Insurance Claims: What is the process?

July 6, 2022

In an ideal world, the insurance claiming process would be fast and simple. Well, think twice. With experience, we learned that dealing with insurance claims is a daunting process. The various steps to follow, the complex language in the policy, and the prolonged waiting time for a decision make it an intimidating process.

However, we are here to take away some of the complexity of filing a claim. Our team of experienced attorneys will assist you throughout the process and get you the results you deserve. For now, here is a basic guideline for you to understand how insurance claims usually work.

Step 1: Record and Address Your Damages

The first thing you must do after you discover a loss at your home is record the damages. Failing to properly document your loss can result in a lower chance of recovery.

Take photographs and videos of the affected areas of your home at the time they occur or when discovered. Also, do your best to depict the damages left by the aftermath of the event without putting yourself in a position of harm.

If you must make any temporary repairs to the property, be sure to keep any receipts for expenses or services. You may be able to have these costs reimbursed.

Finally, obtain independent estimates to restore your property to a pre-loss condition. This is not immediately necessary, but it will help you understand the true cost of your claim. Consulting a property insurance attorney at these early stages of a loss is imperative. We will guide you through these critical steps and refer you to qualified consultants depending on your situation.

Step 2: Report the Claim

A large misconception when you have a loss is that you should call your insurer first. Insurance agents assist with selling insurance, but they are not equipped to advise you on whether it makes sense to file a claim. Similarly, your insurance company will not advise you whether to open a claim. Your insurance company will not assist you in evaluating your damages or give you a preliminary opinion on whether those damages are covered under your policy UNLESS you open the claim. Once you open a claim, it goes on your record, so you want to be sure that opening a claim makes sense for your circumstances.

This is why contacting a professional for an independent evaluation is the first step in the process. We assist policyholders in evaluating potential claims and if necessary, opening claims directly with insurance carriers. The initial reporting of the claim is yet another critical step in the process that can derail a claim right at the outset, if not done properly.

Step 3: Gathering Information

Once you file the claim, your insurance company will begin their investigation process. An insurance adjuster will communicate with you to gather more information about the loss. Insurance companies send letters, emails, and call by telephone during the claim process. They ask for lots of documentation, some which may not even exist. Responding to their requests in a timely fashion is part of your duty as a policyholder.

You also want to make a clear record of the process on your end. It is good practice to follow up via email after telephone conversations memorializing what was said. Put everything in writing as much as you can. When we represent policyholders, we become the main point of contact for the insurance company. That means, we’ll handle all the communications for you so you can focus on life’s other responsibilities. Peace of mind goes a long way.

Step 4: Property Inspection

Then, the insurance company will send an independent adjuster to your property. The adjuster will walk through your home, take some pictures and measurements, and sometimes ask you questions. This is another critical stage of the claim process. Insurance policies are rife with exclusions. Adjusters are versed in asking well-crafted questions that get the policyholder to make statements that jeopardize coverage. Remember, insurance adjusters are professionals. You will want your own professional with you during this process to ensure you are getting a fair shake.

After completing the inspection, the adjuster will report his findings to the insurance company. An insurance agent might contact you if additional information is needed.

Step 5: Coverage Decision

Insurers have timely obligations to respond in writing to policyholders. In Florida, a decision to pay or deny must be made within 90 days of the receipt of notice. If the claim is denied, the coverage decision notice must list the reasons for denial and the part of your policy they are citing. If a payment is made, the insurer must put in writing under which portion of the policy the payment is being made and how that amount was calculated.

Step 6: Seek Help From Our Team of Experts

Handling an insurance claim alone may pose a risk that could cost you the money you need to repair or replace your damaged property. Knowing when to hire a property damage lawyer is as important as knowing who to hire. Do not settle for an underpaid or denied claim. Our knowledgeable team can get you the best possible outcome whether by a settlement, mediation, or going to trial.

If you are dissatisfied with your insurance company’s decision on your claim, our experienced team at Schirmer Law can help. We are experts at handling property insurance claims and providing exceptional results to our clients.