Choice Home Warranty AC Condenser

I received a free year of CHW "ultimate plan" when I bought my house a little less than a year ago. I never used them because I figured it would be a waste of the service fee call, however I saw I had a "free service call" https://imgur.com/HyjAQRW. Called them about an AC issue, when tech arrived I was still required to pay the $65 fee, and CHW will not reimburse me for the service fee or fix the condenser due to is not being "normal wear and tear". Just wondering if anyone has tried to fight them on these grounds and what your outcome was.

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This is the response I received:

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Thursday July 28th, 2022 Claim [redacted policy, name, and address], This letter is in reference to your Air Conditioning claim. We have carefully reviewed the details of the claim and a coverage determination has been reached.
During the coverage period, our sole responsibility will be to arrange for a qualified service contractor to repair or replace, at our expense, the systems and components mentioned as "Included" in accordance with the terms and conditions of your contract so long as such systems and components:

  1. Are located inside the confines of the main foundation of the home or attached or detached garage (with the exception of the exterior pool/spa, well pump, septic tank pumping and air conditioner);and
  2. Become inoperative due to normal wear and tear; and
  3. Are in place and in proper working order on the effective date of this home warranty contract. This Contract provides coverage for unknown/undetectable pre-existing conditions so long as the malfunction could not, or would not, have been detected by a visual inspection or simple mechanical test.

Your claim was submitted on 07/20/22 and was assigned to RHERD Co. LLC DBA AR-TEX A/C & HEATING on 07/26/22. After the appointment date on 07/27/22 the technician submitted details pertaining to your system failure. It has been determined the condenser coils fins are damaged, restricting the necessary airflow throughout the system. The system is now in need of replacement. This is not a failure that occurs under normal wear and tear conditions.
Please refer to your terms and conditions section A number 2; which require systems become inoperative due to normal wear and tear. Your policy provides coverage for failures that are the result of normal wear and tear. Failures that occur due to abnormal operating conditions or catastrophic events are excluded from coverage. Appeal Rights You may request a review of this claim in writing by visiting https://www.choicehomewarranty.com/cads/claimreview.php?ccid=VpLIEAN97x_e8h1gEi8ZQk7VGoPvJPVpuEjOOY_6Q7s. The request for review must be sent within 7 days of receipt of this letter and state the reasons why you feel your claim should have been approved. Nothing contained in this letter should be construed as a waiver of any rights or defenses under the policy. This determination has been made in good faith and without prejudice under the terms and conditions of the contract, whether or not specifically mentioned herein. Thank you for choosing Choice Home Warranty to be part of protecting your home from unexpected covered repairs. Sincerely, Team CHW * Please log in to the account center to view complete limits of liability and any exclusions. CHW offers service contracts which are not warranties.

We pride ourselves on having satisfied customers, and we are committed to customer satisfaction and allowing every customer the opportunity to voice their concerns. Case managers are available for policyholders to review material relating to a claim and discuss any issues important to our customers. The case manager will review the appeal and compare the information of the claim to ensure that policyholders understand all claim determinations and understand the benefits of coverage. It is important to note that a case manager cannot change the policy for a policyholder nor the benefits of coverage. Customers can request a case manager review 24 hours a day, seven days a week, 365 days a year. Case managers are available during regular normal business hours and will contact the policyholder within 48 hours from assignment. To book a meeting time with a case manager, you can easily schedule a time to discuss with a case manager at the following easy to use website: https://www.choicehomewarranty.com/cads/claimreview.php?ccid=VpLIEAN97x_e8h1gEi8ZQk7VGoPvJPVpuEjOOY_6Q7s, or by calling (800) 496-7813. The request for review must be sent within 7 days of receipt of this letter and state the reasons why you feel your claim should have been approved. We advise our policyholders to book a meeting with their case manager as soon as possible to minimize wait time and streamline the appeal.



Submitted July 29, 2022 at 12:25AM by shapoopytroopy https://ift.tt/sKjD73T

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