Filing Number:     288743

Filing Accepted:  6/28/2015

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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 # * 0316-07-13U Claim #* 0316-07-13U

Attorney

Attorney is Applicable

Violation

Insurer Type *   Authorized Insurer Unauthorized Insurer   Insurer Name Insurer Name*   UNITED SERVICES AUTOMOBILE ASSOCIATION Insurer Name* Street Address* City, State Zip* , NAIC Company Code 25941   Name of individual responsible for violation (if any):* KRISTEN VAN DER LINDE, KATHRYN MERKER OUGHTON, SARA SEPULVEDA, DEBORAH CAKOUROS Type of Insurance * Auto

Reason for Notice * Other : Section 817, Commercial Conspiracy to Defraud Other : Complicity (Criminal Complicity) Other : Aiding and Abetting Other : Fraud and other criminal concealment, as well as destruction/disposal of documents Other : Intentional Infliction of Emotional Distress Other : Negligent Infliction of Emotional Distress Claim Delay Unsatisfactory Settlement Offer Other : A commercial scheme to defraud including but not limited to patterns of fraud Other : Insurance Fraud in partnering with a provider to liquidate assured's benefit package Other : Deliberate acts to deceive and delay the assured, Insurance Commissioner, and third parties Other : Criminal Mischief Other : Intentional dishonest and deceitful and delayed responses & handling to previous Civil Remedy filing Other : Deliberate acts to delay and deceive proceedings and processes Other : Inequitable Doctrine use of legal counsel to abuse the assured * 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)(d) Denying claims without conducting reasonable investigations based upon available information. 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) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). * Specific policy language that is relevant to the violation. Enter all words or phrases (one at a time) that should be used to filter. Despite multiple requests, the insurance company USAA purposely sent policy to the wrong address. Their records (and now mine) clearly show they sent policy to an address knowingly as an attempt to further their criminal mischief in a federal direction.   * Facts and circumstances giving rise to the violation. Enter all words or phrases (one at a time) that should be used to filter. Nearly 80 (Eighty) Civil Remedy complaints have been filed relating to Civil and Criminal violations of the claims teams, attorneys, and representatives of insurers (USAA and their affiliates) regarding a loss and their material mishandling of their obligations connected to an event which occurred on August 29, 2010 or thereabouts. The responses to Civil Remedy notices have been delayed until the last possible time for response, and yet not any to the complainant's recollection have been addressed or dealt with. Every single Civil Remedy response has seen undue delay with inadequate response. Several are very good indications of fraud, as the insurer stated that had or would initiate some action which they failed. The response to Civil Remedy was a ruse. The insurer USAA and their affiliates are using the Civil Remedy process itself (abuse of process) to unduly agitate, irritate, delay, and annoy the assured/complainant. This is repetitive proof of Intentional Infliction of Emotional Distress, and Negligent Infliction of Emotional Distress. The frauds committed are too numerous to list herein, and have been only partially outlined in previous notices. We now see a clear-cut, well orchestrated fraud, pattern of frauds, and a commercial scheme to defraud as outlined previously. As it appears none of the Civil Remedy responses have been properly addressed, and no attempt to reconcile or acknowledge/address the concern we find the insurer (USAA) and their representatives are repetitively ignoring and abusing the Civil Remedy process itself. Their fraud(s) and patterns of fraud in this regard are abundantly clear. The deceptions, lies, and material misrepresentations of USAA's personnel, agents, attorneys, and affiliates appear to have no end. In each instance it appears material statements of dishonest nature have been made by USAA's representation. In fact, it is hard to find an accurate statement in any of their correspondence. For more than 2 years (since legal counsel was appointed to cover for an inhouse USAA fraud set) no correspondence has been properly handled by their representative/attorneys, who have failed in all fiduciary responsibilities to acknowledge, address, adjust and respond to material documents. Claims handling of this loss was derailed some 4+ years ago when USAA unlawfully stated that benefits were exhausted, when in fact we can all see at this juncture this was never the case. The numerous responses since that deception have been an attempt it would seem to cover that fraud. This is a convoluted but well documented, focused conspiracy to defraud. It is perceived that this type handling is routine by USAA, their handlers, agents, and attorneys, because it has been perpetuated throughout without hesitation at all levels of the organization. The wire transfer details for the assured was relayed to the USAA's attorney during a video recording of their own request. If/when they deem a payment is/was due then they were given access early on to make the transfer of funds. When the alleged "Statute of Limitations" passes without full payment of policy limits then the commercial fraud is "perfected" and we revert to Criminal Statutes governing the event. Criminal Statutes in this regard have no limits of liability nor statute of limitations. All along USAA has been in command and control of the commercial conspiracy to defraud, with the assured the victim of their abuses. Only full payment can alleviate the responsibility subject to the policy. The reckless and irresponsible handling of USAA and their agents ran costs of pursuits completely out of hand without any regard to sensible accounting, adjusting, or handling practices. The fake/HOAX EUO (Examinations Under Oath)(BOTH of them) are clearly reckless handling and misdirection of resources for the benefit of the attorney abuses. Failure to perform fiduciary duties in the face of reckless claims handling to justify their exorbitant costs. The attorneys, agents, handlers, and personnel of USAA and their affiliates on this loss have repeatedly, perpetually, and incomprehensibly ignored common practice and a lawful approach to the Civil Remedy system and normal claims practices, proving the criminal mischief and abuses were always at the core of their handling. As stated numerous times before, the claim as submitted can be paid in full via wire transfer directions given over at the Second Hoax EUO to criminal operative Kristen Van Der Linde, given before and since in submissions which Van Duh Linde and her team have failed to acknowledge, address, or adjust. I await transfer of funding to my account.

Comments

User Id   Date Added   Comment kvanderlinde@boyd-jenerette.com 09-07-2015 A letter was sent to the Complainant on 8/27/2015 in response to the Civil Remedy Notice.