(12) A 'peanut' size little claim that reveals and proves how Insurance Business has evolved to what it is today! It happens always, and everywhere! Now, it is even digitally played! Are we in "Insurance" Business?

From: Xxxxxxxxxx
Sent: Xxxxxxxxx-xx-xx x:xx PM
To: 'Xxxx-Xxxxxxxx Xxxxxxxxx'
Subject: RE: RE: FW: RE: RE: Claim Closing Notice (FW: Xxxxxx Xxxxx Xxx. Policy No. xxxxxxxxxx d.o.l. xx/xx/xx Cash in transit)[WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIFFRE][WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIF...

Hi, Xxxx,

In our marketing (placing) and underwriting process, "crime" cover always includes and understood as including "theft".

The words "disappearance" and "wrongful abstraction" both have "theft" possibility and cause included in them too, unless it is proven to be something otherwise that traditionally needs separate insurance, like fidelity loss. Even if that's the case, our marketing (placing) and underwriting process never differentiate that "theft" is excluded, anywhere, and needs to be specified and spelled out at placing and underwriting. We have never been told by any underwriter as such. It is simply part of the crime section.

Also, your company frequently send us bulletin communications, telling us that no need to mention cerntain coverage as needed, because it is already included especially with "improved" wording as read-in.

The Insured reported their money loss incident, as presented. We even found the wordings applicable in the policy, also as presented.

However, you said "theft" is not covered!

Now, it seems we even have to spell out "theft" was intended to be covered at placing! It is a bit awkward.

By the way, it was you who decided that it was a "theft", by itself, it is already questionable on the application of wordings, about facts, possibilities, and intention, as explained in the above.

I showed you the wordings I used. You found your "XXXX 2.0" to apply instead. So, which is right and which is to apply? Based on facts, or based on your decision that it was "theft", even if your decision about "theft" were right in the first place? I think, we have to worry about the insurance contract making proferendum rule too!

We always work properly and fully for our clients, irrespective whether the claim is big or small. And when it comes to claim, we don't want more, but we don't want less either.

Hope you won't find us "high maintenance", which were the words used by a senior person 30 years ago, as an excuse to do what he did against us, wrongly!

Thanks for your kind attention and consideration.

Xxxxxx Xxx

Xxxxxxxxxx Xxxxxxxxx xxx Xxxxxxxxx Xxxxxxxx Xxx.

Tel: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email:xxxx@xxxxxxxxxx.xxx


From: Xxxx-Xxxxxxxx Xxxxxxxxx [mailto:xxxxxxxxxx@xx.xxxxxx.xxx]
Sent: Xxxxxxxxx-xx-xx x:xx XX
To: Xxxxxxxxxx
Subject: RE: RE: FW: RE: RE: Claim Closing Notice (FW: Xxxxxx Xxxxx Xxx. Policy No. xxxxxxxxxx d.o.l. xx/xx/xx Cash in transit)[WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIFFRE][WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIF...

xxxxxx Xxxxxxxxx Xxxxxxx
Claim Number : Xxxxxxxxxx
Policy Number : xxxxxxxxx
Date of Loss : Xxxxxx xx, xxxx

Hi Xxxxxx,

I can understand that you want to know what you are selling. The thing is that if theft would be covered under the Crime endorsement , it would be clearly stated. Which is not , as mentioned , money is only covered for disappearance or wrongful abstraction.

I did not ''Decided'' to pull another wordings , I searched for the one covering our insured, in that case, the only one that could be found was under ''XXXX 2.0''

Maybe you could reach to the underwriter to obtain the best explanations on the products. They are the one selling it to you. It would be better than my manager in that case.

Please let me know what you think.

Thank you,

Sincerely,

Xxxx-Xxxxxxxx Xxxxxxxxx
Claims adjuster in personal-lines damage insurance
Xxxxxx xxxxxxxxx Xxxxxxx
xxxxX Xxxxxxxxxx Xxxx Xxxxx xxx, Xxxxxxxx, XX, XXX XXX
Telephone: xxx-xxx-xxxx xxxxxx
Fax: xxx-xxx-xxxx
Email: xxxxxxxxxx@xx.xxxxxx.xxx

From: Xxxxxxxxxx Xxxxxxxxx
To:
Cc:
Date: Xxx Xxx xx xx:xx:xx EDT 2019
Subject: RE: FW: RE: RE: Claim Closing Notice (FW: Xxxxxx Xxxxx Xxx. Policy No. xxxxxxxxxx d.o.l. xx/xx/xx Cash in transit)[WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIFFRE][WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIF...

Hi, Xxxx, I would like to reach out to your manager for his comments on the case. I am a sole proprietor, so I do not have a manager I could refer to.
Thanks for explaining to me multiple times. If I don't have any question and concern on your explanations, I wouldn't have bothered you further.
The cash disappeared and lost during transit. I checked the policy and I forwarded the wordings attached in the above.
You replied that 'theft' is not covered, which I didn't even know, because disappearance and wrongful abstraction are both covered and mentioned in the said wordings about money in transit by messenger, which was the case, and theft was not even mentioned anywhere.
At the same time, you showed me another set of wordings which limit and apply to loss by theft (as you decided) to $1,000 only.
I checked Google, out of over 10 links explaining Wrongful Abstraction, only 1 has "employee" involvement mentioned therein.
I raised my questions about what wordings to apply. I could not find your wordings. I even asked whether they were digitally recorded somewhere in the policy until you brought them up.
I really need to know the exact application of the policy wordings, so that we may know what we are selling in future, when it comes to Edge covers.
Thanks for your patience. We appreciate it.
Xxxxxx Xxx
Xxxxxxxxxx Xxxxxxxxx xxx Xxxxxxxxx Xxxxxxxx Xxx.

Tel: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxx@xxxxxxxxxx.xxx


From: Xxxx-Xxxxxxxx Xxxxxxxxx [mailto:xxxxxxxxxx@xx.xxxxxx.xxx]
Sent: Xxxxxxxxx-xx-xx x:xx XX
To: Xxxxxxxxxx
Subject: RE: FW: RE: RE: Claim Closing Notice (FW: Xxxxxx Xxxxx Xxx. Policy No. xxxxxxxxxx d.o.l. xx/xx/xx Cash in transit)[WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIFFRE][WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIF...

Xxxxxx Xxxxxxxxx Xxxxxxx
Claim Number : Xxxxxxxxxx
Policy Number : Xxxxxxxxx
Date of Loss : Xxxxxx xx, xxxx

Hi Xxxxxx,

Wrongful abstraction is when an employee is ''stealing'' from his employer. That is considered ''Wrongful Abstraction''

This is clearly a theft, and as previously mentioned , the only coverage for money for our insured is on XXXX 2.0 at point 47 - Money & Securities, limited to $1,000.00

If you do not agree on coverage decision , I would please like you to reach out to my manager or speak with yours as I provided all the information / explanations you requested and multiple times.

Thank you,

Sincerely,

Xxxx-Xxxxxxxx Xxxxxxxxx
Xxxxxx xxxxxxxx in personal-lines damage insurance
Xxxxxx Xxxxxxxxx Xxxxxxx
xxxxX Xxxxxxxxxx Xxxx Xxxxx xxx, Xxxxxxxx, XX, XXXXXX
Telephone: xxx-xxx-xxxx xxxxxx
Fax: xxx-xxx-xxxx
Email: Xxxxxxxxxx@xx.xxxxxx.xxx

The information contained in this email is confidential and believed to be accurate and reliable when sent. We cannot guarantee its accuracy at all times. It is subject to change and does not represent a final status or determination of your claim. Please consult the claims department for full details and your insurance contract for a complete description of your coverage and exclusions. If you are not the intended recipient, please immediately notify the sender and delete this communication. Any other use or disclosure is prohibited.

---------Replied by Xxxx-Xxxxxxxx Xxxxxxxxx on 16/09/2019 3:21 PM---------

From: Xxxxxxxxxx Xxxxxxxxx To:
Cc:
Date: Xxx Xxx xx xx:xx:xx EDT 2019
Subject: FW: RE: RE: Claim Closing Notice (FW: Xxxxxx Xxxxx Xxx. Policy No. Xxxxxxxxx d.o.l. 12/08/19 Cash in transit)[WARNING: MESSAGE ENCRYPTED][AVERTISSEMENT: MESSAGE CHIFFRE]

Hi, Xxxx,
It seems your correspondence with me on the subject claim is separated into two different email chains, which I also attached herewith together.
It is a bit confusing.
I showed you where I got the coverage information from, as per attached in the above.
Yet, you showed me another set of wordings in another email chain which I could not find from the policy. Is it hidden digitally somewhere?
By the way, what is the difference between theft and wrongful abstraction? And who to decide and how?
Please kindly clarify.
Should there be conflict in wordings, even if known to the Insured, the claim should be in favour of the Insured.
We await your advice.
Thanks.
Xxxxxx Xxx
Xxxxxxxxxx Xxxxxxxxx and Xxxxxxxxx Xxxxxxxx Xxx.

Tel: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxx@xxxxxxxxxx.xxx


From: Xxxxxxxxxx
Sent: Xxxxxx-xx-xx xx:xx XX
To: 'xxxxxxxxxx@xx.xxxxxx.xxx'
Subject: FW: RE: RE: Claim Closing Notice (FW: Xxxxxx Xxxxx Xxx. Xxxxxx No. xxxxxxxxx d.o.l. 12/08/19 Cash in transit)
Hi, Xxxx,
When I tried to write you, your named email address did not appear automatically.
Even though you are a day driving distance away, anyway, the attached is what we found under the policy. Yet, it seems you based your decision on something else (another piece paper). Which is to apply on the claim?
We have to face the client. They bought the Edge cover. Please kindly clarify, so that we may explain to the client, just in case, and also learn.
Thanks.
Xxxxxx Xxx
Xxxxxxxxxx Xxxxxxxx xxx Xxxxxxxxx Xxxxxxxx Xxx.

Tel: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxx@xxxxxxxxxx.xxx


From: Xxxxxxxxxx
Sent: Xxxxxx-xx-xx x:xx XX
To: 'Xxxx-Xxxxxxxx Xxxxxxxxx'
Subject: RE: RE: RE: Claim Closing Notice

Thanks, Xxxx.
What I got are the attached.
Where was yours from?
Is there any conflict?
Also, the incident was theft or wrongful abstraction?
We await your advice.
Thanks.
Xxxxxx Xxx

Tel: xxx-xxxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxx@xxxxxxxxxx.xxx


From: Xxxx-Xxxxxxxx Xxxxxxxxx [mailto:xxxxxxxxxx@xx.xxxxxx.xxx]
Sent: Xxxxxx-xx-xx xx:xx XX
To: Xxxxxxxxxx
Subject: RE: RE: RE: Claim Closing Notice

Xxxxxx Xxxxxxxxx Xxxxxxx
Claim Number : Xxxxxxxxxx
Policy Number : Xxxxxxxxx
Date of Loss : Xxxxxx xx, xxxx

Hi Xxxxxx,

I have attached a print screen of the XXXX 2.0 wordings and you can see at Point 47 , for Money and securities , limit is $1000.00

Thank you,

Sincerely,

Xxxx-Xxxxxxxx Xxxxxxxxx
Xxxxxx xxxxxxxxx in personal-lines damage insurance
Xxxxxx Xxxxxxxxx Xxxxxxx
XxxxX Xxxxxxxxxx Xxxx Xxxxx xxx, Xxxxxxxx, XX, XXXXXX
Telephone: xxx-xxx-xxxx xxxxxx
Fax: xxx-xxx-xxxx
Email: xxxxxxxxxx@xx.xxxxxx.xxx

The information contained in this email is confidential and believed to be accurate and reliable when sent. We cannot guarantee its accuracy at all times. It is subject to change and does not represent a final status or determination of your claim. Please consult the claims department for full details and your insurance contract for a complete description of your coverage and exclusions. If you are not the intended recipient, please immediately notify the sender and delete this communication. Any other use or disclosure is prohibited.

---------Replied by Xxxx-Xxxxxxxx Xxxsxxxxxx on 16/08/2019 12:37 PM---------

From: Xxxxxxxxxx Xxxxxxxxx
To:
Cc:
Date: Xxx Xxx xx xx:xx:xx EDT 2019
Subject: RE: RE: Claim Closing Notice

Hi, Xxxx,
Thanks for advice.
I did not see the $1,000. I saw the $5,000 limit indicated on the endorsement.
Would you please kindly show me.
Thanks.
Xxxxxx Xxx
Xxxxxxxxxx Xxxxxxxxx xxx Xxxxxxxxx Xxxxxxxx Xxx.

Tel: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxx@xxxxxxxxxx.xxx


From: Xxxx-Xxxxxxxx Xxxxxxxxx [mailto:xxxxxxxxxx@xx.xxxxxx.xxx]
Sent: Xxxxxx-xx-xx xx:xx XX
To: Xxxxxxxxxx
Subject: RE: RE: Claim Closing Notice

Xxxxxx Xxxxxxxxx Xxxxxxx
Claim Number : Xxxxxxxxxx
Policy Number : Xxxxxxxxx
Date of Loss : Xxxxxx xx, xxxx

Hi Xxxxx,

Money is not covered for theft / robbery under the crime coverage but only for disappearance , destruction or wrongful abstraction.

I settled this one under XXXX 2.0 : Section 3 - Individual Extensions point 47 - Money and securities

We do cover the loss of money , but to a limit of $1000.00

Deductible was not applied and insured was made aware of all of it and agreed for the settlement. I also advised him to contact you before hand but he said all was good.

Hope this helps.

Thank you,

Sincerely,

Xxxx-Xxxxxxxx Xxxxxxxxx
Xxxxxx xxxxxxxx in personal-lines damage insurance
Xxxxxx Xxxxxxxxx Xxxxxxx
xxxxX Xxxxxxxxxx Xxxx Xxxxx xxx, Xxxxxxxx, XX, XxxxXX
Telephone: xxx-xxx-xxxx xxxxxx
Fax: xxx-xxx-xxxx
Email: xxxxxxxxxx@xx.xxxxxx.xxx

The information contained in this email is confidential and believed to be accurate and reliable when sent. We cannot guarantee its accuracy at all times. It is subject to change and does not represent a final status or determination of your claim. Please consult the claims department for full details and your insurance contract for a complete description of your coverage and exclusions. If you are not the intended recipient, please immediately notify the sender and delete this communication. Any other use or disclosure is prohibited.

---------Replied by Jxxx-Xxxxxxxx Xxxxxxxxx on 16/08/2019 12:17 PM---------

From: Xxxxxxxxxx Xxxxxxxxx
To:
Cc:
Date: Xxx Xxx xx xx:xx:xx EDT 2019
Subject: RE: Claim Closing Notice

Hi,

According to what we know and understand, crime coverage, especially concerning the money part, is not subject to deductible.

The Insured told us the loss was about $2,000.

If there is deductible, then please contact the client (or us) and let them decide whether to claim or not.

Thanks.

Xxxxxx Xxx

Xxxxxxxxxx Xxxxxxxxx and Xxxxxxxxx Xxxxxxxx Xxx.
Tel: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxx@xxxxxxxxxx.xxx