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teppy

Rough_Rock
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I posted here a couple months ago after i lost one of my diamond earrings. they were 3.25 cts. I have state farm insurance. we made the claim after looking for about almost a week. i just really didn''t want to make that call to them. Anyway, i asked right off if we had the ''pairs'' clause included in our policy. my husband was the one who insured them after purchasing so i was not there. the claim rep told me that we did not have it after pausing for a moment. so, we went about replacing the one. they told me that i had to go to one of their jewelers and to pick one while i was on the phone that day. so, i did without knowing who i was choosing. she just gave me the names of about 10 while i was on the phone and i had to pick one. i did, but spoke with my jeweler who sold them to us. they are not lab graded. i know that alot of people don''t like that, but we trust him and i know how my diamonds look under an asset that i have from him. anyway, thats not the issue here. since they are not lab graded, i did prefer to have him find me a replacement. so, i contacted state farm and in turn he started the process to be a ''state farm'' approved vendor. all is good again at this point and i''m grateful to state farm for working with me. my jeweler called me the other day, he had two diamonds in for me to look at and choose from. i did not ask the price of these, but i can see already how beautiful they are. my original earrings were 1.6 ct each approx., SI2''s, and G-H. Even though SI2''s, they were eye clean. I had to buy a 10x handheld loupe to see anything. One had a feather under the table that somehow was not visible face up, and the other one has some carbon spots when looking at it from the side that you can see with the loupe. they were always pretty earrings. the ones he got in are a VVS1 and a VS1(I believe), not for sure if i remember on the second one. anyway, i did not choose the VVS1 because i liked the way the lower clarity one sparkled better. when holding each of them up on the side of my one mounted earring that he has there, they really do both look acceptable, but not perfect in my eyes. i am just probably being overly picky, and i my mind i know that one is being replaced and not the same ''set''. i know that diamonds don''t come in sets and have to be matched, but its just me being me. anyway, i got a call from state farm telling me that they could either send me the check for $9900 or deal with the jeweler, but since he''s not really on the approved vendors list yet that they would rather just mail me the check. i agreed. while we were talking though, i asked him again if he''s positive that we didn''t have the pairs coverage. nobody really seemed to know for sure at first, even at my agents office. he was real nice and told me no i did not have it. he then told me that i could speak with my agent and add it on for in case next time. yeah right, how many people lose a diamond more than once? how many times will an insurance company insure you after claims made? so, that was that. later that same day by coincidence, i got a call from my agents office about another matter. we have everything with state farm. they automatically take over $1000 month out of my checking for my policies. while we were on the phone i mentioned to her that we had just settled on the earring claim a few hours earlier. she said oh good, you do know that i found the papers on you jewelery insurance and you do have the pairs. I freaked out! she told me to calm down and that she was going to take care of it and call me back. that was yesterday, i got a message on my machine later yesterday afternoon from her telling me that she wanted to let me know that she had put in two calls to the claims agent but had not heard back yet. its late afternoon here now and i still have not heard anything yet. i''m sure there is some ''c**p" going on. i am just really pissed that they tried to get over on me. now, she did say that they turned in the original paperwork with the pairs added on, but that they must have maybe not included it in my policy at the main office. i told her that was their mess and they should honor it. she agreed and told me that they may want me to make up the difference in the policy cost up to date that i must have not been paying. this kind of makes sense now in retrospect by the way that there was always a pause after i asked the question if i had it. and, now that i think about it, the way that they made the acception to let my jeweler handle this. and, my jeweler took maybe longer than usual getting some stones in and not to mention with the extra time it took to get the OK to let him handle it, state farm seemed to be very eager to settle this claim. they made a few calls and even put a higher up claims agent in to finish this case.

im wondering what i should make of this? i would like opinions from people other than myself on what i should do. do i keep pressing them now? should i expect them to honor the pairs coverage? i really would feel better starting out with a new pair that have been matched together instead of trying to get in stones and try to match to the one in my jewelers shop. it just seems like he could order in new ones with the same specs and do better. better yet, do i insist that he order a new pair with a grading cert this time? this i will probably do for sure if they honor this coverage that i was supposed to have.
 
Whatever you do, do NOT cash the check if it is already on it''s way. They DO need to honor the pairs clause and pay you for both diamonds. I am very skeptical about the idea that the premium would have been higher. The thing was their mistake anyway, so I cannot see them making you back-pay the premiums.

But by all means, I''d want the money to go toward ideal cut, certified stones if it was me, especially with that kind of budget. And for sure, I''d be checking the vendors here because their prices will likely beat the local jeweler.
 
Date: 9/17/2009 5:17:23 PM
Author: diamondseeker2006
Whatever you do, do NOT cash the check if it is already on it''s way. They DO need to honor the pairs clause and pay you for both diamonds. I am very skeptical about the idea that the premium would have been higher. The thing was their mistake anyway, so I cannot see them making you back-pay the premiums.
ditto....

Also have you consider going to another insurance carrier that deal strictly with Jewelry? like Jewelers Mutual or Gem Shield or even Chubbs stand alone personal policy after this? I worry that after this incident that State Farm may try to hike up your premiums moving forward and if this is a rider to your home insurance policy- well it may increase, just a thought.
 
great advice, and believe me, i will not cash the check! I was just so happy that they have been so nice and accomodating to me through this knowing all along that i had the coverage. my agent must have sent them the information, but they chose to not tell me. really they could have gotten away with it because you don''t deal with your agent after a claim is made. they were betting that i would not find out. thanks for the replies so far. i just wanted to check to see if i was being anal about this, or if i may be justified at all.
 
The pairs clause insurance companies offer generally has more to do with the mountings than the diamonds and you haven’t discussed this. What the pairs clauses are for is if they can’t replace the lost one exactly then they need to replace both so that they match properly and the company gets the other one (the one you didn’t lose). You don’t end up with 3 earrings out of the deal. For designer type things, antiques or things that are going to be impossible to match this becomes important but for ‘stud’ style earrings it doesn’t really come into play. It’s, of course, crazy that they didn’t know if you had the coverage or not but I’m saying it may not matter and if it’s not going to apply, you sure don’t want to be paying retroactive premiums to get it.

It sounds like it’s moving along fairly well and that the jeweler is treating you right here. I’m a big fan of being highly picky and have no issue with suggesting the jeweler find a better matching stone for you but the process seems to be working fairly well, no? You just aren't at the end yet. There’s more to matching diamonds than the weight/clarity/color but it’s not rocket science either. Have them try again.

I do have a question or two. Where did the $9900 cash settlement figure come from? Is that the face value of the policy, the bid from their replacement jeweler, the bid from your jeweler or something else entirely? Also, what did the appraisal you submitted for the insurance policy say about the description of the piece?

Ditto the above, don’t cash the check and don't sign anything until you’ve worked this out.

Neil Beaty
GG(GIA) ICGA(AGS) NAJA
Professional Appraisals in Denver
 
denverappraiser,
thanks for letting me know that. i don''t want to look and sound like a crazy person in the end. the amount of the settlement came from what the jeweler submitted to them. thats what he told them it would cost to purchase either of the two stones that he got in. my policy was for $20,000 total. he was right under the $10,000 for one. I''m very aware of the fact that if they replace both, that they will get the one. I''m also aware that if the lost one turns up, that i have to give that one to to them too, because they basically bought it. the appraisal that state farm has states one pair of diamond earrings, princess cut, 3.25 carats total weight, G-H color, SI2.
 
Next time you buy insurance here is a list of questions you might want to ask your agent
7.gif
from the American Gem Society)

•Is an appraisal necessary for full coverage?
•Will I have an easier time and more equitable replacement if the appraisal has been preformed by an American Gem Society jeweler?
•What is the difference between scheduled and non-scheduled coverage?
•Is there a deductible? If so, how much? May I ask for a larger deductible for a premium savings?
•Is my policy all-risk (covering damage, robbery, mysterious disappearance, etc.)?
•Am I still covered if there is negligence or carelessness involved?
•Is it covered if lost, stolen or damaged while in someone else''s possession?
•What if only a part is lost, e.g., diamond out of ring?
•If there is a loss, do I have a choice of cash or replacement?
•Can I go to whomever I choose for the replacement or repair?
•If a loss has been replaced or repaired through an insurance company source, will I be allowed to verify proper replacement by a reputable firm?
•If I ask for a cash settlement, will I get the full amount?
•Is there a difference in limitation between jewelry and silverware?
•Are their any geographical limitations to my coverage, outside my home or business, internationally?
•How much will it cost per thousand for full coverage? Partial? What do I sacrifice for the limitation?
•Is depreciation ever imposed?
•How often should I have an appraisal update?
•Am I limited to appraised replacement cost should there be a sizeable increase in the value of my jewelry?
•If there is damage to a piece, can I replace it or must I be limited to repair? If adjustment is limited to repair, am I renumerated for the loss of value?
•What if the lost item is irreplaceable?
•Are there any security precautions required? If not, would it affect the premium if there was?
•What proof is needed to justify a claim?
•What kinds of jewelry insurance are available?
•Are there any exclusions?
•What is the "pair & set" clause?
•What types of property are not covered?
 
Unless there’s something else going on that isn’t clear to me, the insurer is obligated to provide you a 1.63/G/SI2/princess and a setting (I'm assuming that each stone was half of the total weight which may or may not be correct but it can and should be calculated by examining the remaining stone). $9900 is an entirely reasonable budget for that. I’d still sit on the check because it doesn’t cost you anything to drag your feet a little bit here and it might benefit you to wait and see how this evolves but basically it sounds like State Farm is treating you just fine. The only question I would have for the adjuster would be about the handling of the sales taxes, assuming you live in a state that collects them. Does the $9900 settlement offer include this or will these be added at the end and covered by you?

Stay on top of the jeweler. For $10,000 it’s entirely reasonable for you to expect a fantastic match. He’s making good money on this deal, he made good money on the original deal and his customer isn’t State Farm, it’s YOU. Stand firm and get what you want.

Given that description and assuming there's no issue on matching the mounting, it doesn't sound like a pairs clause would apply anyway.

Neil Beaty
GG(GIA) ICGA(AGS) NAJA
Professional Appraisals in Denver
 
Date: 9/17/2009 7:22:42 PM
Author: ct-appr
Next time you buy insurance here is a list of questions you might want to ask your agent
7.gif
from the American Gem Society)

•Is an appraisal necessary for full coverage?
•Will I have an easier time and more equitable replacement if the appraisal has been preformed by an American Gem Society jeweler?
•What is the difference between scheduled and non-scheduled coverage?
•Is there a deductible? If so, how much? May I ask for a larger deductible for a premium savings?
•Is my policy all-risk (covering damage, robbery, mysterious disappearance, etc.)?
•Am I still covered if there is negligence or carelessness involved?
•Is it covered if lost, stolen or damaged while in someone else''s possession?
•What if only a part is lost, e.g., diamond out of ring?
•If there is a loss, do I have a choice of cash or replacement?
•Can I go to whomever I choose for the replacement or repair?
•If a loss has been replaced or repaired through an insurance company source, will I be allowed to verify proper replacement by a reputable firm?
•If I ask for a cash settlement, will I get the full amount?
•Is there a difference in limitation between jewelry and silverware?
•Are their any geographical limitations to my coverage, outside my home or business, internationally?
•How much will it cost per thousand for full coverage? Partial? What do I sacrifice for the limitation?
•Is depreciation ever imposed?
•How often should I have an appraisal update?
•Am I limited to appraised replacement cost should there be a sizeable increase in the value of my jewelry?
•If there is damage to a piece, can I replace it or must I be limited to repair? If adjustment is limited to repair, am I renumerated for the loss of value?
•What if the lost item is irreplaceable?
•Are there any security precautions required? If not, would it affect the premium if there was?
•What proof is needed to justify a claim?
•What kinds of jewelry insurance are available?
•Are there any exclusions?
•What is the ''pair & set'' clause?
•What types of property are not covered?
?????????????? Why would this matter? I would look at the overall qualifications and reputation of the appraiser.

www.metrojewelryappraisers.com
 
denverappraiser-
i do hear everything your saying, but after thinking about it last night, i have to wonder, why they kept this info from me? I know for sure now that they knew, especially by the way they were behaving. And, how would you justify the ''higher up'' claims agent telling me to contact my agent so that i can make sure to have the pairs clause added next time so that i could get the pair replaced if this happened again? why didn''t he, or the other claims rep tell me this from the get go? i just went and looked at the wording on the pairs clause. it does not say anything about only replacing the pair if it cannot be matched. it simply states that if you have it, they agree to replace the pair and upon replacing the pair that the "one" is relinquished to state farm. i hope to hear something by today. as far as my earrings being an SI2, i have seen matched pairs of earrings on blue nile where one is maybe an SI1 and the other might be a VS1. Anyway, like i said before, my SI2''s never showed anything when looking at them normally or close up for that matter. I know where the bad spots are, and i could not even see anything looking at them under normal viewing. i could always tell them apart when looking at them closely because one was a better cut than the other. It became obvious to me after finding this forum and learning so much about cut quality. I then noticed how one clearly was more sparkly and brighter than the other, but only slightly. if these really were/are SI2''s, they are good SI2''s.
 
I still dont understand why you think they "knew" about the pairs clause. Sounds like your local agent knew but
the main office didnt know for some reason??? (really no good excuse for them not to know but I dont know
if they were trying to pull one over on you)

Anywho...I dont see whats wrong with your jeweler getting in more stones to match your current stone? Two
totally new stones would have to be matched too. Are you saying that because yours doesnt have certificates
with table, depth and angle measurements that its harder to match?

If I had the choice I would definitly want the new stone(s) certed.

I would keep on your jeweler until he finds one that is a match that you are happy with. Or, if you do get a new
pair, he finds a certed pair that you love.
 
the reason i know now that they at the main claims office knew was that my agents office told me that they let them know after they found the copies of the original paperwork. they did send this in to the the main state farm claims office after the claim was made to show that i did have the pairs coverage. i''m not guessing that they knew, i was told that they had been informed by my agents office. somehow, even though the original paperwork shows the pairs coverage was bought from day one, state farm did not add it when the policy was first bought. either it was overlooked, or it was ignored. that was the confusion at first because my agent knew that my husband had purchased it, but did not know why it was not showing up for the claims reps. i only wish that the agents office had contacted us too to let us know that they had the original paperwork showing the coverage instead of just contacting the claims office. And yes, if i am entitled to the pairs coverage, well then thats what i want. i probably will opt for cert stones this time, not because i don''t trust my jeweler, but to make sure that years from now if my daughter ever needs to file a claim or needs verification of what these are, then i want to simplify this for her. 3.25 carat earrings are a nice size and i would rather have a cert backing them up.
 
Date: 9/18/2009 8:05:58 AM
Author: teppy
denverappraiser-

i do hear everything your saying, but after thinking about it last night, i have to wonder, why they kept this info from me? I know for sure now that they knew, especially by the way they were behaving. And, how would you justify the ''higher up'' claims agent telling me to contact my agent so that i can make sure to have the pairs clause added next time so that i could get the pair replaced if this happened again? why didn''t he, or the other claims rep tell me this from the get go? i just went and looked at the wording on the pairs clause. it does not say anything about only replacing the pair if it cannot be matched. it simply states that if you have it, they agree to replace the pair and upon replacing the pair that the ''one'' is relinquished to state farm. i hope to hear something by today. as far as my earrings being an SI2, i have seen matched pairs of earrings on blue nile where one is maybe an SI1 and the other might be a VS1. Anyway, like i said before, my SI2''s never showed anything when looking at them normally or close up for that matter. I know where the bad spots are, and i could not even see anything looking at them under normal viewing. i could always tell them apart when looking at them closely because one was a better cut than the other. It became obvious to me after finding this forum and learning so much about cut quality. I then noticed how one clearly was more sparkly and brighter than the other, but only slightly. if these really were/are SI2''s, they are good SI2''s.
It only academically matters if they were SI2/H at this point. That’s what the policy says they were and that’s what the company has agreed to replace with. For lack of further description the assumption on cutting will be ‘good commercial grade’ or words to that effect.

If you feel the company or the agent is being disingenuous with you then this is a reason to find other insurance for your future needs but it doesn’t have a lot to do with this particular claim. I wouldn’t venture to guess ‘why’ they handled the application the way they did. Maybe the agent screwed up, maybe the underwriter screwed up. I seriously doubt that there''s an effort on the part of the company or the adjuster to extort a few premiums out of you at this point.

You seem eager to replace both, why?

Neil Beaty
GG(GIA) ICGA(AGS) NAJA
Professional Appraisals in Denver
 
why do i seem set on replacing the pair? really i was not even aware of such a thing, or anything to do with jewelry insurance at all for that matter. i posted here back at the beginning of august when this first happened. It actually was you who answered my post and asked me if i had pairs coverage. i guess the fact that i do have it, and the fact that something is not ''right'' about this in the end, is whats making me want to replace the ''set''. before i knew that i did actually have the pairs coverage i was set to be done with this. here is your post to me back in august. and again, you did say before that ''if they can''t replace the piece with an exact match, but again after reading the rider sheet in my policy, state farm does not say anything about if they cannot match the one that was lost. it only states that if you have this clause that they will replace the entire set if one is lost or stolen.


denverappraiser

Ideal Rock
Total Posts: 4,473
Last Post: 9/18/2009
Member Since: 7/21/2004
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Ask your agent or your claims adjuster if a ‘pair and set clause’ applies to your policy. Basically it means that they have to replace the entire set rather than just the one (and they get to keep the other one). This is an option that’s available on some policies and presumably would have been discussed with at the time you bought it and it has to do with how they work it out if they can’t replace the lost piece with an exact match.

Basically, what usually happens is that the insurer will to send you to a jeweler that they have prequalified as someone they will work with. Mostly this means that they agree to discount prices and to dealing with the paperwork hassles that insurance companies are so famous for. It also means that they get along well enough with customers that they don’t generate too many complaints. In exchange the jeweler gets a steady stream of referral business. Most major cities will have quite a few that you can choose from as well as several that do business online and through the mail. Your claims adjuster should be able to provide you a list.

The jeweler is going to bid how much they will charge to replace the piece. This will be based on the description in your appraisal and, in your case, probably by inspecting the remaining earring that supposedly matches the lost one. They’ll produce a bid and, assuming this is less than the face value of the policy (which it almost always is) this becomes the value of the claim. They’ll either replace the piece at the replacement jeweler, pay that amount to some other jeweler to replace it, or cut you a check for that amount less your deductible, if any. You get to pick. If your preferred jeweler wants more for it then you get to make up the difference yourself unless you can make a persuasive argument that what is being offered by the replacement guys is not of ‘like kind and quality’, a phrase that appears repeatedly in your policy. This argument, if you have it, will revolve around the appraisal that you presented and is one of the reasons or turning in a highly detailed appraisal when you bind a policy. Most the replacement jewelers are pretty reputable outfits by the way. It doesn’t benefit the insurers to deal with fly-by-night sources. They are trying to protect the interests of the company and that may not be what you want but one of those interests is happy clients.

Neil Beaty
GG(GIA) ICGA(AGS) NAJA
Professional Appraisals in Denver
There''s never a crowd when you go that extra mile.
 
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