Thursday, November 22, 2012

U.S. INSURANCE ADM. APPEALS - MASS


Gwendolyn Cranmore v. MPIUA

COMMONWEALTH OF MASSACHUSETTS
                   Office of  the Commissioner
             Office of Consumer Affairs and Business Regulation
                   Massachusetts Division of Insurance
                   1000 Washington Street - Suite 810
                     Boston, MA 02118-6200
__________________________________________________________________________


GWENDOLYN CRANMORE,
              Petitioner/Applicant
                                      v.
MASSACHUSETTS PROPERTY INSURANCE                                                                                                                        UNDER-WRITING ASSOCIATION (MPIUA),
                   Respondent


___________________________________________________________________

PETITIONER’S VERIFIED PETITION  FOR  REVIEW OF THE  DECISION OF THE     REFEREEES, ANDREW J. HIMMEL, PAMELA BUSH AND RICHARD  CORNETTA DATED NOVEMBER 14, 2012 PURSUANT TO M.G.L. Part 1 Title XXII Chapter 175 SEC. 100 ;M.G.L. Part 1 Title XXII Chapter 175 SEC. 101B; M.G.L. Part 1 Title XXII Chapter 175 SEC. 101D;  M.G.L. Part 1 Title XXII Chapter 175 SEC. 101E;  M.G.L. ch. 106 § 2-718; MGL c.176D (Unfair Methods of Competition and Unfair and Deceptive Acts and Practices in the Business of Insurance); Massachusetts Regulations, 940 CMR 3 ( Consumer Protection - General Regulations) ; 5th and 14th Amendments to the U.S.  Constitution (Due Process Rights and Procedural Due Process); M.R.C.P. 65; G.L. c. 175, § 186; Northwestern Mut. Life Ins. Co. v. Iannacchino, 950 F.Supp. 28, 30 (1997); Chicago Ins. Co. v. Lappin, 58 Mass.App.Ct. 769, 773 (2003); Northwestern Mut. Life Ins. Co. v. Iannacchino, 950 F.Supp. 28, 30 (1997); Employers' Liability Assurance, Ltd. v. Vella, 366 Mass. 651, 655 (1975); Bagley v. Monticello Ins. Co., 430 Mass. 454, 458 (1999); Liberty Mut. Ins. Co. v. SCA Servs., Inc., 412 Mass. 330, 336-37 (1992); Government Street Lumber, Co, v. Amsouth Bank 553 So 2b 78 72 (Ala 1989); Keeton v. Bank of Red Bay  466 So 2b 937 940 (Ala 1985); National Security Fire & Casualty Co. v, Bowen, 417 So 2d 179 (Ala 1982); etc.
                        _______________________________________________________________________
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Gwendolyn Cranmore v. MPIUA

A.                 RECORD AND PROCEDURAL HISTORY

Location of the Disputed Property: 631 Blue Hills Parkway Milton MA 02186

Nature of Proceeding:   Insurance Reference Proceeding

Names of the Referees:       Mr.  Andrew J. Himmel, Chair
                                           Ms Pamela Bush (for the Insured)
                                           Mr. Richard Cornetta (for the Insurer)

Representatives or Attorneys:   Dr. Phillip C. Ofume & Associates for the Insured
                                                Mr. William O. Monahan for the Insurer


Parties:                          Mrs. Gwendolyn Cranmore – Insured

                                     Massachusetts Property Insurance Under-writing Association -  Insurer.

Date of Site Visit:   10/15/2012

Date of Start of Hearing (Brockton): 10/15/2012

Date Hearing location was opposed: 10/15/2012

Hearing Location: Hyatt, Braintree, MA

Start of Hearing in Braintree: 10/23/2012

Hearing relocated to Hilton, Dedham, MA

Hearing relocated and Continued at Hyatt, Braintree, MA

Date of Closing Argument by the Insured/Insurer: 11/14/2012

Date of Decision: 11/14/2012

Date Decision was served up on Insured and Insurer: 11/14/2012

Nature of Decision:  In part Insured Prevailed

Award Issue to the Insured: $92,958.00   ____________________________________________________________________________
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Gwendolyn Cranmore v. MPIUA

Petitioner or Insured, Mrs. Gwendolyn Cranmore, hereby requests that the Commissioner of Insurance  Review the entirety of the Decision of the Referees, Mr.  Andrew J. Himmel, Ms Pamela Bush and Mr. Richard Cornetta dated November 14, 2012 because of the following reasons supported by the laws aforementioned:

B.                                 BACKGROUND

1.     In March 2010 and August 2010 two heavy rain/wind storms hit Insured’s home and rift off her roof and brought massive water into her home and for over nine (9) months the insurer failed to remediate the incident and allowing her home to be soaked and moistured. This delay led to outbreak of dusty and toxic mold and fungal into her home which infected insured’s entire body and life, dumped her in multiple illnesses and finally destroyed her business and caused her durable homelessness and heavy loss of income and earning, etc.  To cover this damage, the insurer paid insured’s agents to deceive her to report fire incident as paid path to connect water and fire to defuse March 2010 rain/wind storm because there is a connection between water and fire in several insurance transactions. Now this third prong led to three loss claims (Nos. 274179, 274772 and 279935)  selfishly presented by the MPIUA in breach of the Insurance Reference Proceeding.

2.    March 2010 and August 2010 two heavy rain/wind storms rendered  insured’s home unlivable because of over nine (9) months delay and negligence of the Insurer, MPIUA to recognize the  double storms and the devastating damage done to her home particularly the outbreak of dusty and toxic mold and fungal which infected her home and her  entire body and life, destroyed her business and caused  heavy loss of income and earning, etc. Insurer failed to provide additional living assistance and rendered her homeless. Checks issued for some remediation were not issued on her name in order to sanction usage of the money particularly to remediate and clear the dusty and toxic mold and fungal to enable her return to her business and personal residence.

3.   Expert, Mr. Ernest Kirwan  said that "MPIUA/RURJ complete property inspection report dated 08/31/2009, with no special conditions applied, mold infectation or on-going water seepage identified...Report by AirCare environmental Engineering - indicating  widespread mold infestation and Expert, Mohamed H. Hussein, P.E. Consulting Engineer report - recommending
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Gwendolyn Cranmore v. MPIUA
gutting the house - down to studs and treating the molds...MPIUA internal document: " investigation & Adjustment Report Form" with conflicting reports for " Cause of Loss" and "Detail of Loss & Recommendation" for Claim #174179...Insured’s  inspectors found no visible signs of "ground water and sewage had enter through the basement" and no evidence provided by MPIUA or SFME to support said claim/denial. ( exhibit #5, 5a, 5b)...Settlements 174179 and 274772 totaling approx $70,000.00 is inadequate to restore the house back to, up to code requirement, its original state before the storm damages and or a habitable standard (ex. #7)...Aegus, in their Mold Report fail to mentioned the March 2010 three day rainstorm with hurricane force winds, dislodge tree branches that also penetrate the rear roof above the bathrooms causing severe water intrusion. Also the August 2010 three day record breaking rainstorm that MPIUA and SFMe agreed (ex. #6) duplicated the March 2010 storm damages."

4.     Insured retained experts,  Construction company Gusten, Mr. Chinedu Augustus U. Okoye, Cedeno Construction Co., Mr. Ernest Kirwan AIA) and Mohamed H. Hussein, P.E. Consulting Engineer and they did site inspections of her home and  they wrote reports which cut across piece by piece but under estimated some  real costs  required to fix or rebuilt insured’s home. Fixing must include but unlimited to patched roof, porch and rain/wind storm water damage, expert mold remediation of the detected interior spaces and other repairs and restorations of her home, the following estimates were reported and herewith attached and apportioned as follows:

4. a.   Mr. Chinedu Augustus U. Okoye:..........................$475,000.00
      General Contractor Profit 15%..............................$45,254.25
4.b.    Mr. Patrick Cedeno:.............................................$334,650.00
     General Contractor Profit.......................................$43,650.00
4.c  Mr. Ernest Kirwan AIA  supported the estimate submitted by
      Mr. Okoye

B.                                   JURISDICTION

5.   Per legislative power embedded under   M.G.L. Part 1 Title XXII Chapter 175 SEC. 100 ;M.G.L. Part 1 Title XXII Chapter 175 SEC. 101B; M.G.L. Part 1 Title XXII Chapter 175 SEC. 101D;  M.G.L. Part 1 Title XXII Chapter 175 SEC. 101E The Honourable  Commissioner of Insurance has personal and subject matter jurisdictions over this Petition. 

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Gwendolyn Cranmore v. MPIUA

6.   M.G.L. ch. 106 § 2-718; MGL c.176D (Unfair Methods of Competition and Unfair and Deceptive Acts and Practices in the Business of Insurance); Massachusetts Regulations, 940 CMR 3 ( Consumer Protection - General Regulations) overwhelmed the entire reference proceeding which was heard  October 2012 through November 14, 2012.


7.  5th and 14th Amendments to the U.S.  Constitution (Due Process Rights and Procedural Due Process); M.R.C.P. 65; are  severely  violated to extent that the insured was not allowed to present her loss claim and the three loss claims stated above which were presented by the insurer failed to disclose any expert reports on costs to rebuild insured home which was invaded by 8000 counts of mold and other deadly fungal. During the entire hearing Mr. Monahan hijacked the chair of the references and the entire proceeding thereby commanding the chair, Mr. Himmel by motion to left and right against the insured.

8.    Local and other cases are opposed to the conduct of the reference proceeding. See Northwestern Mut. Life Ins. Co. v. Iannacchino, 950 F.Supp. 28, 30 (1997); Chicago Ins. Co. v. Lappin, 58 Mass.App.Ct. 769, 773 (2003); Northwestern Mut. Life Ins. Co. v. Iannacchino, 950 F.Supp. 28, 30 (1997); Employers' Liability Assurance, Ltd. v. Vella, 366 Mass. 651, 655 (1975); Bagley v. Monticello Ins. Co., 430 Mass. 454, 458 (1999); Liberty Mut. Ins. Co. v. SCA Servs., Inc., 412 Mass. 330, 336-37 (1992); Government Street Lumber, Co, v. Amsouth Bank 553 So 2b 78 72 (Ala 1989); Keeton v. Bank of Red Bay  466 So 2b 937 940 (Ala 1985); National Security Fire & Casualty Co. v, Bowen, 417 So 2d 179 (Ala 1982); etc.


C.                      STATEMENT OF ARGUMENT


9.     Because of the irate domination and control of the chair of the referees by the counsel for the insurer, the chair of the referees overruled extreme majority of the reports signed and notarized by experts such as the Construction company Gusten, Mr. Chinedu Augustus U. Okoye, Cedeno Construction Co., Mr. Ernest Kirwan AIA and AIRCARE Company, Mohamed H. Hussein, P.E. Consulting Engineer , the official position of the United State Federal Environmental Protection Agency (FEPA), etc. The unsupported opposition of the Counsel for the Insurer and Chair of the Referees manufactured the insufficient award to the Insured.  See  EXHIBITS A, B, C,  D, E & F.

10.        5th and 14th Amendments to the Constitution of the United States such as the Due Process Rights of the Insured and Procedural Due Process of the Reference Proceeding were matchlessly violated. Insured’s Loss Claim was not allowed on the table of this proceeding.
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Gwendolyn Cranmore v. MPIUA
Insurer’s Loss Claims, Nos. 274179, 274772 and 279935 were allowed and considered and used to construct an award consideration of the sum of $92,958.00 which is contrary to all expert reports ( Construction company Gusten, Mr. Chinedu Augustus U. Okoye, Cedeno Construction Co., Mr. Ernest Kirwan AIA) and Mohamed H. Hussein, P.E. Consulting Engineer report relating to the actual amount of $475,000.00 required to gut down and rebuild Insured building located at 631 Blue Hills Parkway Milton MA 02186. Experts stated above supported the Expert Report of the AIRCARE Company. In support of this Petition the Insured has incorporated the expert reports of Construction company Gusten, Mr. Chinedu Augustus U. Okoye, Cedeno Construction Co., Mr. Ernest Kirwan AIA and AIRCARE Company, Mohamed H. Hussein, P.E. Consulting Engineer report and will be marked EXHIBITS A, B, C,  D & E.

11.     Apart from the expert reports issued by the Construction company Gusten, Mr. Chinedu Augustus U. Okoye, Cedeno Construction Co., Mr. Ernest Kirwan AIA and AIRCARE Company, Mohamed H. Hussein, P.E. Consulting Engineer, the Insurer has no expert reports showing the costs to rebuild insured’s home or costs required to bring the home to livable which cannot be less than gutting down the entire building because of 8000 counts of mold which was brought into the home because of the unprofessional work of the ServiceMaster and the negligence of the Insurer to timely remediate danger ahead after the extensive rain/wind storm which occurred in March  2010 and further extensive rain/wind storm which occurred in August 2010.

12.      Paragraph B.1 above suffered set back because Mr. William O. Monahan for the Insurer controlled the Reference Proceeding Chairman, Mr.  Andrew J. Himmel and Mr. Monahan opposed over 98.3% of the evidence presented by the insured for admission into exhibits. Each time Mr. Monahan opposes the submission of the insured Mr. Himmel overrules and concurs with the frivolous and personal opposition of Mr. Monahan.  Under the strict control of Mr. Monahan over Mr. Himmel, there was a shameful and ugly  incident  when during prior hearing Mr. Monahan lured Mr. Himmel to overrule submission of the insured’s signed, and notarized documentary or paper exhibits and Mr. Himmel ruled that the author of such intended paper exhibit must be present before him before the paper exhibit could be entered into evidence but during further hearing in this proceeding Mr. Monahan and his witness present an unsigned and unnotarized paper issued by fictitious person called SERVICEMASTER and shamefully Mr. Monahan forced Mr. Himmel to enter this fictitious paper into evidence and swiftly Mr. Himmel entered it into evidence. This conduct drew opposition from the insured and the insured requested to exit or withdraw from the proceeding because this type of misconduct had occurred
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Gwendolyn Cranmore v. MPIUA

time to time throughout the hearing.

13.     The Insured was sanctioned from recording the proceeding or hearing whereas the Insurer was allowed to record the entire hearing. During the hearing the insured’s rep observed that the recording company usually tempers with the gadgets and closely watching him, he (reporter) stops typing each time the insured is presenting important evidence and speaking on core part of her case. To get copies of the tapes and transcripts, Insured has to pass through lengthy process and there is no evidence that the insured will get complete and accurate transcripts of the proceeding.

14.   Expert, Mr. Ernest Kirwan  said that "MPIUA/RURJ complete property inspection report dated 08/31/2009, with no special conditions applied, mold infestation or on-going water seepage identified...Report by AirCare environmental Engineering - indicating  widespread mold infestation and Expert, Mohamed H. Hussein, P.E. Consulting Engineer report - recommending gutting the house - down to studs and treating the molds...MPIUA internal document: " investigation & Adjustment Report Form" with conflicting reports for " Cause of Loss" and "Detail of Loss & Recommendation" for Claim #174179...Insured inspector and the site visit on October 15, 2012 by the referees and other parties in this proceeding  found no signs of "ground water and sewage had enter through the basement" and no evidence provided by MPIUA or SFME to support said claim/denial. ( exhibit #5, 5a, 5b)...Settlements 174179 and 274772 totaling approx $70,000.00 is inadequate to restore the house back to, up to code requirement, its original state before the storm damages and or a habitable standard (ex. #7)...Aegus which claim being smack experience of detection of mold.  Aegus’ Report fail to mentioned the March three
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Gwendolyn Cranmore v. MPIUA
day rainstorm with hurricane force winds, dislodge tree branches that also penetrate the rear roof above the bathrooms causing severe water intrusion. Also the August 2010 three day record breaking rainstorm that MPIUA and SFMe agreed (ex. #6) duplicated the March 2010 storm damages" and caused irreparable damage because of the negligence of the Insurer, MPIUA.  

D.                                            RELIEF

15.    Reliant on the foregoing, Applicant requests that The Hon. Commissioner of insurance grant Insured’s Loss Claim as reported by experts or other relief as The Hon. Commissioner deems appropriate to rebuild  her mold invaded home.
16.   Payment of all overdue Advance Living Expense (ALE) which was stopped for long time and caused Insured untold hardship and homelessness and the money she works is diverted to food, housing and  other personal maintenance expense instead of payment of her mortgage. EXHIBIT G

17.   Remove all liens placed on insured property including the $10,000.00 put by the ServiceMaster that jumped into gutting her home with over 8000 counts of mold and fungal as path to remediate these quantity of dusty/toxic molds and fungal without knowledge, training, experience  and license  for treatment and removal of molds and fungal.


E.                        VERIFICATION

I, Mrs. Gwendolyn Cranmore hereby respectfully verify the above mentioned documents and  that they are correct to the best of my knowledge and signed and authorize submission under the pains and penalties of perjury this 20th    day of  November 2012.

____________________
 Mrs. Gwendolyn Cranmore - Petitioner
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Gwendolyn Cranmore v. MPIUA


                                     CERTIFICATE OF SERVICE

I,  Dr. Phillip Ofume certify that a true copy of the above mentioned Petition  was served up on all parties by  U.S. Postal Service first class mail or Hand Delivery on November 21, 2012 at:  
                                                                           
 
Mr. William O. Monahan
MONAHAN & ASSOCIATES , P.C.
113 Union Wharf East
Boston, MA 02109

Mr.  Edward M. Phelan
Counsel to the Commissioner
Massachusetts Division of Insurance
1000 Washington Street - Suite 810
Boston, MA 02118-6200

Clerk, Civil Action
Suffolk County Superior Court Department
Suffolk County Courthouse , 12th Floor
Three Pemberton Square
Boston, MA 02108

 Mr. Richard Cornetta
649 North Main Street
Brockton, MA 02032

Ms. Pamela Bush
66 Maple Street
Hyde Park, MA 02136

 ______________________
 Mrs. Gwendolyn Cranmore     

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