American Home Shield · Claim #H-2214 · Vague exclusion
To the Claims Review Department:
This letter contests the denial of the above claim and demands reconsideration on the following grounds:
1. The denial cites "wear and tear," yet the policy expressly covers mechanical systems under five years of age against failure. The unit is three years old. §4.2 · CA INS. CODE §790.03(h)
2. The carrier approved this identical unit in 2023, estopping the present position. Prior course of dealing.
3. The $1,500 appliance sublimit was misapplied to a scheduled $3,900 HVAC system. Schedule A, item 3.
Please be advised that continued denial in the face of the policy's own language may constitute a violation of the Unfair Insurance Practices Act, with attendant bad-faith exposure.
— On behalf of the policyholder
CERTIFIED MAIL · RETURN RECEIPT REQUESTED