Insurance won't approve BUT what about exchanging?

[Wholovesskunks]

Long story short- I lost my original ER and through insurance I am approved for a 2 carat, J-I1 round brilliant with a halo up to $8500. I fell in love with a stone and setting that is completely different from my original stone (It's an emerald in a solitaire setting- I always have loved emeralds- I used to wear emerald cut gemstones exclusively before marriage) that has a retail of $8500. Through B2C jewels, Jewelers Mutual does not have an arrangement with them so they would pay retail price of a 2 carat J/I1 + halo setting asked by B2C up to the $8500 limit.

Because the new stone and setting is so different from my original ring they will not allow me to go that route- I HAVE to pick what I was insured for that is similar as it is REPLACEMENT only. They are being serious sticklers on this. Even though they will pay B2C $8500 regardless of whether I get the replacement that's almost identical stats wise to my original stone or the completely different stone and setting I really found and love.

So here's my question- B2C has a 30 day return policy. Let's say I agree to a stone that is a 2 carat, J/I1 and they pay B2C $8500. But I don't like it. So I want to send it back and exchange it. Is the relationship over with JM once they've paid B2C in full and the original replacement is sent? Can I return it and use the $8500 towards the stone and setting I really want and just pay the bit of difference?

Is this considered unethical? I'm not asking for more than they would pay I just really fell in love with this completely different stone and setting.

 

[whitewave]

I'll be interested in the answer.

I had to cancel my appraisal appointment a few months ago-- getting my pieces reappraised for actual value, and then I'm going to reassess all of my jewelry policies (state farm and gem safe) to see what kind of policies I have/need/want.

 

[MollyMalone]

B2C's general, 30-day return policy (10 days for loose stones or jewelry pieces $50,000 and up) is a nice one, especially since the cost of the insured, return shipping via FedEx is borne by them; the customer isn't responsible for that. But even B2C's return policy doesn't cover "Special orders, such as custom mountings or jewelry pieces that were requested but are not specifically shown on our website"; those "are non-cancelable and non-refundable items." Scroll down towards the bottom of this page to see that in the Terms & Conditions:
http://www.b2cjewels.com/return-policy
So I don't know if what you'd like to do is possible insofar as B2C is concerned.

Even though Jewelers Mutual and B2C don't have an existing "arrangement", have you asked B2C to wrangle with Jewelers Mutual to see if they can get JM to agree that the $8500 (or close to it) can be applied to the emerald solitaire?

 

[Wholovesskunks]

There seems to be a bit of a language barrier when communicating with B2C. They are very very nice but not interested in haggling with JM. Johnny today seemed confused about having JM pay them and told me they only accept wire and cash payment. Simon has said they will take payment from JM. JM has stated that B2C will not make any deals with them on pricing so I would have to use B2C's retail pricing but that they will pay up to $8500 to B2C and they have sent B2C funds for a claim one time. Johnny has stated that if the funds from the claim are paid by JM, I would be the customer, not JM. Johnny stated they have a 30 day return policy. But seemed unsure how to answer on whether I could return it for a completely different stone or whether or not that would be an insurance issue. (I'm a total rule follower- I have no problem playing with the rules- but I won't blatantly break them. Like what if JM found out I returned the original replacement to exchange for the emerald? Would they consider that fraud and require me to pay them back?) There seems to be so much confusion at this point that I'm ready to end this and replace my ring with a crappy one from the local jeweler. :/ I have an appointment tomorrow to see a few other stones in the am but highly doubt the quality is as good as what I'm finding online. I don't have any clue what to do. I hate all this.

 

[Wholovesskunks]

And what I really don't get is I thought I could upgrade and pay whatever the difference was. But because this stone is the same $8500 but a higher quality than my original (Emerald costs less than round though) it isn't eligible to use toward my replacement. I'm so annoyed. I can just seen myself caving and feeling pressure just to pick a stone locally tomorrow because this is such a pain.

 

[Lookinagain]

I'm not an expert but it seems to me that once JM satisfies your claim against the policy by replacing your lost ring with one of like/kind, that the replacement ring is yours and you can do whatever you want with it. You could certainly sell it to me. Or trade it with me for one of my rings. So isn't an exchange the same as a trade? That would be my argument. JM probably doesn't want to deal with B2C because they are treating them like a regular B & M store where they would typically get a price below retail. But B2C is probably already charging below what a B & M retail would charge so they are not going to go down more. Anyway, I think the ring will be yours and you should be able to do with it what you please. I guess the other approach would just be to ask JM your question and see what they say.

 

[Lookinagain]

But because this stone is the same $8500 but a higher quality than my original (Emerald costs less than round though) it isn't eligible to use toward my replacement.

I'm not really sure what you are saying here.

 

[Wholovesskunks]

Here is what JM said to me. They couldn't approve it for payment because it isn't similar.

 

[Wholovesskunks]

The second paragraph she stated she couldn't send over payment.

 

[Lookinagain]

well the last sentence of the first paragraph tells you that you can apply the funds to whatever you want, so I don't know why you wouldn't apply it to the emerald.
the second paragraph seems to be saying that the specs on the diamond you sent over as the "replacement" don't match the specs of the original ring, so they won't use that to establish value to determine what the replacement cost of your original ring would be. Did you send over info on a diamond that had the same specs as your original ring? Same shape, color, cut, clarity? I think that's what they want you to do so they can establish replacement value. At least that is what it sounds like to me. If you sent over info on the emerald, then they are saying that isn't suitable to establish the replacement value of your original ring. And that is all they will pay you, the cost of a replacement of a similar ring to the lost ring. Once they pay the jeweler, you can apply the money to any piece of jewelry you want. At least that is how I read it.

 

[Lookinagain]

The second paragraph she stated she couldn't send over payment.

that's not how I read it. I read it that you sent over info on a diamond that does not match the specs of the lost ring so she can't use it to establish value, which she needs to do to determine how much to pay you. I know your ring was insured for $8500 but if it can be replaced for $7500, she will only pay you that so she wants to know what it will cost to replace your ring with a ring that has a stone of the same quality. If you gave her info on the emerald, then she is comparing apples to oranges. She wants to compare apples to apples.

 

[whitewave]

I read that as B2C only has to send them an invoice for a stone that is similar to the one you had. You don't have to buy that stone. JM will then send B2C the money for that stone, you don't buy that one and you can then buy whatever you want...

It's a formality... you have to send them an invoice for a J round brilliant I1 with a halo setting for them to release funds.

 

[Snowdrop13]

In my limited experience with insurance companies they like to stick to the letter of their contract with you and can be quite inflexible. I don't see any problem at all doing what you suggest and would not consider it unethical. The insurance company are giving you $8500 which is a lot of money. Tastes change over time, get what you want!

 

[Wholovesskunks]

I'm sooooooo excited!!! This is exactly what we are doing! I have the invoice for the 2.00 carat stone in a J/I1 and will transfer funds to the different stone. Hopefully the different stone isn't scooped up before the funds get there but if so, I'll still have $8500 to use towards anything at all at B2C! Fingers crossed all goes through smoothly so I'm not back here hunting for a diamond again. LOL!

Thank you to everyone who has helped me! You all are amazing! I'm so grateful to have found this site!

 

[Diamondz1]

I'll be the party pooper and suggest that this is probably not allowed by your policy and, were you to ask JM about it directly, they would tell you so.

I'm happy that you found a resolution that works for you. I also have a JM policy and dread ever having to use it because it seems like the consumer in any insurance scenario always loses (sigh). But, er, you might consider asking the mods to remove this thread. I wouldn't want my plan to manipulate my insurance policy floating around on the internet...

 

[tyty333]

Fingers crossed for you WLS...I hope it works out for you so you can get something decent that you will love!

I read it the way whitewave read it so it does seem legal/ethical according to JM...but I'm not lawyer and dont work
for JM!

 

[Diamondz1]

Hm... maybe I'll correct myself. I'm re-reading and the rep at JM does seem to be implying that you can apply the funds anywhere. You wonder why they have the rule at all, that your payout can't be applied to a different stone if they themselves are going to suggest a work-around. Je ne sais pas! Insurance will never cease to be a mystery to me. In any case, like I said, glad you found a favorable outcome!

 

[Lookinagain]

Hm... maybe I'll correct myself. I'm re-reading and the rep at JM does seem to be implying that you can apply the funds anywhere. You wonder why they have the rule at all, that your payout can't be applied to a different stone if they themselves are going to suggest a work-around. Je ne sais pas! Insurance will never cease to be a mystery to me. In any case, like I said, glad you found a favorable outcome!

They are saying you can't use an unlike stone to establish replacement cost of the lost stone. They don't care what you buy with the money once they send it to your jeweler, but you need to provide them with the cost of a stone that is the same quality/cut/clarity etc of the lost ring so they can figure out what to pay under the policy, which is the replacement cost of the lost ring, not the purchase price of a dissimilar one. It's not a work around. It's the way it is done. I think the OP just misunderstood what JM was saying to her when she sent them the stats on the emerald that she wanted to buy.

 

[Diamondz1]

They are saying you can't use an unlike stone to establish replacement cost of the lost stone. They don't care what you buy with the money once they send it to your jeweler, but you need to provide them with the cost of a stone that is the same quality/cut/clarity etc of the lost ring so they can figure out what to pay under the policy, which is the replacement cost of the lost ring, not the purchase price of a dissimilar one. It's not a work around. It's the way it is done. I think the OP just misunderstood what JM was saying to her when she sent them the stats on the emerald that she wanted to buy.

Ok, I misunderstood a few things. I thought B2C generated a bogus invoice for a nonexistent stone to initiate the release of funds. But in actuality there's a stone and so, a legit invoice, which satisfies JM's criteria. I understand what whitewave meant when she called it a formality.

I stand corrected. Carry on.

 

[Wholovesskunks]

You were correct! B2C actually required approval from JM to transfer the funds to the new stone and setting and it's been approved! Wanna see what i ultimately upgraded to? And keep in mind, I do like a warmer color and it has an excellent cut according to B2C. I hope I did good!

 

[Wholovesskunks]

They said it has an amazing cut. Hope they were being honest!

 

[Diamondz1]

Oooo what a beauty! Are you so excited? When will you have it in hand?

 

[whitewave]

Very exciting!

 

[derbygal]

Wow. Internally flawless K! I love it and can't wait to see it set and on your hand. So happy you got it all worked out.

 

[canuk-gal]

HI:

Come back with (IRL) pictures!!

cheers--Sharon