Most homeowners have little to no experience with property insurance claims. Many of us haven’t experienced accidental damage to or loss of our property because catastrophic events like house fires or wind and hailstorms don’t happen very often. And even when they do, many people avoid making insurance claims out of concerns about how that will affect their insurance premium in the future.
But when an accident occurs, it’s important for homeowners to understand the steps the insurance company will follow and what they should do to make sure their claim is properly adjusted. Typically, a homeowner contacts their insurance agent and reports a claim involving damage to their property. The insurance agent then reports the claim to the insurance company’s home office, which assigns a claims adjuster to inspect the damage. These initial interactions are often positive experiences – the claims adjuster typically visits the home, reassures the homeowner that everything will be okay, and documents the damage.
Unfortunately, issues arise that can shatter the friendly exchanges between an insured and an insurer. These issues often manifest as what can be perceived by an insured as complex and extensive document and information requests from the insurer. Requests for the insured to appear to give testimony at an examination under oath are common as well. Sometimes insureds are advised that certain insurance benefits such as additional living expenses are about to run out.
Of course, it is the duty of the insured to prove his/her claim, but it is also the duty of the insurer to make a reasonable investigation of the claim. In a well-handled claim, the insurer will request certain information and the insurer will provide it. The insurer will pay the claim and the claim is resolved.
An insured should contact an attorney as soon as the insured becomes aware that the insurance claim is disputed. Typical signals that insurance claim is disputed are when the insurer requests an examination under oath, when the insurer disagrees with the amount of the loss that is claimed by insured, or when an insured discovers that he/she cannot repair or replace damaged property with the claim settlement amount offered. Sometimes the insurer simply does not respond to the insured’s attempts to find out the status of the claim, even though state law requires them to do so.
Insurance policies usually contain unexpectedly short deadlines for claim resolution; therefore, action must be taken before those deadlines expire. These procedural deadlines are different in every state, and when missed, operate as a bar to certain payments or potentially a full bar to recovery. An attorney can identify those deadlines, explain the insurer’s and the insured’s obligations under the Policy and perhaps, avoid a claim denial.