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CONSUMERS BEWARE: The Missouri Department of Insurance - Consumer Affairs Division - Decides in Favor of MetLife Insurance

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To begin, let's recap the facts of the story - 


“During the late night hours of October 30, 2009, rainwater met a clog in the City of O’Fallon’s sewer main line that runs along Brookfield Lane and 4” of backed-up stormwater flooded our finished basement. All contents in the finished basement were saturated and destroyed including the hot water heater, clothes dryer, refrigerator, two business computers, additional peripheral electronic pieces, a television, dozens of family heirlooms, photos, childrens’ toys, etc. The carpeting and drywall were also destroyed. The losses are tallied at somewhere between $13,000 -$14,000.   

  There is no doubt of the causative factor. The City of O'Fallon pump truck was called out and removed tree roots from the sewer line located over 40 yards away and across the street from our property line. Approximately two – three years prior to this incident, the same scenario happened in the same place causing a sewer back-up in our basement. We caught that incident, as it occurred during daytime hours, and Alliance Water Resources was able to correct the problem quickly, limiting the amount of damage to a few hundred dollars. The claims were paid within a couple days. We have the complete file on this incident in our possession now proving this same problem occurred before and there was prior knowledge of the problem.  This time, we immediately filed a claim through the City of O’Fallon. However, the city’s insurance company, Travelers Insurance denied the claim stating:
 

THE CITY OF O'FALLON MUST HAVE PRIOR KNOWLEDGE
THAT THE BACK UP WAS GOING TO OCCUR FOR
TRAVELER'S INSURANCE TO DEEM THEM LIABLE.

  Their insurance agent, Margaret Loyd, advised us to file a claim with our homeowner’s insurance company. We filed the claim with claims adjuster Susan Wade of MetLife Insurance, our homeowner’s insurance company. Before the explanation of the event was even finished the agent announced the company’s position that they would not cover the claim. The first reason given was:


“If it didn’t happen on your property, we don’t cover it.”

When we didn't meekly accept that answer, she blurted out
“You don’t have sewer back-up insurance”.

 So, we asked for a signed copy of the original insurance policy that stated we needed a rider for this coverage. After all, this policy was purchased back in 2002 and we figured to assume there were never any changes made in coverage would be ridiculous. MetLife stated that our agent provided this to us at the time of purchase.  This is false for we purchased the insurance over the phone after shopping around for rates.  The only documentation we ever received was through the mail at the time of the annual renewal. After the fact, it was discovered this was only a 'declaration page', not the actual policy. So,  when MetLife insisted we had an agent, we asked for an errors and omissions report on this mysterious agent that MetLife claims we have.  We have never received any of these documents.


  “We decided to alert our community of this travesty of justice by hanging a professionally made sign on the front porch of our home for all passer-bys to read.  We have had a tremendous response to the informational sign we hung in front of our home. We’ve also experienced a shocking lesson in life when dealing with the City of O’Fallon government and insurance companies as VICTIMS of damage caused by the failure of the City of O’Fallon sewer system. We have learned that there are two separate issues that must be dealt with – one is the payment for damages sustained by failure of the City of O’Fallon sewer system. The second, and perhaps most important issue is, correcting the causative factor that caused the damages to stop this from happening again.
  Since this incident occurred, we've learned that several of our neighbors have experienced similar back-ups that were started at the same area of sewer pipe owned by the City of O’Fallon. All the parties have lived in their homes for 20 – 30+ years. All the back up problems began at the same time. The neighbors can almost clock the sewer back-ups into their homes for they have happened two times a year, every year, since a retention pond was built to eliminate storm water drainage from the O’Fallon Walk Shopping Center located at Feise Road and Highway K (2004).
   In spite of the City of O’Fallon/Traveler’s Insurance denial of knowledge of these back up incidents, the homeowners affected state they DID contact the City of O’Fallon in each situation. After each complaint was filed,  the sewer service truck arrived, cleaned out the line and the sewer water went back down their basement drains. Then, the City of O’Fallon systematically denied responsibility and the homeowners were forced to bear the financial losses. As a result of the sewer back up problems, the homeowners have had limited use of their lower levels of their homes and at least one of the homeowners lives daily with mold growing in their basement. The home values have been seriously harmed because of the on-going problem. We asked why they did not fight for what's right. They responded they are sick and tired of fighting with the City of O'Fallon over the issue and gave up.
  I contacted a civil engineer and works as a home inspector. I was advised by this professional that the bacteria content in sewer water cultivates BLACK MOLD in the proper growing environment. Since the neighbor that lives with this added problem fights serious health problems on a daily basis, my concern has grown and my determination is peaked to work to eliminate this problem from ever happening again! And, the awareness that the homeowners contacted the city on several occasions but received no assistance in remedying this long-term problem fuels my determination further.
  I have asked several sources along this bizarre road of irresponsibility, ‘Why is stormwater coming out of our sewer pipes, especially when the retention pond to the north of our subdivision is full?’ City staff denies the possibility. Yet, the Department of Natural Resources and the Environmental Protection Agency personnel I’ve spoken with feel there a realistic possibility this could be happening.  Both feel the city should know why the problem keeps happening. But, the City of O’Fallon claims to know nothing and their insurance company actually states this in writing.
  Though the elected officials profess that they are trying to save taxpayer money, this mistake could end up costing the city dearly. Instead of doing the ‘right thing’ and installing one-way valves in critical problem areas or inspecting the critical areas monthly during the spring and fall when the repeated back-up occur, they’ve chosen to take the “don’t know anything” road of deceit.
  So, to begin addressing the actual problem long-term, I formally requested a SSO Inspection (Sanitary Sewer Overflow Study) from the Department of Natural Resources for this particular area of problems. I strongly encourage anyone who has experienced the same problems to do the same. The EPA is a federal agency that oversees the development of standards and practices for the Department of Natural Resources – this service is not limited to just O’Fallon or St. Charles County problems. This service is available to all Americans!" 

Consumers: the following is the actual letters received from the Missouri Department of Insurance - Consumer Affairs Division and MetLife's response to our complaint:

page 2

Page 1

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____________________

 Consumer Affairs Division? 

  This consumer heard our lesson loud and clear. Does anyone know of a list that consumers may review to ensure that ALL possible riders are revealed and reviewed before the purchase of a policy? This finding from the State of Missouri Insurance Board clearly states it is the consumers responsibility to be sure everything they want protected with an insurance policy, whether they know of potential losses or scenarios or not, is covered in a policy or the insurance company doesn't have to pay. Scary, huh?

  This consumer feels duly reprimanded for not doing what the Missouri Department of Insurance considers due dilligence. However, what is truly troublesome as a consumer is - in spite of the fact that we were never given a signed copy of the original insurance policy that stated we needed a rider for this coverage or has this document ever been found by the insurance company, nor provided an errors or emissions  report on a mysterious agent that we have never met, nor even been provided  with an agent for service to this day - Missouri Department of Insurance did not in so much even shake a finger in the direction of The MetLife Insurance Company for the lack of service or shabby maintenance of client documents.

We still await findings for the complaint filed against Travelor's Insurance and the City of O'Fallon. We will be most interested in finding out if we are responsible for the damages caused by a clogged City of O'Fallon sewer pipe located across the street and three houses away from our property line. 

Stay tuned...