Process of making your insurance claims

Insurance companies are in business to make money, so don’t expect that they will act in charity at all times to satisfy you. It is most likely that in certain situations you will find yourself in disagreements with them over claims or procedure of settlement.

If there was a loss and your property is assessed and claims approved, it is important you review the risk report before you collect the cheque so that you don’t come back after you have collected part of the money to raise fresh issues. Experts from MoneyWatch listed a number of procedures to follow claims:

Review the adjuster’s report carefully

After an adjuster inspects your loss, they’ll prepare a written assessment of the damage that needs to be repaired, items to be replaced and their estimate of the costs for each. It’s important to know that adjusters typically use a replacement cost computer program to prepare their reports and the costs for materials and contractors will be based on regional or national averages. The adjuster will provide their report to the claims supervisor, who will then issue you a check based on the coverage in your policy and the adjuster’s report.

If you have a mortgage secured by the damaged property, the mortgage company or bank will also be named on the insurance settlement check. Because of this, you’ll have to endorse the check and send it to the mortgage company. The mortgage company will hold the funds in a loss draft account, and then disburse the funds to you in installments to pay your contractors/builders.

The offer

When you receive the first check from the insurance company, do not deposit it or send it to your mortgage company until you have carefully reviewed the adjuster’s report and agree with all items and costs. Look for things such as missing items, partial or incomplete measurements and low-balled contractors costs.

In local markets where builders and skilled labor are in short supply, the regional costs used in the adjuster’s report may be significantly less than what it will actually cost to replace what you had before the loss. If this is the case, do not agree to accept the first offer from the insurance company. The insurance company will recommend that you do and that you can later bring additional items to their attention and they would make supplemental claims later. Instead, return the first check and request that the adjuster revise the report and request a check from the insurance company for the correct cost of the damage.

How to complain effectively

At times, you may feel that your requests for covered losses are not being responded to fairly, or at all. It is in these times that your written documentation will pay off.

Make all complaints in writing: Be complete but concise, be professional and polite. Be specific in your written complaint and include:

•The specific issue or problem

•A specific request for resolution

•A response time frame

Also, it’s a good idea to copy the complaint to a supervisor or manager one level up. Make sure to ask the insurer if they require any additional information from you and when they need it. Finally, include in your complaint that if a reasonable resolution cannot be offered you are prepared to file your complaint with the regulatory agency.

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