Insurance Claim Secrets & Tips
Secret #1 The insurance company is not your friend
I hear all the time from our clients “My agent is one of our best friends” While they may be nice and send you birthday and christmas cards. When it comes to a claim they have no authority and they want to keep their “loss ratio” low or they will lose their year end bonus. Don’t make the mistake of thinking they are on your side. Their best interest is the opposite of your best interest
Secret # 2 Your insurance company thinks you are stupid
Insurance is the business of statistical odds. The insurance industry is based around this and there is nobody that does it better than them. They are betting not only that they are going to collect more money from you through your premiums then they will pay out in claims settlement. They also set the state to ensure this happens through the claims practices. They also know when you are in a tight spot and need money fast you will settle for much less than you are owed. We know you are smarter than the average policyholder you are reading this after all.
Secret #3 The insurance company knows you have never read your policy
Nobody ever reads their own policy past the first page or two. Even if you did you probably did not understand it. Policies are complex documents designed to confuse and make legal loopholes to deny coverages. Unless you understand insurance it is easy to get taken advantage of through the policy language. Oftentimes one section of the policy takes away coverage and then is added back in later in the policy. The carrier will cite the denial language but not tell you about the other sections that add the coverage back in. The lesson to Learn: READ YOUR ENTIRE POLICY & FIND THE HIDDEN COVERAGES
Secret #4 What is an insurance policy?
An Insurance Policy is a contract of indemnification. It means that it owes to make the policyholder(You) whole from your financial loss from a covered peril (Damage). That is a mouthful for sure! So what does that really mean? If the recommended repairs do not put you in the same financial condition as you were prior to the loss. Then your policy has not been properly effected and you were not Indemnified as you are owed.
Secrete #5 Their adjuster works for them. Your Adjuster works for you
If you were to buy a home you would hire a home inspector. Depending on who hires the inspector will determine what is in that report. As a buyer you would want to make sure you hire the inspector to tell you what is wrong with the property and if it is safe for your family. On an insurance claim, the inspector hired by the insurance company is going to tell them what they have been told to tell them. You want to make sure to have your own inspection done by an unbiased inspector/adjuster to make sure you are getting all of the facts.
Secret #6 Your insurance company thinks you will give up
They are counting on you giving up. 99% of policyholders do. That is the sad statistical truth. Especially since 99% of insurance claims go underpaid. The fact is that you have paid your premiums on time every month for the promise of protection and when you need that protection they are nowhere to be found.
Secret #7 Secret You are not alone
Taking on the insurance company is difficult to do alone. The most important secret is to know you are not alone. There are resources available to help you.
There are many contractors that work with (not for) your insurance company. They can be helpful in smaller claims. But they have limitations and can not discuss your policy with you or the insurance company.
There are adjusters that work only for the policyholder like Claim Rangers Public Adjusters. There are public adjusters all over the country that are able to help complete you after loss duties and settle the claim and advise you if dispute resolution is needed and which direction to take.
You could also use the services of an attorney. We love our attorneys but there is a time and a place for them. You do not usually want to bring them in too soon. This is because they will be paid out of the claim proceeds if you do. We like to bring them in once the claim is properly ripened and their fee is in addition to the claim amount.
Tips when handling your claim
- Be pro-active in the claim process and keep good notes.
- You’re not on a level playing field when you’re dealing with an insurance claim.
- Don’t pad or exaggerate your claim.
- Give your insurance company a chance to do the right thing, but don’t mistake a friendly representative for a friend.
- Document and support your claim with proof, details, and estimates.
- Present clear requests in writing that explain what you need, when you need it, and why
you’re entitled to it.
- Think of your insurance claim as a business negotiation—you’re dealing with a for-profit
- Don’t sign legal documents without consulting with a qualified attorney.
- Try to resolve problems informally but complain in writing, go up the chain of command
and/or use government agency help when necessary.
- Get specialized professional help when you need it