ComplaintsforHomeowners of America Insurance Co.

• Initial Complaint

  03/28/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I filed a claim in 8/2021 for water damage to my house. A company came out and to remove the damage and dry out the home. They changed 10K to do so. The insurance company paid that but is now avoiding me to have my home repaired back to it's original state. I keep getting the run around and no one is returning my calls. The insurance company is Home Owners of America. Claim # XXXX-XX-XXXXXX. The original adjuster for this claim was Javier ***** who is no longer with the company. So, they just dropped the ball. I have also left a message for a supervisor by the name of Deion *******

  Business response

  06/01/2022

  Business Response /* (1000, 8, 2022/04/25) */ To Whom It May Concern: We are in receipt of your letter dated March 29, 2021 regarding the above-referenced complaint. We appreciate the opportunity to investigate this matter in order to determine how one of our valued customers became displeased, and hopefully reach an amicable resolution. This matter has been referred to me, Stephanie *****, Regulatory Compliance Analyst, for handling. UNDERWRITING COMPANY NAME: Homeowners of America Insurance Company ("HOAIC") NAIC NUMBER: XXXXX COMPANY'S POSITION ON THE ISSUES RAISED IN THE COMPLAINT: The Insured's Property is insured by HOAIC under a Texas HO-3 Homeowners Policy. On 8/24/2021, HOAIC received a loss stating there was water damage to the home. On 8/25/2021 an adjuster inspected the residence and verified water damage resulting from a leaking toilet valve. An initial estimate for $20,794.21 was prepared, however, this policy contains limited water damage coverage with a policy limit of $10,000.00. STEPS TAKEN TO RESOLVE THE MATTER: o On 9/2/2021, HOAIC issued a payment for the policy limit of $10,000.00 and mailed the insured a formal correspondence outlining the policy limit payment. **** Corporate Drive Suite *** Irving, TX XXXXX ************ www.hoaic.com Page 2 of 2 o On 03/28/2022, the Insured contacted HOAIC with questions on their claim and requested to speak to a supervisor. o On 03/30/2022, claims supervisor Dion ****** contacted the client and confirmed that the policy contains a limit of $10,000.00 for water damages which was previously paid in September 2021. We trust that this response and subsequent actions provide the Bureau with the information that it needs in order to consider this complaint file closed. However, should you have any questions or require anything further, please do not hesitate to contact me directly.

• Initial Complaint

  03/23/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  April 2021- present Individuals involved: Sam ********* Keith ***** Ryan ******** lee ******* Claim number# XXXXXXXXXXXX Evidence:10 +Recorded phone conversation with individuals involved, 20+ emails sent/received and pictures My garage was damaged by a company( America Leak detection) that homeowner of America sent out to find a leak that was in my roof from the winter storm. They cut holes in my wall looking for a pipe after I explained the leak was coming from the roof. They claimed that there was a pipe in the wall after I told them it wasn't. Also I have audio of them tell me about the water and what they see but they wrote up the report different than what was said on audio. The adjuster that Homeowners of America did the exact same thing and I have audio of that too . I was secretly recording them after the first adjuster lied. the first adjuster lied that's why Sam ************ they fired a week later) sent out the leak detection team. I sent Sam picture of the wet wall and he seen mildew forming in the picture. Homeowners of America are all crooked and I have all the audio to prove 100% facts. I have recorded adjuster lying and the leak detection company lying about what was the cause of damage/found vs what they put in the report. Homeowners of America are working with companies that helps them deny claims and again the audio I have will prove it to be factual. I have filed verbal complaint about all these individuals which is recorded on audio. Also they(Keith ***** are entering false information/notes into account to cover up there fraud, Audio doesn't Lie. Keith never called me back after he talked to Ricardo from el sol roofing as requested and the last person that I spoke with was Ryan ******* and no return call. Ricardo emailed what he asked for. Also I filed a claim for damage do to water leaking from tub drain and Keith Hall canceled them. I recorded claim. Audio was emailed to Keith Hall. Audio will not attach. NEED MORSPACE

  Business response

  05/16/2022

  Business Response /* (1000, 7, 2022/04/11) */ To Whom It May Concern: We are in receipt of your letter dated March 24, 2022 regarding the above-referenced complaint. We appreciate the opportunity to investigate this matter in order to determine how one of our valued customers became displeased, and to hopefully be able to reach an amicable resolution. This matter has been referred to me, Stephanie *****, Regulatory Compliance Analyst, for handling. UNDERWRITING COMPANY NAME: Homeowners of America Insurance Company ("HOAIC") NAIC NUMBER: XXXXX COMPANY'S POSITION ON THE ISSUES RAISED IN THE COMPLAINT: o On 05/04/2021, HOAIC received notice of a claim asserting hail damages to the roof and a leak in the garage. An adjuster from Mid-America Catastrophe Services contacted the Insured and inspected the residence on an agreed upon date of 06/01/2021. No observable storm damages were found to the roof during the inspection, and the adjuster noted interior water damages to the garage paneling, and laminate flooring in a bedroom and the living room. Conversations with the insured during the inspection indicated that the garage paneling would get worse when it rains, and the flooring damage was reported to be a possible result of a bathtub drain leak or water draining at the base of the back patio. Since no storm damages were observed to the roof and the policy requires that a storm created opening for interior roof leaks to be covered, a coverage denial letter was sent to the Insured on 06/14/2021. ******************** Suite 300 Irving, TX XXXXX ************ www.hoaic.com Page 2 of 2 o Also on 06/14/2021, HOAIC agreed to pay for the expense of American Leak Detection ("ALD") to inspect and determine if any plumbing leaks were present causing any other damages to the residence. The ALD inspection concluded the following: "Domestic Slab Detection: Complete electronic detection of domestic hot/cold water system. No domestic water leaks detected at this time. ALD went into attic to attempt to find if the roof was leaking. ALD did not find any area where water was coming in from roof. ALD was advised by homeowner to cut the panel. When ALD cut panel, ALD found moisture on the top two layers of the panel. ALD believes it may be moisture build up from humidity. No leaks detected at this time." o On 7/13/2021, a coverage denial was issued to the insured since the policy does not cover interior water loss caused by rain, snow, sand or dust, whether or not driven by wind, unless the direct force of wind or hail makes an opening in the roof or wall and the rain, snow, sand or dust enters through this opening and causes the damage. o On 07/26/2021, a different adjuster from ***** Adjusting Services reinspected the residence at the Insured's request. This adjuster concluded that water appeared to have entered through a ridge vent from snow/ice melting in February 2021. No damages were noted to the roof. o On 8/16/202,1 an additional coverage denial was issued to the insured since, again, the policy does not cover interior water loss caused by rain, snow, sand or dust, whether or not driven by wind, unless the direct force of wind or hail makes an opening in the roof or wall and the rain, snow, sand or dust enters through this opening and causes the damage. o On 10/28/2021, a supervisor spoke with the Insured's contractor, Ricardo ********, and advised of our need for any documentation they possess regarding the cause of loss for interior water damages and any leaks within the residence. Mr. ******** advised he would follow up by 11/01/2021. As of today's date, no additional information has been submitted to HOAIC and no further contact has been received from the Insured or his contractor. If the Insured would like to submit any additional information, we will be happy to review it. We trust that this response and subsequent actions provide the Bureau t with the information that it needs in order to consider this complaint file closed. However, should you have any questions or require anything further, please do not hesitate to contact me directly. Respectfully Submitted, ********* ***** Regulatory Compliance Analyst Toll-Free: XXX-XXX-XXXX, ext. 4303 Email: ******@hoaic.com

• Initial Complaint

  03/14/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I had a leak in my bathroom that required: Water mitigation: $3608.35 Water damage repair: $4925.33 Plumbing repair: $570.89 Total: $9104.57 I reached out to Home Owners Insurance of America to file a claim. During the claim process, everything was fairly straightforward. After all the paperwork was filed HOIA only claimed $3314.82. I followed up by sending all of the invoices that we have received and making at least 7 calls to our claim adjuster, Gerardo Aguilar. I have only received one call from him promising me a callback a few days after he reviewed our paperwork. It's been 10+ days and has yet to receive a call, email, or text back. We have paid on time every month and met the deductible. At this point, it appears that HOAI is refusing to meet the minimum amount required to cover the costs we have incurred. Claim #: XXXXXXXXXXXX Claim Adjuster: Gerardo Aguilar Claim Adjuster Email: ********@hoaic.com Claim Adjuster Phone #: XXX-XXX-XXXX x4345 Home Owners of America Insurace claim amount: $3314.82

  Business response

  05/18/2022

  Business Response /* (1000, 8, 2022/04/20) */ To Whom It May Concern: We are in receipt of your letter dated 3/15/2022 regarding the above-referenced complaint. We appreciate the opportunity to investigate this matter in order to determine how one of our valued customers became displeased, and to hopefully be able to reach an amicable resolution. This matter has been referred to me, Stephanie A****, Regulatory Compliance Analyst, for handling. UNDERWRITING COMPANY NAME: Homeowners of America Insurance Company ("HOAIC") NAIC NUMBER: XXXXX COMPANY'S POSITION ON THE ISSUES RAISED IN THE COMPLAINT: This is in response to concerns raised with respect to the above referenced claim. The Property is insured by Homeowners of America Insurance Company ("HOAIC") under a Texas HO-3 Homeowners Policy. On 2/11/2022, HOAIC received a loss stating a pipe leaked in the guest bedroom bathtub area. An independent adjuster inspected the residence on 02/23/2022 and verified water damage. An initial estimate for $3,314.82 was prepared. After application of the $2,358.00 policy deductible, HOAIC issued an initial payment of $956.82 on 02/28/2022. On 03/01/2022, the Insured provided mitigation invoices and estimates from their contractor, W.B. Arthur. The total amount of water mitigation invoiced was $3,608.35; the total amount of estimated repairs was $4,935.23. HOAIC proceeded to review and investigate the amounts claimed and we have now finalized our review. HOAIC has accepted both the mitigation invoice1400 Corporate Drive Suite 300 Irving, TX 75038 866.407.9896 www.hoaic.com Page 2 of 2 and repair estimate and has issued a supplemental payment of $5,228.86 based on the following: Mitigation Invoice $3,608.35 Repair Estimate $4,935.23 Total: $8,543.58 Less Deductible $2,358.00 Less Prior Payments $956.82 Payment Due $5,228.76 As of 04/14/2022, HOAIC has issued payment for the submitted water mitigation invoice and the repair estimate. Our records do not reflect that we have received a copy of the $570.89 plumbing repair invoice, however, the plumbing repairs would not likely be covered under the policy terms. STEPS TAKEN TO RESOLVE THE MATTER: If the Insured would like to provide copies of the plumbing repair invoices, we will be happy to review and verify if there is any coverage.. We trust that this response and subsequent actions provide the Bureau with the information that it needs in order to consider this complaint file closed. However, should you have any questions or require anything further, please do not hesitate to contact me directly. Respectfully Submitted, Stephanie A**** Regulatory Compliance Analyst Toll-Free: 866-407-9896, ext. **** Email: sa****@hoaic.com Consumer Response /* (2000, 10, 2022/04/21) */ (The consumer indicated he/she ACCEPTED the response from the business.) The insurance company ended up covering nearly all expenses after reviewing the case with the Texas Department of Insurance. Thanks!

• Initial Complaint

  03/04/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Tornado caused tree to fall on my home on January 9, 2022. I filed claim with Homeowners of America the morning of January 10th. On January 11th Homeowners of America sent a mitigation company, Entrusted, to my home to assess and remove any thing from interior that was damaged. After receiving assurance that Entrusted and Homeowners of America were working in concert, Entrusted removed all damages, including kitchen cabinets, kitchen flooring and sheetrock from kitchen walls. Homeowners of America is now refusing to pay to replace all things associated with the kitchen due to a previous claim. Our desk adjuster, Jeremy *********, did not respond to email till Jan 27th. At no point were we told we would be responsible for the kitchen. Their sub-contractor (Entrusted), did work, I have a text from my contact with Entrusted saying I would not be financially responsible for the work. Entrusted has also been paid for removing the items in the kitchen. Homeowners of America is responsible for the work of their sub-contractor, especially when their representative will not communicate in a timely manor. I have been out of work since November, had I know I would be financially responsible for anything other than my deductible I would have stopped the work, I can't afford to have my kitchen re-built.

  Business response

  05/16/2022

  Business Response /* (1000, 8, 2022/04/11) */ To Whom It May Concern: We are in receipt of your letter dated March 9, 2022 regarding the above-referenced complaint. We appreciate the opportunity to investigate this matter in order to determine how one of our valued customers became displeased, and to hopefully be able to reach an amicable resolution. This matter has been referred to me, Stephanie *****, Regulatory Compliance Analyst, for handling. UNDERWRITING COMPANY NAME: Homeowners of America Insurance Company ("*****") NAIC NUMBER: 12536 COMPANY'S POSITION ON THE ISSUES RAISED IN THE COMPLAINT: Mr. *** submitted a claim to ***** on 1/9/2022 for wind collision and damage to his property on 1/9/2022. During the inspection for this claim it was found that ineligible repairs needed from claims filed in 2017 and 2021 from surface water and saturation in the kitchen had not been resolved. o On August 28, 2017 a claim was reported to ***** that Hurricane Harvey caused a water leak under the front & back door, as well as a window. o In January 5, 2021 a claim was reported to ***** stating that the insured was replacing the bamboo flooring and noticed water damage to the floor. This water damage has existed since the time of the 2017 claim and had not been repaired. This claim was withdrawn. o On January 9, 2022 a claim was submitted to ***** due to roof damage from a fallen tree and that water had entered the dwelling. An inspection made on January 11, 2022 ******************** Suite 300 Irving, TX 75038 8*********** www.hoaic.com Page 2 of 2 revealed that once again, this is damage from the 2017 claim and no repairs had been made. To conclude this claim, ***** paid $40,589.60 for damages to the roof. o Page 6 of Mr. ***'s policy excludes coverage of the damages as follows: "We do not cover loss caused by or resulting from flood, surface water, waves, overflow of streams or other bodies of water or spray from any of these whether or not driven by wind. We do not insure for such loss regardless of the cause of flood, surface water, waves, overflow of streams or other bodies of water. We do cover an ensuing loss by theft or attempted theft or any act of stealing." STEPS TAKEN TO RESOLVE THE MATTER: We asked that Mr. *** reviews his records and immediately submit any documentation that supports completed repairs. Absent of such, we are unable to make any payments for the associated water damage discovered to the kitchen area of the home. CORRECTIVE ACTION TAKEN: Should we receive the requested documentation, we will be able to re-review Mr. ***'s claim. We trust that this response and subsequent actions provide the Bureau with the information that it needs in order to consider this complaint file closed. However, should you have any questions or require anything further, please do not hesitate to contact me directly. Respectfully Submitted, Stephanie ***** Regulatory Compliance Analyst Toll-Free: 8***********, ext. 4303 Email: ********oaic.com

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