Civil Remedy Notice of Insurer Violations
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Filing Number:     262367
Filing Accepted:  7/23/2014
   Print Filing
Complainant
Last/Business Name *  
WHIDDEN   First Name   THEODORE
Street Address * P.O.BOX 158
City, State Zip * CHIPLEY, FL 32428
Email Address TEDWHIDDEN@GMAIL.COM
Complainant Type: Insured


Insured
Last/Business Name*   WHIDDEN   First Name   THEODORE
Policy # 0317 06 13U Claim #* 0317 06 13U


Attorney
Attorney is Applicable


Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name   UNITED SERVICES AUTOMOBILE ASSOCIATION (25941)
 
Name of individual responsible for violation (if any): SARA SEPULVEDA, DEBORAH CAKOUROS, KRISTEN VAN DER LINDE, KATHRYN OUGHTON
Type of Insurance * Auto   
Reason for Notice *
Claim Delay
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
626.9541(1)(i)(3)(i) Unfair claim settlement practices
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE ABOVE LISTED LEGAL VIOLATIONS ARE REPETITIVE OFFENSES OVER A 3 ½ YEAR PERIOD OF TIME IN WHICH VIRTUALLY ALL WHO HAVE ENGAGED THIS FILE ON BEHALF OF UNDERWRITERS HAVE COMMITTED OR INVOLVED THEMSELVES IN A CRIMINAL SCHEME TO DEFRAUD. THE LISTED INSURANCE VIOLATIONS ARE ONLY A FEW OF THE MANY THEY HAVE EMPLOYED TO FURTHER THEIR CRIMINAL EFFORTS. PREVIOUS CIVIL REMEDY FILINGS HAVE NOT BEEN ADDRESSED. UNDERWRITERS AND THEIR AGENTS CONTINUE TO AGGRESS THE ASSURED WITHOUT CAUSE. THEY HAVE FAILED TO COOPERATE IN THEIR CONTINUED BAD FAITH, AND ACCUSE THE ASSURED OF REACTING TO THEIR OFFENSES. THE LOSS TO WHICH THIS FILING REFERS STEMS FROM A REAR END COLLISION SUSTAINED BY THE ASSURED/VICTIM ON A CLEAR OPEN STRETCH OF INTERSTATE HIGHWAY, WHEREIN AN 18 WHEELER PRESUMABLY AT HIGH SPEED AND OUT OF CONTROL SLAMMED THE REAR END OF THE ASSURED’S VEHICLES LEAVING A TRAIL OF DEBRIS SOME 1100+ FEET ALONG THE HIGHWAY. SINCE THAT TIME THE INSURANCE CARRIER USAA AND THEIR AGENTS/AFFILIATES HAVE COMMITTED COUNTLESS DECEPTIONS AND OFFENSES TO AVOID, DELAY, AND DENY THEIR RESPONSIBILITY UNDER COVERAGE OF AN AUTOMOBILE POLICY. IT IS NOW ABUNDANTLY CLEAR THAT MATERIAL DOCUMENT MISHANDLING AT THE HANDS OF USAA AND THEIR AGENTS HAS TAKEN PLACE. IN FACT THE LAWYER (KRISTEN VAN DER LINDE) HAS REPETITIVELY FAILED TO ACKNOWLEDGE, ADDRESS, OR ADJUST DOCUMENTS AS FOUND IN HER FILE, THE FILE OF HER CLIENT AND AS FORWARDED TO HER. SHE IS SO CALLOUS, CRUEL, AND CORRUPT IN HER HANDLING OF DOCUMENTS THAT WE NOW HAVE RECORDED EVIDENCE OF HER DISPOSING/MISHANDLING OF DOCUMENTS. HER STAFF HAS BEEN ALERTED TO THEIR INVOLVEMENT IN HER DOCUMENT TAMPERING/FRAUD BY WAY OF THEIR FACILITATION (AIDING AND ABETTING). FORTUNATELY, THE MATERIAL MISHANDLING IS SO EASY TO ANTICIPATE THAT DOCUMENTING DOCUMENT TAMPERING BECAME EASY TO CAPTURE. THE APPOINTED CLAIMS HANDLER/ADJUSTER SARA SEPULVEDA HAS BEEN ADVISED VIA CIVIL REMEDY NOTICE THAT SHE IS AIDING AND ABEDDING AS WELL. THERE IS LITTLE/NO REASON IT SEEMS TO EXPECT ANY HONOR OR INTEGRITY FROM THE CLAIMS TEAM AT USAA. BAD FAITH IS ABUNDANTLY CLEAR AT A MINIMUM, AND CRIMINAL ATTEMPTS ARE IN THE MULTIPLES, DEMONSTRATING PATTERNS OF CORRUPTION. THE ATTORNEY ACTING AS “ADJUSTER” HAS SUBMITTED A LETTER TO THE ASSURED (COPY TO THE COMMISSIONER) REFERRING TO THEIR CONCLUSIONS IN REGARD TO CAUSE, EXTENT AND PERMANENCY OF THE CONDITION OF THE ASSURED/VICTIM (WHIDDEN). THIS “DIAGNOSIS” BY THE LEGAL TEAM IS CLEARLY OUTSIDE THE SCOPE OF THEIR EXPERTISE, AND NOT REFLECTED EITHER IN THE FILE OR THE RECORDED (HOAX EUO OF 2/14/2014). THIS IS A CLEAR ACT OF DECEPTION. AS A FOLLOW-UP EXAMINATION AND REPORT HAS BEEN FORWARDED TO USAA AND THEIR CRIMINALLY OPERATING CLAIMS HANDLER IT IS ANTICIPATED THAT THIS DOCUMENT WILL BE DISPOSED. THE DOCUMENT BEING FORWARDED AT THIS TIME TO USAA AND THEIR AGENTS CLOSES IN ESSENCE STATING: AFTER CAREFUL CONSULTATION AND EXAMINATION IT IS MY OPINION THAT THE INJURIES THAT THE PATIENT REPORTS ARE THE RESULT OF THE AUTOMOBILE COLLISION THAT OCCURRED 8/29/2010. MR. WHIDDEN IS NOT ABLE TO WORK DUE TO HIS INJURIES. IT WOULD BE ADVISABLE FOR HIM TO RECEIVE THERAPY FOR A PERIOD OF 2 TO 3 YEARS AND FOCUS ON HEALING. IT IS MY HOPE THAT HE WILL RECOVER SOME OF HIS COGNITIVE FUNCTION AND RETRAINED FOR EMPLOYMENT.”………… THIS COMES FROM A 6/24/2014 FOLLOW-UP EXAMINATION BY DR. TIM DOUGLASS WHO WAS THE FIRST MEDICAL PROFESSIONAL TO DOCUMENT EXAMINATION OF THE ASSURED FOLLOWING THE WRECK. HIS RECORDS STEM FROM THREE DAYS OR LESS FROM THE ACCIDENT TO PRESENT. DR. DOUGLASS’ CARE WAS INTERRUPTED FOLLOWING THE ACCIDENT DUE TO FAILURE OF USAA TO PAY INVOICING AS BILLED. UPON RETURN TO DR. DOUGLASS TO CLEAR THESE BACK ACCOUNTS, DR. DOUGLASS DEMONSTRATED HIS ABILITY TO TEMPORARILY ALLEVIATE PAINS, PRESSURES, AND SOME OF THE CONCERNS. AS A RESULT CARE WITH THIS PRACTICIANER WAS RESUMED. IT IS ANTICIPATED THAT USAA AND THEIR AGENTS WILL DISPOSE/MISHANDLE THIS FOLLOW-UP EXAM AS IT ADDRESSES MANY MATERIAL CONCERNS SUCH AS CAUSE, EXTENT, AND PERMANENCY WITH PRESCRIPTION FOR A 2-3 YEAR “SABBATICAL” TO ADDRESS WHAT HAS NOT BEEN HANDLED FOR THE EXTENDED PERIOD WHILE ASSURED WAS IN NEED OF MATERIAL FINANCIAL RE-IMBURSEMENT. IT IS WITH HOPE THAT IN LIGHT OF THIS INFORMATION USAA AND THEIR AGENTS CAN REDIRECT THEIR PAST PROCESSES AND FUND THE LOSS PROPERLY. DR. DOUGLASS REITERATES THE CONDITIONS NOTED THROUGHOUT THE FILES AND INVESTIGATIONS OF ALL PRACTICIANERS NOTING: ARTERIAL BLOOD FLOW DISRUPTION, CRUSHING INJURY, POST CONCUSSION SYNDROME, CERVICAL STRAIN/SPRAIN, SPRAINS/STRAINS THORACIC, SPRAIN/STRAIN LUMBAR, LEFT SHOULDER AND UPPER ARM SPRAIN, RIGHT ANKLE SPRAIN. THESE CONDITIONS WERE MOSTLY NOTED AND ESTABLISHED VIA MOTION XRAY AND OTHER METHODS IMMEDIATELY FOLLOWING THE ACCIDENT, AND INJURY LONG TERM (POSSIBLY PERMANENT) NOTED ALMOST 4 YEARS LATER BY THE SAME EXAMINING PHYSICIAN. PRIOR TO HAVING TO LEAVE A WORK ASSIGNMENT LEADING TO THE ABOVE REFERENCED REPORT/EXAM, I WAS ABLE TO RESTORE MY INCOME TO IN EXCESS OF $90,000 IN THE FIRST SIX MONTHS OF 2014 ONLY. EVIDENCE OF INCOMES OF $40,000 PER YEAR FOR THE 3 PRIOR YEARS HAS BEEN PROVIDED TO USAA AND THEIR AGENTS MULTIPLES OF TIMES, WITH MEDICAL EXPENSES PRETTY MUCH WIPING OUT ALL INCOME SINCE THE ACCIDENT SOME FOUR YEARS AGO. EVEN A CURSORY REVIEW OF DOCUMENTS WOULD DEMONSTRATE THE LOSS FAR EXCEEDS POLICY AMOUNTS INCLUDING THE THIRD PARTY COVERAGES WAIVED PREVIOUSLY BY USAA’S APPOINTED AGENT IN THE DECEMBER 19, 2013 MEETING IN MIAMI-DADE COUNTY COURT. I WOULD LIKE TO INITIATE LOSS OF INCOME PORTION OF CLAIM ON TOP OF THE ESTIMATED $120,000 IN OUT OF POCKET ALREADY BEFORE USAA AND THEIR AGENTS, HOWEVER WOULD LIKE TO HAVE SOMEONE OF INTEGRITY TO DEAL WITH AS WE EXPLORE THE INCOME RECORDS AND PRIVACY ISSUES KEPT FROM THOSE AGENTS OF FOUL PLAY LEADING TO THIS POINT. NOTE: TWO YEARS OF INCOME LOSS AT THE PRESENT ABILITY TO EARN WOULD CLEARLY WIPE OUT THE POLICY. UNDERWRITERS HAVE ALREADY BEEN ASKED TO ADJUST CLAIM TO THE EXTENT POSSIBLE USING OUT OF POCKET EXPENDITURE, RATHER THAN INCOME FOR REASONS OF TAXATION. FOR THE BENEFIT OF THOSE WHO MAY READ IN COPY, THE ASSURED’S FILE/FILINGS WITH USAA HAVE REVEALED FOR MORE THAN 3 YEARS BRAIN TRAUMA TESTING AND RESULTS, INDICATING NEUROCOGNITIVE DEFICITS AS A RESULT OF THE SUBJECT ACCIDENT, BALANCE DISORDER, BRAIN OXYGEN DEFICIT ISSUES, POST TRAUMATIC ISSUES, AND A HOST OF PARTIALLY ADDRESSED ISSUES STEMMING FROM THE ACCIDENT OF 8.29.2010. USAA REPRESENTATIVES DEMANDED AND RECEIVED PROVIDER FILES MORE THAN 2 YEARS AGO. USAA’S EXPLORATION FOR PRE-EXISTING CONDITION/ISSUES PRODUCED NOTHING. USAA HAS BEEN FULLY AWARE OF THE CONDITION, DEGRADATION, AND OSCILLATION OF THE ASSURED’S CONDITION BY WAY OF REGULAR FILINGS BY THE ASSURED. USAA HAS PERPETUATED AND CONTINUE IN AN APPROACH USING DELAY, DENIAL, AND DECEPTION TO AVOID THEIR RESPONSIBILITY. USAA HAS REFUSED ALL ALONG TO ENGAGE IN SENSIBLE COMMUNICATION REGARDING THE ACTUAL ACCIDENT. USE OF THE CIVIL REMEDY SYSTEM IS SEEMINGLY THE ONLY MEANS TO GET USAA AND THEIR AGENTS TO COMMUNICATE WITH THE ASSURED. IT IS CLEAR TO THE CASUAL OBSERVER THAT ASSURED IS SIGNIFICANTLY IMPAIRED AS A RESULT OF THE ACCIDENT AND THIS IS AFFIRMED BY MEDICAL REPORTS, FILES, AND SUPPORTS ALL PROVIDED TO USAA. IT HAS BEEN APPARENT THROUGHOUT THE LAST FOUR YEARS THAT USAA AND THEIR AGENTS HAVE BEEN TRYING TO TAKE UNDUE ADVANTAGE OF THE ASSURED’S SITUATION. IT IS WITH HOPE THAT A RESOLUTION CAN SOON BE ACHIEVED USING A NEW AGENT OF HONOR AND INTEGRITY. IN MOST “GOOD COP, BAD COP” HARASSMENT SCHEMES THE GOOD COP EVENTUALLY SHOWS UP. IT IS TIME FOR THAT PERSON TO ARRIVE AND MEDIATE THIS SITUATION. THUS FAR PLEAS FOR MEDIATION AND/OR REASONABLE HANDLING HAVE BEEN IGNORED BY USAA. USAA AND THEIR AGENTS HAVE CONSISTENTLY FAILED TO ACKNOWLEDGE, ADDRESS, AND/OR ADJUST DOCUMENTS AS SUBMITTED BY THE ASSURED. THE APPROACH OF USAA MOST SIGNIFICANTLY CHANGED AT A POINT WHEN THEY BECAME INVOLVED IN MULTIPLE INSTANCES OF INSURANCE FRAUD IN THE EARLY DAYS OF THE ACCIDENT. FAILURE TO PAY FULL POLICY LIMITS BY THE END OF THE STATUTE OF LIMITATIONS “PERFECTS” THE FRAUD AGAINST THE POLICY ATTEMPTED AT THAT TIME, AND USAA IS CLEARLY PARTY TO THAT FRAUD PERFECTED SOME 3 YEARS AGO. FURTHER TO THIS NUMEROUS FRAUDS OUTLINED IN CIVIL REMEDY FILINGS BECOME PERFECTED DEMONSTRATING A PATTERN AND INTENT TO DEFRAUD MAKING IT A SCHEME TO DEFRAUD. IT IS ANTICIPATED THAT IF THE AGENTS OF BAD FAITH AND ABUSE THAT HAVE BEEN PARTY TO THIS LOSS ON BEHALF OF USAA REMAIN INVOLVED THEN CONTINUED DISSERVICE AND ABUSE WILL BE SUSTAINED BY THE ASSURED. FOR 3+ YEARS THE ASSURED HAS BEEN REQUESTING SOMEONE OF HONOR AND INTEGRITY APPOINTED TO MANAGE/HANDLE THIS FILE. CLEARLY TIME IS OVERDUE FOR SUBSTANTIAL PAYMENT ON THE FILE. ANY FURTHER DELAY IS CLEARLY INTENDED AS HARASSMENT. FAILURE TO PAY FULL POLICY AMOUNTS PROMPTLY WILL CLEARLY EXTEND LIABILITIES OF USAA AND THEIR AGENTS UNDER THE CRIMINAL PROSECUTION SIDE OF THIS LOSS. 624.155(1)(B)(1) NOT ATTEMPTING IN GOOD FAITH TO SETTLE CLAIMS WHEN, UNDER ALL THE CIRCUMSTANCES, IT COULD AND SHOULD HAVE DONE SO, HAD IT ACTED FAIRLY AND HONESTLY TOWARD ITS INSURED AND WITH DUE REGARD FOR HER OR HIS INTERESTS. 624.155(1)(B)(3) EXCEPT AS TO LIABILITY COVERAGES, FAILING TO PROMPTLY SETTLE CLAIMS, WHEN THE OBLIGATION TO SETTLE A CLAIM HAS BECOME REASONABLY CLEAR, UNDER ONE PORTION OF THE INSURANCE POLICY COVERAGE IN ORDER TO INFLUENCE SETTLEMENTS UNDER OTHER PORTIONS OF THE INSURANCE POLICY COVERAGE.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE ABOVE LISTED LEGAL VIOLATIONS ARE REPETITIVE OFFENSES OVER A 3 ½ YEAR PERIOD OF TIME IN WHICH VIRTUALLY ALL WHO HAVE ENGAGED THIS FILE ON BEHALF OF UNDERWRITERS HAVE COMMITTED OR INVOLVED THEMSELVES IN A CRIMINAL SCHEME TO DEFRAUD. THE LISTED INSURANCE VIOLATIONS ARE ONLY A FEW OF THE MANY THEY HAVE EMPLOYED TO FURTHER THEIR CRIMINAL EFFORTS. PREVIOUS CIVIL REMEDY FILINGS HAVE NOT BEEN ADDRESSED. UNDERWRITERS AND THEIR AGENTS CONTINUE TO AGGRESS THE ASSURED WITHOUT CAUSE. THEY HAVE FAILED TO COOPERATE IN THEIR CONTINUED BAD FAITH, AND ACCUSE THE ASSURED OF REACTING TO THEIR OFFENSES. THE LOSS TO WHICH THIS FILING REFERS STEMS FROM A REAR END COLLISION SUSTAINED BY THE ASSURED/VICTIM ON A CLEAR OPEN STRETCH OF INTERSTATE HIGHWAY, WHEREIN AN 18 WHEELER PRESUMABLY AT HIGH SPEED AND OUT OF CONTROL SLAMMED THE REAR END OF THE ASSURED’S VEHICLES LEAVING A TRAIL OF DEBRIS SOME 1100+ FEET ALONG THE HIGHWAY. SINCE THAT TIME THE INSURANCE CARRIER USAA AND THEIR AGENTS/AFFILIATES HAVE COMMITTED COUNTLESS DECEPTIONS AND OFFENSES TO AVOID, DELAY, AND DENY THEIR RESPONSIBILITY UNDER COVERAGE OF AN AUTOMOBILE POLICY. IT IS NOW ABUNDANTLY CLEAR THAT MATERIAL DOCUMENT MISHANDLING AT THE HANDS OF USAA AND THEIR AGENTS HAS TAKEN PLACE. IN FACT THE LAWYER (KRISTEN VAN DER LINDE) HAS REPETITIVELY FAILED TO ACKNOWLEDGE, ADDRESS, OR ADJUST DOCUMENTS AS FOUND IN HER FILE, THE FILE OF HER CLIENT AND AS FORWARDED TO HER. SHE IS SO CALLOUS, CRUEL, AND CORRUPT IN HER HANDLING OF DOCUMENTS THAT WE NOW HAVE RECORDED EVIDENCE OF HER DISPOSING/MISHANDLING OF DOCUMENTS. HER STAFF HAS BEEN ALERTED TO THEIR INVOLVEMENT IN HER DOCUMENT TAMPERING/FRAUD BY WAY OF THEIR FACILITATION (AIDING AND ABETTING). FORTUNATELY, THE MATERIAL MISHANDLING IS SO EASY TO ANTICIPATE THAT DOCUMENTING DOCUMENT TAMPERING BECAME EASY TO CAPTURE. THE APPOINTED CLAIMS HANDLER/ADJUSTER SARA SEPULVEDA HAS BEEN ADVISED VIA CIVIL REMEDY NOTICE THAT SHE IS AIDING AND ABEDDING AS WELL. THERE IS LITTLE/NO REASON IT SEEMS TO EXPECT ANY HONOR OR INTEGRITY FROM THE CLAIMS TEAM AT USAA. BAD FAITH IS ABUNDANTLY CLEAR AT A MINIMUM, AND CRIMINAL ATTEMPTS ARE IN THE MULTIPLES, DEMONSTRATING PATTERNS OF CORRUPTION. THE ATTORNEY ACTING AS “ADJUSTER” HAS SUBMITTED A LETTER TO THE ASSURED (COPY TO THE COMMISSIONER) REFERRING TO THEIR CONCLUSIONS IN REGARD TO CAUSE, EXTENT AND PERMANENCY OF THE CONDITION OF THE ASSURED/VICTIM (WHIDDEN). THIS “DIAGNOSIS” BY THE LEGAL TEAM IS CLEARLY OUTSIDE THE SCOPE OF THEIR EXPERTISE, AND NOT REFLECTED EITHER IN THE FILE OR THE RECORDED (HOAX EUO OF 2/14/2014). THIS IS A CLEAR ACT OF DECEPTION. AS A FOLLOW-UP EXAMINATION AND REPORT HAS BEEN FORWARDED TO USAA AND THEIR CRIMINALLY OPERATING CLAIMS HANDLER IT IS ANTICIPATED THAT THIS DOCUMENT WILL BE DISPOSED. THE DOCUMENT BEING FORWARDED AT THIS TIME TO USAA AND THEIR AGENTS CLOSES IN ESSENCE STATING: AFTER CAREFUL CONSULTATION AND EXAMINATION IT IS MY OPINION THAT THE INJURIES THAT THE PATIENT REPORTS ARE THE RESULT OF THE AUTOMOBILE COLLISION THAT OCCURRED 8/29/2010. MR. WHIDDEN IS NOT ABLE TO WORK DUE TO HIS INJURIES. IT WOULD BE ADVISABLE FOR HIM TO RECEIVE THERAPY FOR A PERIOD OF 2 TO 3 YEARS AND FOCUS ON HEALING. IT IS MY HOPE THAT HE WILL RECOVER SOME OF HIS COGNITIVE FUNCTION AND RETRAINED FOR EMPLOYMENT.”………… THIS COMES FROM A 6/24/2014 FOLLOW-UP EXAMINATION BY DR. TIM DOUGLASS WHO WAS THE FIRST MEDICAL PROFESSIONAL TO DOCUMENT EXAMINATION OF THE ASSURED FOLLOWING THE WRECK. HIS RECORDS STEM FROM THREE DAYS OR LESS FROM THE ACCIDENT TO PRESENT. DR. DOUGLASS’ CARE WAS INTERRUPTED FOLLOWING THE ACCIDENT DUE TO FAILURE OF USAA TO PAY INVOICING AS BILLED. UPON RETURN TO DR. DOUGLASS TO CLEAR THESE BACK ACCOUNTS, DR. DOUGLASS DEMONSTRATED HIS ABILITY TO TEMPORARILY ALLEVIATE PAINS, PRESSURES, AND SOME OF THE CONCERNS. AS A RESULT CARE WITH THIS PRACTICIANER WAS RESUMED. IT IS ANTICIPATED THAT USAA AND THEIR AGENTS WILL DISPOSE/MISHANDLE THIS FOLLOW-UP EXAM AS IT ADDRESSES MANY MATERIAL CONCERNS SUCH AS CAUSE, EXTENT, AND PERMANENCY WITH PRESCRIPTION FOR A 2-3 YEAR “SABBATICAL” TO ADDRESS WHAT HAS NOT BEEN HANDLED FOR THE EXTENDED PERIOD WHILE ASSURED WAS IN NEED OF MATERIAL FINANCIAL RE-IMBURSEMENT. IT IS WITH HOPE THAT IN LIGHT OF THIS INFORMATION USAA AND THEIR AGENTS CAN REDIRECT THEIR PAST PROCESSES AND FUND THE LOSS PROPERLY. DR. DOUGLASS REITERATES THE CONDITIONS NOTED THROUGHOUT THE FILES AND INVESTIGATIONS OF ALL PRACTICIANERS NOTING: ARTERIAL BLOOD FLOW DISRUPTION, CRUSHING INJURY, POST CONCUSSION SYNDROME, CERVICAL STRAIN/SPRAIN, SPRAINS/STRAINS THORACIC, SPRAIN/STRAIN LUMBAR, LEFT SHOULDER AND UPPER ARM SPRAIN, RIGHT ANKLE SPRAIN. THESE CONDITIONS WERE MOSTLY NOTED AND ESTABLISHED VIA MOTION XRAY AND OTHER METHODS IMMEDIATELY FOLLOWING THE ACCIDENT, AND INJURY LONG TERM (POSSIBLY PERMANENT) NOTED ALMOST 4 YEARS LATER BY THE SAME EXAMINING PHYSICIAN. PRIOR TO HAVING TO LEAVE A WORK ASSIGNMENT LEADING TO THE ABOVE REFERENCED REPORT/EXAM, I WAS ABLE TO RESTORE MY INCOME TO IN EXCESS OF $90,000 IN THE FIRST SIX MONTHS OF 2014 ONLY. EVIDENCE OF INCOMES OF $40,000 PER YEAR FOR THE 3 PRIOR YEARS HAS BEEN PROVIDED TO USAA AND THEIR AGENTS MULTIPLES OF TIMES, WITH MEDICAL EXPENSES PRETTY MUCH WIPING OUT ALL INCOME SINCE THE ACCIDENT SOME FOUR YEARS AGO. EVEN A CURSORY REVIEW OF DOCUMENTS WOULD DEMONSTRATE THE LOSS FAR EXCEEDS POLICY AMOUNTS INCLUDING THE THIRD PARTY COVERAGES WAIVED PREVIOUSLY BY USAA’S APPOINTED AGENT IN THE DECEMBER 19, 2013 MEETING IN MIAMI-DADE COUNTY COURT. I WOULD LIKE TO INITIATE LOSS OF INCOME PORTION OF CLAIM ON TOP OF THE ESTIMATED $120,000 IN OUT OF POCKET ALREADY BEFORE USAA AND THEIR AGENTS, HOWEVER WOULD LIKE TO HAVE SOMEONE OF INTEGRITY TO DEAL WITH AS WE EXPLORE THE INCOME RECORDS AND PRIVACY ISSUES KEPT FROM THOSE AGENTS OF FOUL PLAY LEADING TO THIS POINT. NOTE: TWO YEARS OF INCOME LOSS AT THE PRESENT ABILITY TO EARN WOULD CLEARLY WIPE OUT THE POLICY. UNDERWRITERS HAVE ALREADY BEEN ASKED TO ADJUST CLAIM TO THE EXTENT POSSIBLE USING OUT OF POCKET EXPENDITURE, RATHER THAN INCOME FOR REASONS OF TAXATION. FOR THE BENEFIT OF THOSE WHO MAY READ IN COPY, THE ASSURED’S FILE/FILINGS WITH USAA HAVE REVEALED FOR MORE THAN 3 YEARS BRAIN TRAUMA TESTING AND RESULTS, INDICATING NEUROCOGNITIVE DEFICITS AS A RESULT OF THE SUBJECT ACCIDENT, BALANCE DISORDER, BRAIN OXYGEN DEFICIT ISSUES, POST TRAUMATIC ISSUES, AND A HOST OF PARTIALLY ADDRESSED ISSUES STEMMING FROM THE ACCIDENT OF 8.29.2010. USAA REPRESENTATIVES DEMANDED AND RECEIVED PROVIDER FILES MORE THAN 2 YEARS AGO. USAA’S EXPLORATION FOR PRE-EXISTING CONDITION/ISSUES PRODUCED NOTHING. USAA HAS BEEN FULLY AWARE OF THE CONDITION, DEGRADATION, AND OSCILLATION OF THE ASSURED’S CONDITION BY WAY OF REGULAR FILINGS BY THE ASSURED. USAA HAS PERPETUATED AND CONTINUE IN AN APPROACH USING DELAY, DENIAL, AND DECEPTION TO AVOID THEIR RESPONSIBILITY. USAA HAS REFUSED ALL ALONG TO ENGAGE IN SENSIBLE COMMUNICATION REGARDING THE ACTUAL ACCIDENT. USE OF THE CIVIL REMEDY SYSTEM IS SEEMINGLY THE ONLY MEANS TO GET USAA AND THEIR AGENTS TO COMMUNICATE WITH THE ASSURED. IT IS CLEAR TO THE CASUAL OBSERVER THAT ASSURED IS SIGNIFICANTLY IMPAIRED AS A RESULT OF THE ACCIDENT AND THIS IS AFFIRMED BY MEDICAL REPORTS, FILES, AND SUPPORTS ALL PROVIDED TO USAA. IT HAS BEEN APPARENT THROUGHOUT THE LAST FOUR YEARS THAT USAA AND THEIR AGENTS HAVE BEEN TRYING TO TAKE UNDUE ADVANTAGE OF THE ASSURED’S SITUATION. IT IS WITH HOPE THAT A RESOLUTION CAN SOON BE ACHIEVED USING A NEW AGENT OF HONOR AND INTEGRITY. IN MOST “GOOD COP, BAD COP” HARASSMENT SCHEMES THE GOOD COP EVENTUALLY SHOWS UP. IT IS TIME FOR THAT PERSON TO ARRIVE AND MEDIATE THIS SITUATION. THUS FAR PLEAS FOR MEDIATION AND/OR REASONABLE HANDLING HAVE BEEN IGNORED BY USAA. USAA AND THEIR AGENTS HAVE CONSISTENTLY FAILED TO ACKNOWLEDGE, ADDRESS, AND/OR ADJUST DOCUMENTS AS SUBMITTED BY THE ASSURED. THE APPROACH OF USAA MOST SIGNIFICANTLY CHANGED AT A POINT WHEN THEY BECAME INVOLVED IN MULTIPLE INSTANCES OF INSURANCE FRAUD IN THE EARLY DAYS OF THE ACCIDENT. FAILURE TO PAY FULL POLICY LIMITS BY THE END OF THE STATUTE OF LIMITATIONS “PERFECTS” THE FRAUD AGAINST THE POLICY ATTEMPTED AT THAT TIME, AND USAA IS CLEARLY PARTY TO THAT FRAUD PERFECTED SOME 3 YEARS AGO. FURTHER TO THIS NUMEROUS FRAUDS OUTLINED IN CIVIL REMEDY FILINGS BECOME PERFECTED DEMONSTRATING A PATTERN AND INTENT TO DEFRAUD MAKING IT A SCHEME TO DEFRAUD. IT IS ANTICIPATED THAT IF THE AGENTS OF BAD FAITH AND ABUSE THAT HAVE BEEN PARTY TO THIS LOSS ON BEHALF OF USAA REMAIN INVOLVED THEN CONTINUED DISSERVICE AND ABUSE WILL BE SUSTAINED BY THE ASSURED. FOR 3+ YEARS THE ASSURED HAS BEEN REQUESTING SOMEONE OF HONOR AND INTEGRITY APPOINTED TO MANAGE/HANDLE THIS FILE. CLEARLY TIME IS OVERDUE FOR SUBSTANTIAL PAYMENT ON THE FILE. ANY FURTHER DELAY IS CLEARLY INTENDED AS HARASSMENT. FAILURE TO PAY FULL POLICY AMOUNTS PROMPTLY WILL CLEARLY EXTEND LIABILITIES OF USAA AND THEIR AGENTS UNDER THE CRIMINAL PROSECUTION SIDE OF THIS LOSS.


Comments
User Id Date Added Comment
kvanderlinde@boyd-jenerette.com 08-19-2014 A letter was sent to the Complainant on 08/19/2014 in response to the Civil Remedy Notice.
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

After submitting a Notice using this system, you must PRINT A COPY and provide it to the insurer.




DFS-10-363
Rev. 10/14/2008