The trauma of dealing with a natural disaster that destroys your property or home is painful enough for a policyholder, but adding the stress of an adjuster who wants to come in with a low estimate or flat out deny the claim can be jarring. Although it will add to your troubles and cause extra work at a time when you have your hands full, there are steps that you can follow in order to get the carrier to provide you with the reimbursement that is appropriate for your loss or possibly even overturn their denial.
Table of Contents
- 1 Steps To Follow If Your Estimate Is Too Low
- 2 Steps To Follow If Your Claim Is Denied
Steps To Follow If Your Estimate Is Too Low
If your estimate comes in at an amount that is below what you had anticipated and far less than what it will take to make the necessary repairs, these are steps you can follow to appeal.
Choose To Appeal
Most carriers will allow you an option to appeal the initial decision that the adjuster made. When filing the appeal, make sure that you have included all of your documentation to support the claim with photos, written notes, receipts, and witness statements. You’ll need to show that you maintained your home and kept up with all of the necessary safety preparedness through any type of documents you have showing maintenance/inspection reports, e.g. if you had loss by fire, show evidence of smoke detectors or an alarm-type system functioning properly.
Contact Your State Department
Your state’s department of insurance offers resources that will be able to aid you in resolving your claim issue. They are responsible for regulating carriers that operate within each state. They will help you understand your rights. They will also review the claim issue and investigate the complaint in an effort to help resolve the dispute.
Write A Formal Letter
If you see that there is no resolution with the adjuster, a formal letter to someone in a higher position may be helpful for you in which you explain the loss, the reasons your claim were not satisfactorily settled, and why you believe this was an error. Let them know that documentation has already been made available to the company in great detail and include all of your contact and policy information.
Hire An Adjuster
Go ahead and hire a public adjuster via the National Association of Public Insurance (or you can ask an insurance attorney for recommendations) who will be able to review the claim and make their own assessment independently that they can then present to your insurance carrier. This person needs to have a license that is in good standing to work in your particular state and they should specialize in your specific loss. You need to interview a few adjusters after thorough research and getting references.
Use A Third-Party Mediator
Using a third-party mediator who is neutral and objective is sometimes the best option in that the procedures they use are often more informal and tend to be less confrontational than that of a court appearance. It’s also pretty quick and less costly, but settlement may not be as much as you would be able to obtain through a trial.
Steps To Follow If Your Claim Is Denied
There are instances where an adjuster will completely deny your claim and steps that you should take in order to try to overturn the decision.
Consult With An Attorney
If you are not able to come to an agreement with the insurance company over a denied claim, you may need to contact an attorney who will be able to help you understand the language involved in the insurance contracts. For claims under $10,000 filing within small claims court is a more simplified process for resolving claims where you wouldn’t necessarily need to have an attorney. Typically, an attorney won’t take money upfront, they will be paid a portion out of your settlement.
File A Complaint
After consulting the attorney, you’ll need to write up the complaint in order that you can begin your lawsuit which will allege that the carrier has denied your claim, breaching the contract for which you paid money in the instance of certain losses or damages.
Prior to the trial, you will be required to show evidence and information with the defense side for the discovery process which can include requests for written documents or interviews of witnesses who were under oath with the court reporter producing a transcript. During any point of discovery, there could be an offer for settlement from the carrier.
Move On To Court
If discovery doesn’t produce an offer of settlement, the case will move on to trial after which the judge will make a determination.
Situations like this are ones no one wants to find themselves in and, hopefully, with most insurance carriers, these types of instances would be very rare. No one wants to have to go through any of this, particularly after suffering a devastating loss.