 750 for all them injuries. When she is saying that she don't see more to this case even though I'm sending her emergency room papers doctor papers and chiropractor papers and I have more appointments I have to go to, very first time I spoke to her when on the phone within 3 minutes she said she was reading my emails as we were talking and then we got disconnected and then she didn't respond to me again and then I asked her what to hold up was and she said you hung up on me I said no ma'am we got disconnected and she straight lied and said she didn't have a proper email from me. Even though the very first time we were talking within the first few minutes she was reading my emails that I sent to her so she straight lied. I would like my vehicle estimate paid for even though it's not the place I even want to go because they can't even get me in till June 5th to be fixed and it's a half an hour from my home I'd have to have a rental while it's being repaired but he only wants one estimate Mr *****. He wants her side of the story even though it's on camera digital footage at a gas station and she thinks she knows better than three doctors so far and I cannot reason with them I am looking into attorneys and speaking to one trying to figure out where to go from here because I don't feel that they want to resolve the issue they want to still the money owed to me because Ohio is not and no fault state. Ohio is a fault state meaning their client is responsible for all bills which has not been paid for my ER bill has not been paid for and the police report says she's at fault so they're holding me up for no reason. They just keep pushing me to claim through my insurance which I've already spoke to both of them I know the consequences if I did that.

  Business response

  03/02/2023

  RE:                  Case #:                        ********
  
  To whom it may concern:
  
  The Ohio Department of Insurance (ODI) advises us that they are the sole forum to resolve insurance disputes in the State of Ohio.  We are providing a response to this inquiry purely as a courtesy to the Better Business Bureau. 
  We have accepted coverage and liability for this loss and have paid for the damage to the vehicle caused by our policyholder. A rental will be provided at the time of the repairs if needed.
  Regarding the injury claim, some documentation has been provided by the complainant to support her injury claim since the filing of the original complaint. We are in current negotiations and are attempting to resolve. Bodily injury claims are paid at the time of final settlement, therefore if the complainant needs assistance with paying bills immediately, she could seek medical payments coverage through her insurance carrier.
  Ohio Mutual feels they have handled this claim fairly and in compliance with Ohio regulations.
  If you have any further questions or require more details, please do not hesitate to reach out.
  
  
  OHIO MUTUAL INSURANCE GROUP
  
  
  
  ****** *******, CPCU AIC
  Casualty Unit Manager/AMD Strategy Leader
  (800) 686-3011 *****
  (877) 276-9868 Fax
  *****************

• Initial Complaint

  02/21/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Director of Insurance Ohio Mutual Insurance Group 02/20/2023 Policy:*** ******* Director, My husband and I received a non-renewal notice from OMIG dated 2/6/23 and we were both extremely confused and upset. We have been customers for many years, have always paid on time, we have our homeowners insurance and business insurance with you and have really never had any issues until now. According to Waverly Insurance, our insurance agency, the non-renewal was due to filing too many claims. We have had a few deer hits over the past few years and a couple auto accidents, but the last one, which I’m assuming is the one that prompted this was an accident that I notified you about because I was told I had to. I was not in the vehicle when it happened, I was parked and inside of a building. A lady was attempting to park her car and hit me. She came in and told me about it and when I notified OMIG, ******** ***** was assigned to me as an adjuster, I told her I was not in the car, the woman admitted fault and she had me do pics. I was curious as to why, I thought it was policy. Then, when I finally spoke to her last I told her Allstate sent me money and again, they admitted fault as I was not in the vehicle. ******** seemed very dismissive to me and I’m not sure she noted everything correctly because after that situation I received the non-renewal. We live literally in the Shawnee Forest region in southern Ohio. I work for USPS as a mail carrier. I drive 27 miles one way to work 6 days/week to an area that is even more rural than where I live, ***** ******* Ohio. I drive a government issued vehicle to deliver mail once I get there. I will sometimes fill in at other offices which is what I was doing when the lady hit me. USPS did not even consider it an accident. I feel like once the situation was explained to ******** the situation should have been shutdown. None of the accidents we had over the past few years were considered our fault nor have we been cited for any.

  Business response

  02/21/2023

  To Whom it May Concern:
  
  Mr. & Mrs. *******’s auto policy, *** *******, was reviewed by Underwriting for loss activity.
  
  There were eight claims submitted to the company since July 2017 with total combined payout of over $23,000.    While the losses were not considered ‘at fault’, there is concern with loss frequency for this risk.  Therefore, notice of non-renewal was issued.
  
  Please feel free to contact me if any additional information is needed.
  
  Kind Regards,
  
  ***** ****** ***** **** *** ***** ***
  Senior Underwriter - PL
  Office: ************  

  Customer response

  02/22/2023

  
  Complaint: ********
  
  I am rejecting this response because:
  Again, none of these accidents were at fault accidents. It is completely ridiculous. I know, for instance one claim was over $10,000 when the lady who hit me was texting driving on the wrong side of the road and knocked me in a ravine. She lied and presented an insurance card, you had to total my car, take her to court and it took 2.5 years to even get my deductible back. Again, not my fault. The last claim which you are including in this I wasn’t even in my car. It was parked and the lady hit me while I was in a building so you paid nothing out on this claim. There were 5 deer hits, 3 by me and 2 by my spouse in 5.5 years due to the fact that I live in the Shawnee Forest region and I literally see anywhere from 5-10 deer daily. It doesn’t matter that we only had one deer hit ever prior to moving to this area in 2013. We have never been late on a payment plus we generously let you cover us on our homeowner’s as well as our business insurance. You are definitely not looking at the whole picture. It is not right, it is not fair. You are punishing us for other’s mistakes. We will let the Director of Insurance sort it out as we have appealed it. 
  Sincerely,
  
  ******** *******

  Business response

  02/22/2023

  To Whom it May Concern :

  With respect to Mr. & Mrs. *******'s auto policy, *** *******, the non-renewal has been further reviewed with the Underwriter.  At this time we are in agreement with reversing the Non-renewal.    Policy will be allowed to renew April 4, 2023.  

  We have discussed the reversal of Non-renewal with the Agency; an agent will be in contact with the Insured.

  Kind regards,

  *****

  Personal Lines Sr. Underwriter

   

  Customer response

  02/22/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ******** *******

• Initial Complaint

  12/16/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  A home that I own sustained hail damage to it's vinyl siding. I have this home insured thru Ohio Mutual Insurance Group, (Bucyrus, Ohio) with a 100 % replacement cost policy. Ohio Mutual assigned my claim to one of their claims adjusters, ***** *****. Mr. ***** came out to the home to assess the damages. Based on Mr. *****"s assessment he concluded the home sustained hail damage to only an area of 9 square. There was an additional area of 3 square that I felt sustained hail damage although Mr. ***** didn't agree to include the extra 3 square area until I took the liberty to have a Rep. from Hanson's Siding & Windows along with a Rep. from Champion Siding & Windows out to the home to give me their assessment of damages and their estimates for 100 % replacement cost to remove & replace a 12 square area of siding. As a result of I going to this extra effort of challenging Mr. ***** over his area of damage by getting two very experienced & replicable siding businesses involved he then agreed to admit the extra 3 square of siding as being damaged by hail. Although he would not agree to the replacement cost estimates I received and submitted to him from Hanson's or Champion's. So I took the liberty to have 3 other siding installation business out to see If any one of these contractors would be willing to perform the repair work for the cost amount that Mr. ***** estimated. After having obtained 5 estimates from very experienced & replicable contractors and submitting these estimates to Mr. ***** as proof that I could not find a contractor in my area willing to perform the repairs, he still would not agree to adjust his estimate or was he willing to negotiate the cost of repairs with my contractor of choice. As a result, I have had to get his manager (***) involved and the VP of Ohio Mutual (****) involved. Upon speaking to the Mgr and VP they stated to me that they would inform Mr. ***** to negotiate with my contractor of choice but he still will not.

  Business response

  01/03/2023

  Attached is our response to this complaint.

  Business response

  01/04/2023

  [BBB Transcription via Attachment]

  January 3, 2023
  Better Business Bureau
  ATTN: ******** ********
  BBB Investigator & Dispute Resolution Coordinator
  RE: BBB Complaint Case: ********
   Insured: ***** *****
   Claim Number: **********
   Policy Number: *** *******
   Date of Loss: 09/19/2022
   Complainant: ***** *****
  Dear ******** ********:
  We are in receipt of the Better Business Bureau complaint filed by ***** *****, arising from
  a property insurance claim filed by Mr. ***** for damages to his residence.
  We have confirmed the Ohio Department of Insurance is the proper forum for insurance
  related complaints and resolution of those complaints and Mr. ***** has filed a complaint
  with the Ohio Department of Insurance. We will provide a brief response in reg*** to this
  insurance complaint filed by Mr. *****.
  A hail loss did occur to the dwelling. Our adjuster inspected the dwelling on October 4, 2022
  and on October 5, 2022 wrote an estimate with Xactimate estimating program. The estimate
  came to $5,711.66 less the insured’s $2,500 deductible. Payment was issued to Mr. *****
  to repair based upon the Xactimate estimate.
  On October 20, 2022 the agent emailed the adjuster that he missed some damage on the
  back side. The same day the adjuster re-wrote his estimate and issued a check to Mr.
  ***** for $2,405.36 which is the difference between the first and second estimates.
  The adjuster used Xactimate to write his estimate. Xactimate is one of the industry’s most
  used platform for property estimation. 

  Customer response

  01/05/2023

  
  Complaint: ********
  
  I am rejecting this response because:  Ohio Mutual is not reporting all the facts. The facts that Ohio Mutual are not reporting include:

  1) I as a consumer am not able to find any contractors in my area that are willing to perform the repair work to my siding for the low estimated amount that Ohio Mutual estimates based on their Xactimate calculations. 

  2) I as a consumer have supplied Ohio Mutual with 4 estimates from a random pool of local contractors as proof to Ohio Mutual that I am not able to find a contractor in my area that is willing to perform the repair work to my siding for the low estimated amount that Ohio Mutual's Xactimate calculations. However, to date Ohio Mutual has not been willing to negotiate a more realistic repair cost with my contractor of choice. 

  3) I have asked Ohio Mutual for their willingness to negotiate a more realistic repair cost with my contractor of choice and was told by their claims mgr. (***) and their VP (****) that this would be granted and that each gentleman would instruct their claims adjustor (*****) to establish a negotiation between myself and my contractor. However, when last speaking to the claims adjustor (*****)  he informed me that he would agree to have a three way phone conversation although he would not be willing to negotiate or agree to any other or additional repair cost.  Instead of being negotiable, the adjustor (*****) has falsely tried to make his mgr. (***) and his VP (****) believe that is was my contractor that was not negotiable which is farthest from the truth. 

  4) I as a result of my last conversation with (*****) had a follow up conversation with (***) to convey *****'s non-negotiable stance and during that conversation asked for my claim to be reassigned to another one of their other claims adjustors and was told by (***) that this would not be granted because this was against their company policies. 

  5) I as a result of my last conversation with (***) now felt that my only means of recourse would be to get BBB and the Ohio Department of Insurance Involved to help me resolve this issue. 

  To resolve this issue I strongly believe that Ohio Mutual should be willing to negotiate a more reasonable cost of repair with my contractor of choice. This is all that I am asking. My contractor is more than willing to negotiate. 
  

  One last fact that I would like to state is, while having conversation with the claims adjustor (*****) I asked him if he or anyone from Ohio Mutual ever took the time to interview a random pool of contractors in an effort to double check the Xactimate methods that Ohio Mutual uses to arrive at their repair / replacement cost estimates and he stated ... No that they never have and never would feel there to be a need to.  Well, this is not my first experience of dealing with a property loss to a home that I have owned and in every other incident, the insurance company that I have been insured with has never been so against comparing their cost estimating methods to random estimates obtained from local contractors as Ohio Mutual has been.  

   

   

  Complaint: ********
  
  I am rejecting this response because:  Ohio Mutual is not reporting all the facts. The facts that Ohio Mutual are not reporting include:

  1) I as a consumer am not able to find any contractors in my area that are willing to perform the repair work to my siding for the low estimated amount that Ohio Mutual estimates based on their Xactimate calculations. 
  

  2) I as a consumer have supplied Ohio Mutual with 4 estimates from a random pool of local contractors as proof to Ohio Mutual that I am not able to find a contractor in my area that is willing to perform the repair work to my siding for the low estimated amount that Ohio Mutual's Xactimate calculations. However, to date Ohio Mutual has not been willing to negotiate a more realistic repair cost with my contractor of choice. 
  

  3) I have asked Ohio Mutual for their willingness to negotiate a more realistic repair cost with my contractor of choice and was told by their claims mgr. (***) and their VP (****) that this would be granted and that each gentleman would instruct their claims adjustor (*****) to establish a negotiation between myself and my contractor. However, when last speaking to the claims adjustor (*****)  he informed me that he would agree to have a three way phone conversation although he would not be willing to negotiate or agree to any other or additional repair cost.  Instead of being negotiable, the adjustor (*****) has falsely tried to make his mgr. (***) and his VP (****) believe that is was my contractor that was not negotiable which is farthest from the truth. 
  

  4) I as a result of my last conversation with (*****) had a follow up conversation with (***) to convey *****'s non-negotiable stance and during that conversation asked for my claim to be reassigned to another one of their other claims adjustors and was told by (***) that this would not be granted because this was against their company policies. 
  

  5) I as a result of my last conversation with (***) now felt that my only means of recourse would be to get BBB and the Ohio Department of Insurance Involved to help me resolve this issue. 
  
  To resolve this issue I strongly believe that Ohio Mutual should be willing to negotiate a more reasonable cost of repair with my contractor of choice. This is all that I am asking. My contractor is more than willing to negotiate. 
  One last fact that I would like to state is, while having conversation with the claims adjustor (*****) I asked him if he or anyone from Ohio Mutual ever took the time to interview a random pool of contractors in an effort to double check the Xactimate methods that Ohio Mutual uses to arrive at their repair / replacement cost estimates and he stated ... No that they never have and never would feel there to be a need to.  Well, this is not my first experience of dealing with a property loss to a home that I have owned and in every other incident, the insurance company that I have been insured with has never been so against comparing their cost estimating methods to random estimates obtained from local contractors as Ohio Mutual has been.    
  
  Sincerely,
  
  ***** *****

   

   

  Business response

  01/06/2023

  [BBB Transcription via Attachment]

  January 6, 2023
  Better Business Bureau
  ATTN: ******** ********
  BBB Investigator & Dispute Resolution Coordinator
  RE: BBB Complaint Case: ********
   Insured: ***** *****
   Claim Number: **********
   Policy Number: *** *******
   Date of Loss: 09/19/2022
   Complainant: ***** *****
  Dear ******** ********:
  We are in receipt of the follow up Better Business Bureau complaint filed by ***** *****,
  arising from a property insurance claim filed by Mr. ***** for damages to his residence.
  We have confirmed the Ohio Department of Insurance is the proper forum for insurance
  related complaints and resolution of those complaints and Mr. ***** has filed a complaint
  with the Ohio Department of Insurance. We will provide a brief response in reg*** to this
  insurance complaint filed by Mr. *****.
  The adjuster did speak with Mr. *****’s contractor and confirmed their scope of damages
  were the same. The contractor would not negotiate or change his pricing and he also told
  the adjuster that he told Mr. ***** that he doesn’t use Xactimate and the insurance isn’t
  going to pay any more than what that price is.
  The adjuster reached out to Mr. ***** on November 23, 2022 and Mr. ***** hung up on
  him.
  Mr. ***** has been advised verbally and in writing of the appraisal language in the policy.
  Sincerely, 
  Page 2
  BBB Complaint Case: ********
  *** *******, SCLA, AIC
  Property Claim Manager
  Ohio Mutual Insurance Group
  P.O. Box 111
  Bucyrus, OH 44820
  Phone/Fax: 1-************
  *****************
  CC: **** *******, Vice President of Claims
   **** ******
   ***** *** 

• Initial Complaint

  08/11/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I was t-boned by a vehicle while driving my children to school the morning of 11/15/21. My car went to ***** ******* Body Shop the same day. I did not get my car back until 1/26/22 at 1:57pm. I was driving home to my house & at 2:29pm that day it started telling me to shut the engine off. I immediately contacted the insurance company and told them of the issue. The agent said that the damage was done to the drivers & passenger door & it should not have any impact on the engine. I explained that my car was shoved into a ditch so things could have been knocked around in there. There was nothing wrong with my vehicle prior to her client hitting my car. I drove 30-50 miles per day, I am a real estate agent & drive a lot for my job. I had to pay out of pocket to have it towed back to the body shop & then again to a mechanic. Then we had to drive it home from the mechanic because we didn't want to have to pay to have it towed again. You can see by the miles from when I brought it to the body shop until now. It never worked since. Ohio Mutual still has done nothing for me. The mechanic that looked at it said that the engine is failing & he is not sure why. He cannot say whether or not it was caused by an accident. I for one am positive it was caused by the accident given I drive my kids 20 minutes to school & 20 minutes back every single day. I had multiple showings that I drove back and forth for every day. There is in no way that I could have done all that on a failing engine. I didn't even make it home from the body shop before this issue occurred. I had another mechanic look it over and say that the timing belt was knocked off of the engine causing it to fail. That was most likely caused by the accident. I had to purchase a new vehicle, which I couldn't do until March. So I was without a vehicle through March. I cannot sell it because the engine is failing. This was not my fault. I did not hit myself. Bad faith! Due diligence was not done.

  Business response

  08/16/2022

  August 16, 2022
  
  ******** ******
  BBB Investigator
  *** ************ **** *** ************ ********
  ********* ***** – **** ****** ****** **
  ******, ** *****
  
  RE:                  BBB ID:                       ********
                          Customer:                   ******* *******
                          Claim Number:           **********
                          Policy Number:           *** *******
                          Date of Loss:               11/15/2021
  
  
  Dear Ms. ******:
  
  I am taking the opportunity to respond to Ms. *******’s complaint reg***ing the above claim. 
  
  Ohio Mutual received the claim on 11/15/2021. Ohio Mutual called and spoke with Ms. ******* this same day and obtained facts of loss. Ms. ******* stated that as she was driving on ***** ******, Ohio Mutual insured pulled out and struck the driver side rear of her vehicle. Ms. ******* was driving a 2012 GMC Acadia with 127,927 miles.  Ms. ******* also advised that her vehicle is not drivable as the left rear door will not open and there is some vibration when driving the vehicle. Ohio Mutual authorized a rental this same day. Ohio Mutual advised Ms. ******* to take her vehicle to the body shop of her choice so they can assess the damage and we will work with them to obtain an estimate and photos for her vehicle. Ms. ******* advised she would like to use ***** ****** Body Shop.
  
  On 11/23/2021, Ohio Mutual followed up with ***** ****** Body Shop to check the status of the estimate and photos of Ms. *******’s vehicle. The shop advised they are still working on it, but that they would send it over to us when completed. They are hoping by the end of the week.
  
  On 11/29/2021, Ohio Mutual received the approved estimate with supplement from ***** ****** Body Shop for the amount of $4,408.88. Ohio Mutual issued payment directly to the body shop for this same amount.
  
  On 12/15/2021, Ohio Mutual contacted ***** ****** Body Shop to check the status of repairs. Shop advised *** is 12/30/2021.  Ohio Mutual extended the rental for Ms. *******.
  
  On 12/30/2021, Ohio Mutual contacted ***** ****** Body Shop to check status of repairs. Shop advised that a part arrived that they were not able to use and so they had to order a new one. Shop advised that the estimated completion date is 01/07/2022.  Ohio Mutual extended the rental for Ms. ******* accordingly.   
  
  On 01/10/2022, Ohio Mutual contacted ***** ****** Body Shop to check status of repairs. Shop advised they were hoping to have the vehicle repairs completed last week but had some issues with the quarter panel. They are hoping to have repairs completed by the end of this week.  Extended rental to 1/14/2022. 
  
  On 01/17/2022, Ohio Mutual contacted ***** ****** Body Shop to check status and shop advised that vehicle is prepped for paint and will go to paint first thing tomorrow. Extended rental to 1/19/2022.
  
  On 01/24/2022, Ohio Mutual received a text from Ms. ******* stating repairs to her vehicle are still not completed. Ohio Mutual contacted body shop. Shop advised that body and paint are completed, but they are waiting to get vehicle to mechanic to get the vehicle alignment completed. Shop advised that they are hoping repairs will be completed at the latest tomorrow. Ohio Mutual set last day of rental for 01/25/2022.
  
  On 01/26/2022, Ohio Mutual received a voicemail from **** at ***** ****** Body Shop.  He stated that Ms. ******* picked up her vehicle yesterday on 01/25/2022 and she stated that after picking up her kids and driving the vehicle for a while, an oil pressure light came on the dash. So she brought the vehicle back to them. He stated that they will need the vehicle to go to a mechanic to be looked at. He stated that Ms. ******* is needing a rental set up so they can evaluate if this is accident related or not.  Ohio Mutual’s in house mechanic reviewed the damages and stated that the impact was to left rear, unsure how this could be related to the accident. We advised shop that we would need the engine damages assessed to determine if the damages are related before, we could set up a rental. Ms. ******* texted in and advised that she needs a rental and car is back at shop. We advised Ms. ******* the same as we did the shop.
  
  On 01/27/2022, Ohio Mutual called and spoke with **** at ***** ****** Body Shop. We asked **** if he thought this was accident related. He stated he is honestly not sure. But he did say he had her bring the vehicle back and he drove it. He said vehicle went 55 mph and drove nice. He said the engine oil performance light was on but would not be related to the quarter panel repairs. We advised that it needs to go to a mechanic for diagnostic. We advised Ms. ******* the same.  Received text from Ms. ******* advising she is taking the vehicle to **** **** **** ****.  Ohio Mutual contacted **** **** **** **** and asked them to send over any documentation once the damages to the engine are assessed.
  
  On 02/07/2022, Ohio Mutual contacted **** **** **** **** via email to see if there was an update reg***ing the engine issue with Ms. *******’s vehicle. We received a voicemail from ****** ******* wanting us to authorize a rental. Returned his call and advised that at this time we are unable to authorize a rental until we can determine whether the engine damage is related to this accident or not.
  
  On 02/08/2022, Ohio Mutual received an email that the shop sent late in the day on 02/072022. The email was from **** **** with **** **** **** **** and he advised that he believes the engine failed in the vehicle. He stated after it warms up the oil pressure drops to almost zero. He said he cannot tie it to the accident, but his initial thoughts are it just failed after the accident. Ohio Mutual asked for mechanic shop to complete an estimate and send over and we will have our in-house mechanic review.
  
  On 02/09/2022, Ohio Mutual received the documentation from **** **** and sent to our in-house mechanic for review. Our mechanic reviewed and called the shop. The shop stated that this is internal engine failure, no oil leaks or visible damage. Our in-house mechanic agreed the engine damage is not related to the accident. Ohio Mutual advised Ms. ******* that both her mechanic shop and our in-house mechanic state the engine damage does not appear to be related to the accident. There were no visible damages to the engine and based on diagnostics, the engine had an internal failure. Therefore, we are unable to assist with the engine damage.
  
  On 2/10/2022, Ohio Mutual realized that there was an open supplement payment that was not issued to ***** ****** Body Shop for the amount of $139.10 that dated back to 11/29/2022.  Payment was issued to shop for this amount and shop was notified.
  
  Ohio Mutual believes we handled this claim appropriately. Please contact me with any additional questions or concerns.
  
  Ohio Mutual Insurance Group
  
  
  ***** *******
  Claims Unit Manager
  Phone ************ ext. ****
  Fax: ************
  Email: *****************
  
  Cc:  **** *******, Vice President of Claims
          **** ******, Claims Operations Leader
          ***** ***, Meetings & Events Manager
  

  Customer response

  08/17/2022

  
  Complaint: ********
  
  I am rejecting this response because:

  I drove my car every single day until Ohio Mutual's client hit me. I did not even make it from the body shop to my driveway before the engine started failing. My childrens' school is 11 miles (each way) from my house. I drove them to school every morning and picked them up every afternoon. I was on my way to take them to school when I was hit by their client. I am also a real estate agent and have numerous showings each week that I would drive to. I had no issues until their client hit me.

  I had a friend who is a mechanic look over my car and he said that the timing belt is off, which could have caused the engine damage. He thinks that **** **** **** missed that from not looking more into the engine. There is absolutely no way that I drove my car anywhere from 30-40/50miles per day until I was hit, had body work repaired and the engine fails after I picked it up, and say it's not accident related. 

  I understand that this insurance company does not want to do their due diligence and pay this claim but this was 100% caused by their insured driver. Their driver was not paying attention and hit me so h*** it pushed my vehicle into a little ditch area off the road (on my sons side of the car). So I am sure internal damage was done as a result. This is not fair to have been hot by their driver and them not cover it. 

  I have attached the list of showings that I did prior to being hit by their client. As you can see the Saturday prior to the accident I showed 9 homes. If this company can justify how I did that much driving on a failed engine, I would love to hear that. I can also provide proof of driving my kids' to school with their school calendar if needed. The new school calendar is out so I would have to contact the school to get the prior year calendar. I have also attached the route to my kids' school for reference of how much I drive every day (twice a day).

  There is just no way this wasn't accident related. This company has very bad faith considering it would give me a car back that doesn't run because their client hit me. 

  
  Sincerely,
  
  ******* *******

  Business response

  08/24/2022

   August 24, 2022
  
  ******** ******
  BBB Investigator
  BBB ************ **** *** ************ ******** 
  Integrity Place – **** ****** ****** **
  ******, ** *****
  
  RE:     

  BBB ID:                     ********
  Customer:                 ******* *******
  Claim Number:         **********
  Policy Number:         *** *******
  Date of Loss:            11/15/2021
  
  Dear Ms. ******:
  
  This letter is in follow up to your additional request and response to Ms. *******’s complaint reg***ing the above claim.
  
  Ohio Mutual worked with the shop that Ms. ******* chose, and we relied on their expert opinion that the engine damage that occurred to Ms. *******’s 2012 GMC Acadia was not related to the accident.
  
  Ms. ******* mentions that her mechanic looked over her vehicle and said that the timing belt was off which could have caused the engine damage. When researching the 2012 GMC Acadia, these vehicles have known issues with timing chain issues. The complaints reg***ing these vehicles are that timing chain brakes while the car is in motion, faulty timing chain results in vehicle stalling while in motion and stretched timing chains can cause vehicles quickly burn through oil.
  
  It is highly unlikely that a jolt or impact to the vehicle would cause the timing belt to just come off the vehicle. The only way this would occur is if the timing belt was already loose. Had the belt been loose, and the impact caused the timing belt to come off the vehicle at the time of the accident, the vehicle would have immediately seized up as soon as it was running or being driven. Ms. ******* advised us during our first contact with her that she drove the car from the accident scene. She also drove the vehicle to the body shop. Then she picked the vehicle up from the shop and drove it for a period of time before the issue started.
  
  Included are some links for you to reference that show issues with the 2012 GMC Acadia engine. Based on these consumer reports, these engines fail without warning while the vehicle is being driven. 
  
  *************************************************************************
  
  ************************************************************************************
  
  We understand Ms. *******’s concern reg***ing this occurring after the accident. But we cannot relate this common GMC Acadia issue to the accident. Therefore, Ohio Mutual’s position stands.
  
  Ohio Mutual Insurance Group
  
  ***** *******
  Claims Unit Manager
  Phone ************ ext.****
  Email: *****************
  
  CC:     **** *******, Vice President Claims
              **** ******, Claims Operation Leader
              ***** ***, Meetings & Events Manager

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩