In Part 1 of this series, I addressed general requirements for the insurance carrier’s adjustment of claims. Here, I want to focus on communications between the policyholder and the insurance carrier.
Alabama Administrative Code 482-1-125-.06, sets forth specific requirements for communications with the insurance carrier about claims:
(1) Every insurer, upon receiving notification of a first party claim from an insured shall, within fifteen (15) days, acknowledge the receipt of such notice unless payment is made within that period of time. If an acknowledgment is made by means other than writing, an appropriate notation of the acknowledgment shall be made in the claim file of the insurer and dated. Notification given to a producer of an insurer shall be notification to the insurer. Acknowledgment by a producer of an insurer as required above shall satisfy the requirements of this paragraph.
(2) Every insurer, upon receipt of any inquiry from the insurance department respecting a claim shall, within ten (10) working days of receipt of such inquiry, furnish the department with an adequate response to the inquiry in duplicate. This response shall be addressed to the department employee or representative making the request. Furthermore, the insurer shall furnish written notification to the department employee on the final outcome respecting this claim if it is not resolved at the time of the initial response.
(3) A reply shall be made within fifteen (15) days on all other pertinent written communications from an insured which requests a response.
(4) Every insurer, upon receiving notification of a first party claim from an insured, shall within fifteen (15) days mail or otherwise provide necessary claim forms, instructions or reasonable assistance so that first party claimants can comply with the policy conditions and the insurer’s reasonable requirements. Compliance with this paragraph shall constitute compliance with Paragraph (1) of this rule.
One important take away from the above: You should specify in any written communication to the carrier that you want a response. That way there’s no question that you have invoked subsection (3) of the above rule.
if your claim is not being handled promptly, fairly and equitably, you can file a complaint with the Alabama Department of Insurance, or you can contact Merlin Law Group to discuss your situation with an attorney.
In Part 3 of this series, I’ll address how Alabama determines the amount of loss.