Insurance Claim? Don’t be afraid to Ask

I was watching one of the “Homeowners Policy & Claims Bill of Rights Working Group” meetings the other day when a segment of the meeting featured a homeowner couple who took the time to appear at the meeting and tell their story about their insurance loss and claim that resulted from an unfortunate fire in their residence.  These folks told the committee they wanted to share this experience in hopes that something good would come out of their very bad experience trying to deal with an insurance property loss on their own.

The gentleman explained that he actually had some background with insurance as his father had been an adjuster and he was an insurance agent with considerable experience in property insurance.  Armed with this knowledge and experience, these homeowners made a decision to try and work this through with their insurance company and its adjusters.  If you listen to their story, that may not have been a wise decision on their part. Unbelievably, eight different adjusters were involved in their claim, each one being removed and a new one assigned as the process wore on. The last adjuster was supposed to be the one who would finally settle the case as he was supposedly experienced and had decision making authority.  Turns out he was fired by the insurance company who then demanded a proof of loss and an appraisal.

So with their experience and background, why did they have to go through eight different field adjusters, hire an attorney, go through an appraisal process and still not have their claim resolved?  Remember, this was a house fire and while traumatic and devastating to this family, it was not a huge commercial loss with many different components and complex issues.

What really surprised me was that the chairperson of this committee who is also the Consumer Advocate at the Florida Office of Insurance Regulation, said she hears these stories, all too often in her travels around the state.  So could hiring an experienced public adjuster help avoid the problems this family encountered in their claim? My answer is a resounding yes. While I do not know all the details of this loss, I can tell you that communication or lack thereof plays a huge role in the breakdown between the homeowner and the various adjusters assigned to cases such as this.

So what can you do to see if the communication process is working? A good place to start is to find out the “reserves” the insurance company has set aside for your loss. Insurance companies are required by law to set aside an amount of money they expect to have to pay out on a claim early in the process. This is a requirement that must be met within 30 days of receipt of a loss notice. Unfortunately, insurance companies do not want you to know what this is.  But your agent or broker will know, so try and get them to tell you. You can get a pretty good idea of where your claim is going by knowing what your insurance company “thinks” the value of your loss is versus what you are finding out about the scope of loss and actual cost that will likely be incurred. I don’t know if this family knew to ask for the reserve figure, but had they known at the 30-day mark what the reserve was, it may have made a difference in their expectations and methods for handling their own loss. It doesn’t hurt to ask for the amount of money that has been reserved for your loss.  Remember it’s your policy and money and if they won’t tell you, what does that say?  For more tips see: Protecting Your Insurance Claim

If you have a loss to your property and are not sure of your insurance company’s intentions, ask how much money they have set aside to pay your claim. Find out early by asking the right questions.

Total: 1 Comments
Don Murphy - Murphy Insurance Services.
  Mr. Tutwiler; A good piece but I think we need to go further and lobby our representatives to advise them to see the harm that Citizens and the take out group are causing by the removal of the appraisal process. This action removes the insured's timely and economical right to contest a claims damage evaluation. As you point out mediation is no answer. The major carriers, State Farm, Allstate, Farmers, Liberty have not seen it necessary to do this so why does the legislature feel it is necessary to allow Citizens to give the insured no real options. I agree with your assesment that licensing for both appraisers and umpires is necessary and as much as I don't like government involvement perhaps some agency to make assignment of umpires would keep everything above board by doing it on a purely rotational basis.
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