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Jacksonville couple in dispute with insurance company over claim

5:30 PM, Jul 13, 2012   |    comments
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JACKSONVILLE, Fla. -- A fire gutted Thomas and Margaret Setzer's Southside home and tossed them into a fight with their homeowner insurance company. 

"They're just delaying and delaying and delaying," said Thomas Setzer.

Thomas Setzer is a disabled Vietnam veteran and uses a wheelchair to get around.

"I barely got out of the house and watched it go up in smoke," he said.

Setzer, wife Margaret, two daughters, an autistic grandson and two dogs have been living in two motel rooms since May 25.

They say their insurance carrier, Universal Property and Casualty, is refusing to pay some of their expenses.

"It has taken $3,200 to be here and we're still behind," said Margaret Setzer.

The Setzers say according to their public adjuster, they're entitled to an advance and reimbursement, but everything is being delayed.

"We're are not getting a penny from them," said Setzer, "Right now, my wife has 30 cents in her pocket." 

The fire was ruled accidental; it was started by a candle. Mike Rump is a public adjuster hired to help the Setzers with their claim.

"The investigation has been completed by the insurance company," said Rump, "Now it is with management to review as to whether or not they want to pay or will continue the investigation. It is in hold pattern."

Rump said the insurance company is required to pay any additional living expenses, but it has not.

"They're not willing to at this time advance money so the Setzers can get out of the hotel room," said Rump.

They thought the claim process would take four, maybe five weeks. It hasn't.

The said the only thing that has kept them going is their faith, but even their faith is now being challenged by how long it is taking to settled this claim.

"I pray to give me the strength not to lose my faith. This is really trying," said Thomas Setzer.

We contacted Universal Property and Casualty by phone and email and still waiting on a response.

According to Rump, the company agreed to reimburse the Setzers for some of their expenses, but is not moving on other advances.

The Office of the Insurance Consumer Advocate gave rated insurance carriers and Universal Property and Casualty was a poor performer. The office gave the company an "E," the lowest grade in its 2011 report card.

How should you resolve an insurance claim dispute:

-Know your rights. Read your policy thoroughly, fine print and all.

-Keep all paperwork for expenses prior and during a claim.

-Get your agent involved and document the conversation.

-If all fails, file a complaint with the state insurance commissioner's office.

First Coast News

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