
Reversing Denied Insurance Compensation by Excel Adjusters
Few months ago, I wrote a column about a Korean business owner’s unfortunate situation. I decided to fight the insurance company on behalf of the business owner pro-bono and promised to report back to the readers about the result.
Let me remind you about the situation. A restaurant located near Little Tokyo had a leak in the drain hose of its ice maker. Business owner hired a handyman to replace the water pipe and repair the wall. He was able to run the business without interrupting his business.
Some time later, the sandwich shop next door opened a claim for the water damage in the wall and the sandwich shop’s insurance company launched an investigation. When the Korean business owner learned of this, he had to file a claim because he knew that the damage was caused by his business.
The Korean business owner’s insurance company refused the claim because it said the spaces between the walls were a property of the building owner. It further said compensation was not possible since it was not able to verify the damage because the business owner had already repaired it.
The sandwich restaurant’s claim was also denied because its insurance company said the damage was caused by the restaurant owned by the Korean business owner. Mold formed on the wall of the sandwich shop and began to smell. The sandwich shop owner threatened the Korean business owner to immediately pay $4,200 for repair, if he wanted to avoid litigation. I suggested to the Korean business owner to pay for the repair in exchange for settlement agreement from the sandwich shop owner. Our company will then represent his business to get the maximum amount of compensation from his insurance company, all without a fee.
Now, this is the result.
I met the insurance company investigator six months after the insurance company denied the claim. I explained to him why it was wrong to deny the claim. Investigator then agreed to provide compensation; however, I told him that I will not settle unless the company offered compensation in full.
The insurance company then said that they were unwilling to offer full compensation because it was approached by the sandwich shop’s insurance company with a proposal for both insurance companies to each pay $2,500 to the sandwich shop. Accordingly, the sandwich shop should have already received the payment. The insurance company then proposed settle the claim by paying the Korean business owner up to $3,700. Korean business owner was pleased to take the offer.
Jung Park, PA
Excel Public Adjuster