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How To File An Insurance Claim


If you have a claim under your insurance policy, how you handle it can greatly affect how much money you receive for your loss.  Consider the following steps:

Step 1.       Look at the policy to determine loss procedures and deadlines.

IN NO EVENT DELAY PAST THE PERIOD REQUIRED IN THE POLICY TO REPORT A CLAIM. A court may not enforce the time limit -- but it's not worth taking the chance. You may lose the ability to collect any damages if you're even a day late.

Step 2.       Decide whether to report a loss.

  • If you have an insurance agent or broker: Report the loss to him or her as soon as you can. Discuss whether it is worth filing a claim with the insurance company. Reporting losses can result in your policy not being renewed or a large increase in premiums. 
  • If you do not have an insurance agent or broker:  
    • BEFORE contacting the insurance company, review your policy to understand what is covered and what is not covered. This will help you avoid saying anything to the company that could be used to deny or limit the claim.  (Sometimes claims conversations are recorded without your knowledge.)
    • Pay special attention to the section concerning your responsibilities after a loss occurs.
    • How much is your deductible? It is generally not worth filing claims for losses close the amount of the deductible. You may get a little extra cash now, but your ongoing premiums are likely to increase.  
  • If you decide to report the loss: Ask the claims department:
    • How long will it take for your claim to be processed.
    • With whom do you follow-up? What is his or her direct telephone number and e-mail address?
    • Do you need to get estimates for repairs to structural damage?

Step 3.       If you do report the loss, decide whether to use a public adjuster to help.

A public adjuster works on your behalf -- not the insurance company's. For a charge of about 10% of your claim, a public adjuster will negotiate with the insurance company to maximize your reimbursement.

Since a public adjuster will usually also handle all aspects of settling a claim, using one might also help reduce the stress associated with the claims settlement process.

Before using an adjuster, be sure to:

  • Negotiate fees.
  • Find out what services are included and if there are any extra costs.
  • Make sure he or she is licensed.
  • Ask for names and contact information for references -- and contact the references.

To locate a public adjuster, check with your insurance broker or friends and neighbors. Or you can obtain a referral from the National Association of Public Insurance Adjusters ( offsite link).

Step 4.       Do not accept a settlement until you are reasonably satisfied.

If you are not satisfied with the insurance company's offer:

  1. Don't agree to the proposed settlement.
  2. If the denial relies on wording in the policy or state law, ask for the specific wording or provision.
  3. Talk to your broker or claims representative.  Explain why you feel the proposed settlement is unfair.  Be prepared to provide documents supporting your position.  Send a letter and supporting material to the claims executive at the insurance company's headquarters.
  4. Consider hiring a public adjuster.
  5. File a complaint with your State Insurance Department  ( offsite link).
  6. As a last resort, consult an attorney.  Attorneys usually work on these cases on a contingency basis for about one-third of any settlement -- and no payment if you lose. If there is a floor under what the insurance company is willing to pay, perhaps the lawyer will work for a percentage of whatever overage he or she gets you.

 Once you and your insurance company agree on the terms of the settlement, the company must by law send your payment promptly.

NOTE: If you need to hire someone to repair damage, watch out for contractors who are really scam artists. Get references. Check the Better Business Bureau ( offsite link) and online websites. Do not give a deposit until you complete your research.

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