One of the questions I hear most often from policyholders is, “why is the insurance company handling my claim in an inadequate fashion?” Often, the policyholders are confident that if they could just explain the situation and get someone’s attention at the insurer’s main office, their claim would be resolved. Many of my clients and former clients explained they tried to get the corporate office’s attention—and to no avail. This is usually the point where conversations start with a neighbor or co-worker about what to do; late night internet searches are done, and the insureds realize they need to start keeping a tally on just how poorly the claim is being handled. This is when public insurance adjusters are often hired. A client explained to me that she was happy to pay someone 10% of her claim so she could carry on with her everyday life and pass the burden on to a professional. She explained that dealing with the insurance company forced her to take time away from her job, and that if she spent any more time on the phone with the insurance company between 9-5, she was sure she was going to be in trouble with her boss. Now, the same client has also hired a lawyer to get the insurance company’s attention and to get the claim resolved.
In addition, some insureds turn to the local media to try to get the insurance company’s attention. I recently came across an article where a homeowner and her public adjuster have tried this. The damage to the property is very clear. A willow tree crashed into the house on April 29, 2010, and , as of July 9, 2010, the claim has yet to be resolved by Allstate Insurance Company. According to the article, the insured was forced to hire a public insurance adjuster to help with the claim. The public adjuster finally received a verbal response from Allstate regarding the structure assessment of the claim on July 8, 2010, ten weeks after the tree smashed through the roof of the home.
The insurance company must have missed the news segment which reported the extensive damage to the insured’s property immediately after the storm. Now, the claim is making news again because of Allstate’s delay. The insured is obviously beyond frustrated. As you will see from the video, the family has been displaced from the home, and, while Allstate has paid for living expenses, it has not issued any payments for the home.
Allstate was contacted for the story, but the regional spokesman’s response was confusing and contradictory:
Allstate regional spokesman, Brett Ludwig, said, “We discovered that it had already been paid and closed. As the complexity of the claim goes up, so does the time it takes to get it resolved.”
The comments from the homeowner indicate that she has been waiting for the initial claim assessment. As of the date of the article, the claim was not one where the scope or the price was in dispute because Allstate had not yet provided its adjustment information to the insured.
Will the resolution of this claim be handled any differently because the media was contacted? Maybe or maybe not, but someone will remember this story. They will remember the family that spent 10 weeks in limbo while Allstate seemed to lose track of their claim and attempted to determine whether it was open or closed. Stories like these help the general public understand that filing a claim with an insurer can be a long and arduous process.
At the conclusion of the article a link is posted for the Connecticut Insurance Department (CID). This web page offers helpful information for those filing insurance claims. This may be helpful general information for public adjusters in any state to use to explain the insurance process to policyholders.
Here is a copy of the eight claim process tips provided by CID :
Eight Tips for Making the Claim Process Easier
1. Know Your Policy
Understand what your policy says. The policy is a contract between you and your insurance company. Know what is covered, what is excluded, and what the deductibles are.
2. File Claims as Soon as Possible
Don’t let the bills or receipts pile up. Call your agent or your company’s claims hotline as soon as possible. Your policy might require that you make the notification within a certain time frame.
3. Provide Complete, Correct Information
Be certain to give your insurance company all the information they need. Incorrect or incomplete information will only cause a delay in processing your claim.
4. Keep Copies of all Correspondence
Whenever you communicate with your insurance company, be sure to keep copies and records of all correspondence. Write down information about your telephone and in-person contacts, including the date, name and title of the person you spoke with, and what was said. Also, keep a record of your time and expenses.
5. Ask Questions
If there is a disagreement about the claim settlement, ask the company for the specific language in the policy that is in question. Find out if the disagreement is because you and the insurance company interpret your policy differently. If this disagreement results in a claim denial, make sure you obtain a written letter explaining the reason for the denial and the specific policy language under which the claim is being denied.
6. Don’t Rush into a Settlement
If the first offer made by an insurance company does not meet your expectations, be prepared to negotiate to get a fair settlement. If you have any questions regarding the fairness of your settlement, seek a second opinion, or you may contact the Consumer Affairs Division regarding your rights under your policy.
7. Accident and Health Claims
Ask your physician to provide your insurance company with details about your treatment, medical conditions, and prognosis.
If you suspect a provider is overcharging, ask the insurance company to audit the bill and verify whether the provider used the proper billing procedure.
8. Auto and Homeowners Claims
Auto and homeowners policies might require you to make temporary repairs to protect your property from further damage. Your policy should cover the cost of these temporary repairs, so keep all receipts. Also, maintain any damaged personal property for the adjuster to inspect. If possible, take photographs or video of the damage before making temporary repairs.
- Don’t make permanent repairs. An insurance company may deny a claim if you make permanent repairs before the damage is inspected.
- If possible, determine what it will cost to repair your property before you meet with the claims adjuster.
- Provide the claims adjuster with records of any improvements you made to your property.
- Ask the claims adjuster for an itemized explanation of the claim settlement offer.