Fragments of a Broken Trust: 7 Things You Can Do When Your Insurance Company Turns Its Back on You

Sometimes in life, you need a referee or umpire to call the fair play, When you have lost your home or business from fire, flood, hurricane, or worse, your heart just will not take much more.

Most conscientious citizens put their trust in insurance companies. But, when it comes to making decisions on the related expenses and recommending a settlement for damages done, insurance companies may seem to break that personal trust.

The losses can come from many directions. Pain and suffering may follow a personal injury. Your business physical loss may have effects on your business goodwill and employee welfare. Damage from flood, mildew, and mold may not reveal itself until months after the incident. So, it can be tough to identify the expenses immediately.

Any road to recovery after a big loss can be traumatic, but full recovery can be determined first by the language of your insurance contracts. As The New York Times reported, “The disorienting months following disaster are often marked by endless Saturdays spent wandering the aisles of Home Depot; afternoons wasted on the phone arguing with your insurance company about the value of an Ikea crib; and critical decisions made at your most vulnerable hour. And all of this often happens while you are living in temporary housing, wondering if your life will ever return to something like normal.”

Even where the insurance company has no contest with another insurance company, it may disagree on the benefits and costs incurred. You are not likely to fix such problems on your own, but there are things you can do when your insurance company turns its back on you.

7 things you can do to recover damages:

  1. Prepare for the worst: You can avoid or reduce your risks by taking steps in advance. You should make a concerted effort to have emergency plans in place for your home and business. Risk management plans can reduce the level of damage and injury, but they can also save lives and further liability.

Emergency, safety, and recovery plans should impress the insurance adjusters because you have taken the time and care to comply with insurance policy conditions in advance.

  1. Get things right: You want to be in the best position to object about your claim, so re-read your policy carefully. You must know what the “covered perils” are and how they are worded. You should know what is covered and what is excluded.

You will be in a better position if you understand what’s at stake or you’ll have a stronger basis to estimate losses accurately.

  1. Understand the insurer’s notice of denial: If you have received a notice of denial, you must read it closely. Chances are it is phrased in legal language which is not always easily understood. But, the notice of denial could leave you some wiggle room.

Perhaps, you filed the claim incorrectly on incompletely. Perhaps you worded it incorrectly or filed it late. But, even insurance companies do make mistakes. So, you should read the denial carefully to see what you can put together as a response.

  1. Organize your stuff: You should reopen the file you originally made. Then, you can organize the documents by source, type, date, and so on. There are lots of forms, of course. But, you want to confirm that all the forms required are there.

You should also review the forms, estimates, and contracts offered by all the contractors, mechanics, restorers, and other providers involved in making you whole once again. You should include any pictures and videos taken before and after the damage from as many angles as possible. And, you should have complete inventories of possessions, property, equipment, or stock.

  1. Get those doctors’ records: Medical records can be complicated. They can be late being billed and provided. Hospital, doctor, therapy, rehab, and pharmacy bills can overlap and duplicate each other. And, some may have been covered by other resources and insurers.

It may take time, but medical billers do finally get most things correct. However, it may prove you did not have the records you needed for the claim you filed when you needed them.

  1. Consider the settlement: You should not accept the first offer made by your insurance company or the insurer for a negligent party involved. But, you still should have some idea of a high and low number you would consider fair.

You have a right to receive the settlement offer under review in writing even if you are not inclined to sign it, for it is a record you can show to others who might help you resolve the unsatisfactory claim.

  1. Listen to the insurance adjuster: You might call the insurance company adjuster about the notice of denial and listen to their input. It is not the time to argue with them. You just want a record of their view of things, of what you did wrong or what the policy does not do.

You might ask how you should proceed to file a complaint with the insurance company. You have the right to do that as well as the right to file a complaint with your state’s insurance commissioner. But, suing an insurance company or waiting on the state to complete its work means time and expense to you, so you might prefer to contact expert public adjusters.

Your insurance claim takeaway

As Huffington Post says, “A public adjuster works for you, not the insurance company. Your home insurer pays its own adjusters — either in-house or independent — to figure out how much the insurance company should pay for your loss. The insurance company offers its adjusters at no cost to you.”

Insurance claimants using expert public adjusters are protected by Wisconsin Legislative Documents Chapter 618 and by the National Association of Insurance Commissioners (NAIC) and its Model Legislation Act. This assures insurance claimants an additional layer of protection if they opt to hire a public adjuster.


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