Pronto Insurance / failure to pay for damages
This is concerning an car accident and claim that was opened up in November of 2011. After towing the vehicle to BMW Dallas branch for repair we had to wait for Pronto insurance to send out an appraiser to come look at the vehicle before work could be started and before BMW would issue an rental that I could drive. After it taking a while for the appraiser to come out... he did take note that the vehicle was lop sided and sustained damage to the wheel. the shop service repair employee whom met with the appraiser informed the appraiser that the vehicle needed to be lifted up and assessment of the damage under the vehicle needed to be taken into consideration... According to correspondence with our BMW service advisor the appraiser replied "no no that is ok and not necessary, I have everything I need!" Unfortunately the adjuster with pronto insurance only approved enough payment to fix the actual wheel and not the damage to the under carriage... So we got a call from BMW asking what to do with the vehicle as only the wheel had been replaced and no work to the undercarriage had been done... So we contacted pronto insurance and spoke with the claims adjuster Rudy Ramos, finally .and he said he would send another appraiser out... over 3 weeks passed and we could not get an appraiser out to see the vehicle so we canceled the claim with pronto and decided to pay out of pocket so that the car could get fixed and decided to reopen the claim at a later date in the near future so we may then be reimbursed for the rest of the damage over $6000 which was covered by the full coverage policy we purchased from Pronto. We reopened an Claim approximately mid April 2012 . According to Pronto it was a supplement claim even though no claim had finalized any sort of payment. Over 2 weeks we argued with Rudy Ramos on getting an appraiser to review the Invoice we had sent in... During this argument Rudy Ramos Claimed that the Appraiser Tim told him that he went do to BMW and could not get any paper work from the service shop and that the service repair professional had become in-cooperative with him... Further more this same story was told to the primary lean holder of the vehicle . I contacted our service advisor at BMW to see what was going on and he said that he had faxed all the paper work and had not heard anything further from pronto insurance; He also stated that an appraiser was supposed to come and see him at the shop and no contact had been established. The way we saw this is that pronto insurance was lying to us and avoiding the issue as to bypass responsibility for paying this claim. The next morning when we called Rudy Ramos to express our concerns he was very ugly and rash about the process... He agreed to call the appraiser back up but refused to give us contact to the appraiser... After days back and forth he gave us contact to the dispatch center portion of pronto in which we were able to track down the appraiser Tim with Macnally in Dallas. After speaking with Tim he said that he had received the invoice from BMW and had spoken with the service advisor. In Tim's Final report and after speaking with everyone involved he said that Pronto insurance was fully liable for the entire claim; the only issue holding him back according to the report is that the invoice did not have any section that said PAID. I assured him that there was no conspiracy and that the claim was paid... It was after speaking with pronto further that they had delayed the issue and said they wanted proof of payment... we had BMW fax them and email us copies of the Money orders used to pay the shop at BMW; Yet again we ran into another issue about the proof of payment used pay BMW. Connie Elizondo, Rudy's manager suggested that she had received duplicated copies of money orders that were used to pay BMW for repairs. She interrogated me about the authenticity of the money orders and I was insulted. I felt like Connie Elizondo was accusing me of filing a fraudulent claim, which is a felony in Texas, and an assault on my character . They immediately jumped to the conclusion of fraud and threatened to open up an investigation, we said "go ahead!"After that point we encouraged them to call western union. After no action on their part had not immediately taken place we decided to take it upon ourselves to call WesternUnion or Orlandi Valuta and track down the money orders through their accounting and records department. We were able to get Western Union to fax them copies of the money orders and also get a written notice and signed on the statement BMW had provided which stated furthermore that the amount had been paid in full. After calling pronto back after this had been completed they now claim that the appraiser was not able to see the vehicle while it was still damaged! So now we are back at square one. We feel that pronto insurance is in fact the culprit that has continued to commit fraud and formulate issues in an attempt to dodge payment of an claim they are bound by according to state and federal law and by precedence are required to pay. There has been many correspondence via email, phone, and in person between the parties of all entities defined as adjusters at pronto insurance Rudy Ramos, Dayra Delacruise, Connie Elizondo, Eddie Luna, Robert Trevino to name a few, the appraiser Tim with Don Mcanally appraisal, (the lean holder of the vehicle) the service advisor with the BMW service repair shop and those at BMW Dallas accounting office, and the Owner of the vehicle whom was dealing with the claim. There is more then enough proof through records, emails, and correspondence to prove our claim is valid and that Pronto General Insurance is fully obligated to pay us the amount of $6, 373.On a personal note I wanted to express that I have had to do all the work for Pronto General Insurance . Such as providing them with evidence, contact information, reports, etc. to get them to do anything about my claim. I feel as though I should be getting paid. Mostly though I cant help but wonder what I would do if I was at work and I had a full time job... I would have to give up on this claim. I would not have the time to keep up with monitoring their progress, but I would eventually find days later that progress would still not be made. I feel like I have been extremely patient, but that my patience has not paid off. Now I am beginning to feel like I am just going to be scammed, and my faith in feeling like I am protected because I am insured is gone.Texas law requires drivers to have insurance to protect themselves and others. In this day and age in an economy where people are struggling to make a living to pay for basic necessities like auto insurance is growing, it is no wonder why people mistrust insurance companies. Pronto General Insurance and their lack of service has put me in financial situation. I wonder how many other consumers they have screwed.
** Fair Resolution:
If Pronto General Insurance and I do not come to a fair resolution by the date of Monday, May 7 2012 . i.e. - a fair resolution being the complete reimbursement of $6, 373 and only $6, 373 than the conditions for what I consider a fair resolution will be subject to change.Therefore, An appropriate resolution to this complaint would be for Pronto Insurance and Rudy Ramos to be audited, and upon the findings of the Texas Department of Insurance and/or any other agencies, terminated from his position. For the company to seek reform and no longer mistreat, misinform, or mishandle the quality of service to their consumers that they are both obligated and liable for. I have read and understand the laws that insurance agencies and their employees are obligated to, in Texas, and I am deeply concerned about the credibility and accountability of Pronto General Insurance.I am highly concerned that the company morale and company ethics are undeveloped, and perhaps would benefit from a mandatory workshop that would benefit all levels of staff at Pronto General Insurance. I would also suggest that the employees of Pronto General Insurance to be better educated in how to detect fraud with in the company and how to report it. If this has already been done than I would suggest a refresher course. The upper level management could use a mandatory refresher course on employee relations, and of course, I would expect to be reimbursed the full amount of $6, 373 that I had to pay out of pocket to BMW for repairs plus 18% annual interest to be added to the full amount of the claim. As the Texas Department of Insurance states in Sec. 26 in the Consumer Bill of Rights.That would be a fair resolution for how they handled my claim, or should I say how they did not handle my claim.