What to Expect in Making an Insurance Claim?
When you make a claim on an insurance policy, the chain of events that follow can be complicated. It can be unpleasant and full of surprises. It will almost certainly be lengthy and it will become frustrating. Regardless of the insurance company there will almost always be some level of resistance to paying your claim whether small or large.
Claims will vary in how they are executed because of differences between companies, kinds of insurance, and state laws. Our attorneys can help you understand exactly how your claim will ebb and flow -remember, we work for you, and you should clearly understand every step of the process.
REMEMBER - Insurance companies are very deliberate - and everything is geared towards minimizing the money paid to you. All the events during the claims process are out of your control. Needless to say, the average person is at a great disadvantage. Nevertheless, certain events are predictable and the following is a general idea of what's likely to happen when a claim is filed:
- An insurance agent or insurer receives a report of a covered incident commonly referred to as an accident report. It is to your benefit to report any claim as soon as you are able to do so.
- The claim is reviewed by an employee of the insurance company to determine whether there is coverage. You will be notified, usually by mail, of what they decide. Do not be surprised or discouraged if your claim is denied initially.
- If your claim is denied and/or if you are advised that there is no coverage, you can try again with the next higher ranking person until you get to someone who will treat your claim seriously. The following assumption is the basis for many companies to deny all claims on the first attempt at recovery: most people will be discouraged and/or intimidated from pursuing their claim. Once an attorney is involved, many claims that are initially denied are resolved favorably for the person or persons seeking the settlement. Sometimes, all it takes is a letter from an attorney to make an insurer change its mind other times a lawsuit needs to be filed. Either way, that is what your lawyer has been trained to do.
- If you receive notice that you are entitled to coverage, what follows can vary dramatically. For example, in health insurance and auto liability insurance, the insurer will likely pay the health care provider and/or the person you hit directly. They would then inform of these payments. In life insurance policies (assuming natural causes), the insurer will likely pay by return check - they will require proof of death. In a claim by a homeowner or renter, the insurer will want proof of what was lost. They may require that you replace what is lost and then seek reimbursement. In cases of fire insurance, the process will be more drawn out as the insurer will work with you to reconstruct what you have lost.
- In some cases, your insurer will pay you for your loss and then pursue whoever actually caused the loss. This process is known as "subrogation." This process, if pursued, may require your cooperation and/or participation.
- Assuming a settlement is not reached or if it is reached only after a lawsuit is filed, when the lawsuit ends, your insurer will pay whatever amount it is ordered to pay by the court or the terms of the settlement. While the insurer may appeal, this is typically the end of the process at this point.
The entire process can take from as little as hours, to as long as years depending on many variables. Generally speaking, the less money at stake the faster the process will go.
A FINAL IMPORTANT NOTE: All lawsuits must be filed within a certain period of time known as the statute of limitations. Statutes of limitations vary depending on the type of lawsuit but if the time period passes without a lawsuit being filed the opportunity for a recovery may be lost. Act quickly to know your rights under this very important doctrine!
Disclaimer
This publication and the information included in it are general in nature only and are not intended to serve as a substitute for consultation with a licensed attorney. The specific facts of your case and the associated legal issues always require the advice of appropriate legal professionals.