02-10-2022 Problem Report Information Inquiry Page 1 of 5

Problem Report ID: 273877 Problem Report Type: Complaint Responsible Section: Property and Casualty
Status: Closed Opened Date: 01-04-2021 Closed Date: 04-06-2021 Closure Reason:
PROBLEM REPORT DETAILS
TYPE OF PROBLEM OTHER PROBLEM TYPE DESCRIPTION

DESCRIPTION
AAC/ // Home lost in East Troublesome Fire. Agent initiated policy changes in letter dated 12-9-2019.
CONSUMER DETAIL OF COMPLAINT
Our parents lost their home in the East Troublesome fire. Working with the insurance company we come to find they had two declaration policies listed. Travelers Insurance cannot explain why. We have
reached out to the agent but he will not respond to the questions asked. Our parents were never notified of the change verbally and to why the change. We would like to have the answers to be able to settle
and move on. Can you please look into the situation and let us know?
Thank you
CONSUMER DESIRED RESOLUTION
To be paid out at the amount of the declaration my parents had been paying for. If there was a change we would like proof of the change and explanation as to why.
CONSUMER IS COMPLAINING AGAINST CONSUMER IS REPRESENTED BY AN ATTORNEY? HOW DID THE CONSUMER KNOW ABOUT US?
Agency No Insurance agent/company
HAS THE CONSUMER PREVIOUSLY REPORTED THIS PROBLEM TO OUR OFFICE OR ANY OTHER AGENCY? PURCHASED INSURANCE ON THE HEALTH CARE EXCHANGE?
No
RESPONDENT INFORMATION
NAME ADDRESS EIN/NPN
Travelers Property Casualty Company of America One Tower Square 36-2719165
HartfordCT 06183
EMPLOYMENT TYPE NAIC ID REPRESENTATIVE COMPLAINT CONFIRMED
25674 Yes
SOURCE COMPLAINT TYPE INCIDENT DATE RECEIVED DATE PRIORITY LOCATION LOCATION DATE
Consumer Portal 10-22-2020
FINDING TYPE INCIDENT GROUP SUBJECT SUBJECT ADDITIONAL DETAILS STATE ID SYSTEM SOURCE

INSURER AGENT/AGENCY TYPE OF INSURANCE SELF-FUNDED HEALTH PLAN COVERAGE TYPE COVERAGE LEVEL COVERAGE SUBLEVELS
Grant Stailey/Stailey Homeowners No Homeowners Homeowners
Insurance Corporation
NAME OF INSURED POLICY NUMBER POLICY PERIOD BEGIN DATE POLICY PERIOD END DATE POLICY ISSUED STATE INSURANCE CARD ID CLAIM NUMBER
Jankovsky, Bobby IIP8165
TYPE OF POLICY LOCATION OF LOSS IS THE INSURED MEDICARE MEDICARE SUPP. PLAN OTHER PARTY'S POLICY OR CLAIM NUMBER
Property or Casualty Grand County No
COMPLAINANT INFORMATION
MEDICAL INFO.
NAME ADDRESS NPN ORGANIZATION ROLE REPRESENTATIVE AGE GROUP AUTHORIZATION
Jankovsky, Susan 1420 S. County Rd 29 Portal No
Loveland, CO 80537
STAFF MEMBERS
STAFF MEMBER BEGIN DATE END DATE RESPONSIBLE
Cirignano Angela 01-05-2021 04-06-2021 Yes
KEYWORDS
East Troublesome Fire
02-10-2022 Problem Report Information Inquiry Page 2 of 5

Problem Report ID: 273877 Problem Report Type: Complaint Responsible Section: Property and Casualty
Status: Closed Opened Date: 01-04-2021 Closed Date: 04-06-2021 Closure Reason:
REASONS
CATEGORY REASON TYPES RESPONDENT
CH Unsatisfactory Settle Offer Travelers Property Casualty Company of America
PS Notice Requirements Travelers Property Casualty Company of America
Premium Notice/Billing
ACTIVITIES
ACTIVITY DATE ACTIVITY LETTER DESCRIPTION DUE DATE RECEIVED DATE INVOLVED PARTY NAME
STAFF MEMBER TIME BATCH QTY COMMENT
05-05-2021 Letter CORESP
Angela Cirignano 0.5 $8920 paid on 4-26, revised contents
insured found a new home, no addtl ALE needed
coverage A dwelling paid out in full (debris removal)
any addtl pmts for debris removal will be made thru E&O claim
Travelers claim is now closed - E&O claim can now be pursued and settled
04-19-2021 Letter FLWUPLTR 04-29-2021 04-26-2021
Angela Cirignano 0.5 sent via email
04-16-2021 Phone Complainant
Angela Cirignano 0.33 ibc from complainant - Mark Jankovsky
contents is what appears to be holding up claim from being settled in full
all contents information has been provided to the company as of a week or two ago
company paid $13k towards debris removal
consumer obtained an estimate for $20k
unsure if there is more coverage $ to pay towards debris removal - this may fall under e&o claim
e&o claim offer rescinded due to travelers still negotiating their claim (contents)
04-16-2021 Phone Complainant
Angela Cirignano 0.17 obc to mark jankovsky @ - no ans, lvm
04-14-2021 Email Complainant
Angela Cirignano 0.5 req'd the best ph # to reach complainant at and good time to call
her ph # on file is out of service or out of range
------
ib email - land line #
04-14-2021 Phone Complainant
Angela Cirignano 0.5 ibvm - e&o claim cannot be settled until claim w/ Travelers is settled in full
*to date $440k has been paid to insured by Travelers
-----
obc @ : busy signal
redial: all circuits are busy
04-06-2021 Case Closing Report
Angela Cirignano 0.5 confirmed complaint
E&O claim opened and accepted due to agent error - E&O carrier is currently negotiating a settlement with the
insured
04-06-2021 Email Complainant
Angela Cirignano 0.33 sent E&O claim information
04-06-2021 Phone Complainant
Angela Cirignano 0.33 3x obc - busy signal
04-01-2021 Letter CORESP
Angela Cirignano 0.5 response rcvd from u/w dept
they are not re-writing the policy at this time
e&o claim information provided
02-10-2022 Problem Report Information Inquiry Page 3 of 5

Problem Report ID: 273877 Problem Report Type: Complaint Responsible Section: Property and Casualty
Status: Closed Opened Date: 01-04-2021 Closed Date: 04-06-2021 Closure Reason:
ACTIVITY DATE ACTIVITY LETTER DESCRIPTION DUE DATE RECEIVED DATE INVOLVED PARTY NAME
STAFF MEMBER TIME BATCH QTY COMMENT
03-31-2021 Letter CORESP
Angela Cirignano 0.5 "Travelers has been made aware that the agents E&O carrier has accepted the claim filed in this
case. According to a representative at the agency, the E&O carrier is in discussions with the
insureds regarding the amount that will be paid.
While the situation continues to evolve, it appears reasonable that there could be a resolution
imminently. I am requesting an extension of 10 calendar days, until April 1, 2021, to provide a
full and complete response to the inquiry. If granted, I commit to making every effort to respond
sooner if I am able."
--------------------------
claim payment log provided
ALE is up to date
addtl u/e response is pending
E&O claim is open and currently being negotiated with the insured
03-10-2021 Letter FLWUPLTR 03-20-2021
Angela Cirignano 0.5 sent via email
req'd e&o claim info
req'd company explain what they are doing to provide immediate relief to the insured
03-10-2021 Phone Complainant
Angela Cirignano 0.17 ans
went over company response
advised than e&o claim has been filed - but no claim info was provided, analyst to follow up req'ing this info
advised that doi will request that the company expand on what they are doing to provide immediate assistance
to the insured for the dispute in coverage
-----
the insured has found new housing and are comfortable, however, they are anxious to be made whole from
this loss
03-08-2021 Letter CORESP
Angela Cirignano 0.33 the agent has filed an error and omissions claim for this possible error
02-19-2021 Letter FLWUPLTR 03-01-2021 03-01-2021
Angela Cirignano 0.5 sent via email
02-19-2021 Email Complainant
Angela Cirignano 0.33 sent company response and upd on file status
02-19-2021 Phone Complainant
Angela Cirignano 0.17 obc x2- no ans, busy signal after two rings
02-04-2021 Note
Angela Cirignano 0.33 rvwd file w/ tmg
analyst to follow up with company regarding 10-2-401
1. does the company allow an agent to calculate RCV? what authority does the company give and agent in
regards to making these changes? w/o consult from the insured?
2. what is the company's standard RCV caluclator?
3. was this provided by the agent with the change request?
4. were the changes audited by the company?
01-25-2021 Letter CORESP
Angela Cirignano 0.5 agent statement admits to requesting coverage changes with Travelers without speaking to the insured
01-25-2021 Email Complainant
Angela Cirignano 0.17 ib email from complainant - update?
01-07-2021 Email Complainant
Angela Cirignano 0.33 ack complaint
01-07-2021 Phone Complainant
Angela Cirignano 0.17 obc x2 - busy signal, unable to LVM
02-10-2022 Problem Report Information Inquiry Page 4 of 5

Problem Report ID: 273877 Problem Report Type: Complaint Responsible Section: Property and Casualty
Status: Closed Opened Date: 01-04-2021 Closed Date: 04-06-2021 Closure Reason:
ACTIVITY DATE ACTIVITY LETTER DESCRIPTION DUE DATE RECEIVED DATE INVOLVED PARTY NAME
STAFF MEMBER TIME BATCH QTY COMMENT
01-07-2021 Letter INITINQ 01-27-2021 01-25-2021
Angela Cirignano 0.5 sent via email
01-06-2021 Review Materials
Angela Cirignano 0.33
INVOLVED PARTIES
INVOLVED PARTY INVOLVED PARTY TYPE ORGANIZATION COMMENT
Grant Stailey/Stailey Insurance Corporation Portal - Agent/Agency
Jankovsky, Bobby Portal - Insured
STAILEY INSURANCE CORPORATION
DISPOSITIONS
DATE TYPE REQUESTED AMOUNT DISPOSITION AMOUNT PAID AMOUNT
04-06-2021 Compromised Settlement/Resol $ 0.00 $ 0.00 $ 0.00
RELATED DOCUMENTS
SOFTWARE PRODUCT DOCUMENT NAME DOCUMENT PATH NAME
DOC LOC ID SCAN DOC CONFIDENTIAL
Database File System Company Email /sirgov/sgov_p2/15558/rltddoc/01072021152231179273877 Company Email 1.7.pdf
No
Database File System consumer email 4.14 /sirgov/sgov_p2/15558/rltddoc/04142021153835789273877 consumer email 4.14.pdf
No
Database File System Letter /sirgov/sgov_p2/15558/rltddoc/01072021152246719273877 Division Initial Inquiry.pdf
No
Database File System consumer email 1.7 /sirgov/sgov_p2/15558/rltddoc/01072021172646052273877 Consumer Email 1.7.pdf
No
Database File System consumer email 1.24 /sirgov/sgov_p2/15558/rltddoc/01252021181825066273877 consumer email 1.24.pdf
No
Database File System company response /sirgov/sgov_p2/15558/rltddoc/01252021181845257273877 company response 1.22.pdf
No
Database File System consumer email 2.19 /sirgov/sgov_p2/15558/rltddoc/02192021150419716273877 consumer email 2.19.pdf
No
Database File System company email 3.10 /sirgov/sgov_p2/15558/rltddoc/03102021130742940273877 company email 3.10.pdf
No
Database File System letter /sirgov/sgov_p2/15558/rltddoc/03102021130759624273877 DOI Letter 3.10.pdf
No
Database File System company email 3.1 /sirgov/sgov_p2/15558/rltddoc/03092021001852258273877 company email 3.1.pdf
No
Database File System company response /sirgov/sgov_p2/15558/rltddoc/03092021001912314273877 company response 3.1.pdf
No
Database File System company email 2.19 /sirgov/sgov_p2/15558/rltddoc/02192021162541782273877 company email 2.19.pdf
No
Database File System letter /sirgov/sgov_p2/15558/rltddoc/02192021162555690273877 DOI letter 2.19.pdf
No
02-10-2022 Problem Report Information Inquiry Page 5 of 5

Problem Report ID: 273877 Problem Report Type: Complaint Responsible Section: Property and Casualty
Status: Closed Opened Date: 01-04-2021 Closed Date: 04-06-2021 Closure Reason:
SOFTWARE PRODUCT DOCUMENT NAME DOCUMENT PATH NAME
DOC LOC ID SCAN DOC CONFIDENTIAL
Database File System consumer emails 2.20 - upd ph /sirgov/sgov_p2/15558/rltddoc/02222021093230148273877 consumer email 2.20.pdf
#
No
Database File System company email 4.19 /sirgov/sgov_p2/15558/rltddoc/04192021111030645273877 company email 4.19.pdf
No
Database File System letter /sirgov/sgov_p2/15558/rltddoc/04192021111045543273877 DOI Letter 4.19.pdf
No
Database File System company email 3.19 /sirgov/sgov_p2/15558/rltddoc/03312021140253601273877 company email 3.19.pdf
No
Database File System req for ext /sirgov/sgov_p2/15558/rltddoc/03312021140313646273877 company request for addtl time to respond.pdf
No
Database File System payment log /sirgov/sgov_p2/15558/rltddoc/03312021140326023273877 pmt log.pdf
No
Database File System letter to consumer /sirgov/sgov_p2/15558/rltddoc/03312021140344036273877 letter to consumer 3.19.pdf
No
Database File System consumer email 4.15 - upd ph /sirgov/sgov_p2/15558/rltddoc/04152021165446444273877 consume remail 4.15.pdf
#
No
Database File System company email to consumer /sirgov/sgov_p2/15558/rltddoc/05052021143225242273877 company email to consumer.pdf
No
Database File System letter to consumer /sirgov/sgov_p2/15558/rltddoc/05052021143244434273877 letter to consumer 4.26.pdf
No
Database File System company response /sirgov/sgov_p2/15558/rltddoc/04012021112642795273877 company response 3.31.pdf
No
Database File System consumer email 4.6 /sirgov/sgov_p2/15558/rltddoc/04062021155058903273877 consumer email 4.6.pdf
No
Database File System image.jpg I thought I would date them /sirgov/sgov_p2/15558/rltddoc/01052021084947174image.jpg
and highlight the des
No