Reference no: EM131194128

Question:
Case study - letter to unhappy customers

Background: Hurricane Sandy caused extensive property damage to customers of Penn National Insurance. When customers submit a claim for property damage to their insurance company, an adjuster from the company inspects the damage and determines if the damage is covered under contractual terms of the insurance policy, or not covered. Much of Sandy's damage came from flood waters. Floods are not covered by private insurance. Only the federal government provides flood insurance coverage. So any policyholders who submitted claims for damages that were caused by flood waters were denied payment under the terms of their insurance policy.

State law in New Jersey, where the bulk of Sandy's damage occurred, requires insurance companies to include in their written denial of a customer's claim an explanation of the legal process that the state offers to policyholders whose claims have been denied, allowing them to challenge the declination.

In the letters they sent to policyholders whose claims were being denied, Penn National Insurance's local New Jersey claims adjusters failed to include that legal language discussing the appeal process. When management in the company's headquarters realized this, they asked the claims adjusters to issue a second letter to all whose claims had been denied, with an enclosure of an explanation of the appeals process.

The draft copy of the letter, below, is what the company's Claims Division proposed sending to policyholders, to make up for the failure to inform policyholders of the legal process that they can follow to challenge the declination of their claim.

Dear valued insured:
It has come to my attention that you have recently received a denial of coverage letter from our company. This will supplement our recent correspondence in which we informed you that there is no coverage provided for your loss. We sincerely regret that we could not be of assistance to you during these difficult times. Unfortunately, and I hope you can appreciate, we can only pay for those claims in which coverage is provided by the terms and conditions of the insurance contract.

Our original coverage declination letter to you did not include certain language that may be relevant in your situation. Please note that we are enclosing language that outlines certain specific appeals processes. If you feel our position is inaccurate and dispute our findings, you may follow the directions as outlined and the matter will be reviewed in further detail.

Sincerely,
xxxxxxxxxxxxxxxxxxxxxxx

Writing exercise
1. Is this letter written using the direct order or the indirect order? Is the choice appropriate?

2. Make notations on the letter indicating any deletions you will make and flagging any terms or phrases that you don't like.

3. Rewrite the letter