No one wants to have an accident, but they’re almost unavoidable. No matter how well you drive, you can’t control the person driving next to you. No matter how well you keep your home looking nice, you can’t control the weather, burglars, and vandals. That’s why you have insurance.
When you need to use your insurance to make a claim because of an accident or property damage, your insurance agent is on your side. They are there to help you navigate the claims process. It is not meant to be a combative or hostile situation. The problem might involve a hostile claims adjuster.
Some people feel like the insurance company has all the power in a claim situation. Policyholders have rights and any ambiguous statements in the policy are settled in their favor.
Your Insurance Legal Rights
Knowing your rights is the first step to leveling the playing field. Each state has their own insurance policyholder “bill of rights”, with California’s being the most comprehensive. So, if you want to know the specifics for your state, it is best to speak to your insurance agent. In a nutshell, these laws stipulate time frames for settling claims as well as open communication between the policyholder and insurance company. This article will highlight a few examples from different states.
The Department of Commerce for Minnesota has passed multiple regulations for homeowners with impending foreclosures as well as vehicle owners. The following are just some of the rules and regulations that insurance companies must abide by when you file an auto claim:
- Notify you of the benefits available in your policy and any restrictions to your policy’s provisions
- Supply you with all necessary forms and knowledge of deadlines
- Communicate with you regularly and issue a settlement check in a timely manner (five business days after the receipt of the executed settlement agreement)
- Insurance companies cannot deny a claim without investigating it, or determine the value of the loss without researching its reasonable value in the local marketplace
If insurance companies fail to follow these regulations, they can be fined up to $10,000 per violation and may not be allowed to operate in the future.
In Florida, the state government has passed a bill of rights statute specific to homeowner claims. Some of the rights include:
- The insurance company must acknowledge their receipt of your claim within 14 days
- Within 30 days of filing your claim, you can write a request to your insurance company asking for confirmation that your claim is either covered in full, partially covered, or denied
- Within 90 days, your settlement will be completed
- If you need a mediator, the Florida Department of Financial Services will provide one for you at no cost
The California Insurance Code section 790 details the Unfair Practices Act. This law was passed to prevent insurance companies from participating in discriminating and deceptive practices. The regulations cover deadlines for evaluating and making decisions on claims, the settlement of claims, and denial of claims. This includes:
- Delaying an investigation or payment to the insured
- Settling the claim for less than the policyholder is entitled to in their coverage
- Spending an unreasonable about of time affirming or denying a claim
- Misleading the policyholder during the claims process
Resolving a Claim
It may have only taken a split second to incur damage to your home or vehicle, but you need to be prepared for a lengthy claims process. You will not have your claim resolved overnight, or even within a week. There are a number of forms to fill out and steps to follow in order to ensure that you receive the right payment amount.
In order to level the playing field, you need to recognize that the claims process is a journey that has many steps, each of which needs to be followed correctly. This means taking the right steps at the right time. You need to communicate regularly with your insurance agent and adjuster to make sure that they received your completed forms and are taking steps to investigate your claim, make a decision, and follow through with payment. Document every piece of communication. Have a paper trail for everything related to the loss, communication with the repair shop or contractor, and with the insurance company.
If there is a dispute over the claim amount or the validity of the claim, you first need to speak to your insurance company, in writing, and explain what you need covered and why you are entitled to a specific dollar amount. Write to them promptly, professionally, and respectfully. Make a copy of the letter for your records. You need to be honest about the loss you’ve experienced because if you exaggerate, the insurance company will notice.
Sometimes there may be a disagreement between you and your insurance company over the matter of your claim. It may be that you require mediation. This is an inexpensive and quick way for you and your agent to come to terms. According to United Policy holders, “You and the insurance company can use mediation as a way of ‘checking out’ the strength of each others arguments, evidence and credibility.” It is also the best way to avoid a lawsuit, which can be very costly.
Speak to Your Agent
If you have any questions about the progress of your claim, speak to your independent insurance agent today. As always, be sure to document everything in order to ensure a level playing field.
Other Enhanced Insurance articles related to Claims:
Enhanced Insurance is not written by attorneys. If you’re looking for legal advice, you need to contact a lawyer. Further, insurance practices and forms change constantly and are varied from state to state. For definitive answers in your area, contact a local agent.
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