Despite television advertisements by insurance companies portraying their eagerness to settle claims, the truth is quite different. Insurance companies have a methodical process to investigate claims and determine if they will pay claims. Understanding how the process works can help you speed the process up and preserve your rights if your claim is denied.
Initial Phase
The claims process begins when a claim is reported to the insurance company. You may report your claim by calling your agent, speaking to another representative of the insurance company by calling a toll free telephone number, using an insurance company website or by submitting written notice.
When you report your claim, you will be asked some brief information about your loss. For example, you may be asked where and when the loss occurred (address, date and time), who was present, if anyone was hurt, whether police or fire departments responded, and your contact information. You will likely be asked to briefly describe how the loss occurred. It is best to be brief in describing what happened. Do not guess or speculate as to causation or other things that you do not know for certain. Do not give detailed information at this time. It is best to wait until you have time to calm down and think carefully about what happened.
Once your claim has been reported it will be given a claim number and assigned to an adjuster. You need to keep the name and contact information of the adjuster and the claim number where it can be easily located. All contacts with the insurance company will usually be through the adjuster and will reference the claim number.
Investigative Phase
Once the adjuster has received the claim information, you will usually receive a call. Most often, the adjuster will schedule an appointment to meet you and discuss the claim. The adjuster will often bring a camera and take photographs. The adjuster may also ask to take a recorded statement. You may wish to talk to the Insurance Claims Attorneys at Cannon Law, P.C. before giving a recorded statement as this initial statement may lead your insurance company to take a position that is not favorable to your claim. You can simply say that you want to talk to your attorney before giving a recorded statement.
Some losses may lead to investigation by experts. For example, in many fire losses, the insurance company may have a “cause and origin” expert examine the property. This can be a signal that the company is suspicious of the fire and is investigating to see if you were involved in causing the loss. It is best to speak with one of our attorneys if you are told that someone other than the adjuster or a repair company will be inspecting the damage.
You may also be asked to submit to an “Examination Under Oath.” This is a statement where you will be sworn and asked questions before a court reporter. You should speak with one our insurance claims attorneys immediately if you are asked to submit to an examination under oath.
Determination, Negotiation and Litigation Phase
Once the insurance company has determined if it will pay your claim, you will usually receive written notice. If you have completed all required paperwork and the adjuster has spoken with you, you should expect to receive a response within 30-60 days of the time the investigation is complete.
If the claim is accepted , you should promptly receive a check for the damages along with a release. If you have any doubt about whether you are receiving all of the money your are entitled to or if you anticipate additional damage arising from your loss, you should speak with one of our Insurance Claims Attorneys before endorsing a check or signing a release to be sure you have not given up compensation you may be entitled to.
If the claim is not accepted, you should contact us immediately. Insurance policies usually contain limits on when suit must be filed in order to proceed with your claim. Meeting with one of our attorneys does not mean that you are locked into filing a suit against the insurance company. It may be possible to negotiate a settlement without suit being filed. However, if the claim was wrongfully denied and the company refuses to negotiate a fair settlement, you may need to file suit.
Bill Cannon is experienced in dealing with insurance claim lawsuits. Our experience includes representing both clients with insurance claims and insurance companies defending claims. We have successfully resolved insurance coverage disputes and bad faith denial of claims in cases involving homeowners insurance policies, business insurance policies and health insurance policies. Contact us today if we can help you with your insurance claim.