The Insurance Claim Process

| Insurance Claims, Insurance education, Risk Management.

insurance claim process

At some point in your life, you will be involved in the insurance claim process.   You might be a 3rd party claimant collecting from another person’s insurance company.  Or, a 1st party claimant seeking coverage from your own insurance policy.   Either way, there are some important tips that can help minimize the headaches and maximize your settlement:

Know Your Insurance Policies

As an insurance consumer, it is ultimately your responsibility to know and understand your Nevada insurance policies.   This can only be accomplished by actually reading the policy.   Remember, an insurance policy is simply a contract between you and the insurance company.   The policy, or contract, dictates the terms and conditions of your coverage and how a claim will be paid.  Your insurance agent or broker can be a valuable resource and you should feel free to ask questions about terms, conditions, and exclusions.

File The Claim Quickly

The sooner you notify us, the faster an adjuster can be assigned and begin processing your claim.   Your policy may also have a condition that requires the insurer be notified within a certain period of time.   Further, claims that are filed long after the incident has occurred are a “red flag” to insurance adjusters, especially if repair work has already begun.

Documentation and Correspondence

Document EVERYTHING about your insurance claim, including phone calls, and save all correspondence from any party involved in the incident.   You should also save any receipts for expenses you incur.  For property claims, you will likely be expected to create an inventory of items that were damaged, destroyed, stolen etc.    It helps tremendously if you have proof of ownership and value before the claim occurs. Read our blog article Take an Inventory for additional tips.

Be Honest

It should go without saying, but do not misrepresent anything to an insurance company.  At the very least it could be the basis for denial of a claim; at worst it could lead to prosecution for insurance fraud.  Insurance adjusters are generally very savvy investigators and are trained to look for fraudulent or misleading information.

Settlement Offers

For most insurance claims, you should expect a settlement offer within 30 days – hopefully much sooner.   Certain types of claims, such as a large fire, may require additional time to investigate and a full settlement may take several months.   You can, however, ask for a partial settlement for damages that are clear and undisputed.    For example, your Nevada homeowner policy likely contains coverage for “Additional Living Expenses” that will cover the increased cost of meals and rent related to a covered loss.   You can begin submitted receipts for payment under this coverage immediately, even if the claim for damage to your home is unsettled.   Nevada business insurance policies may include coverage for “loss of income” that can likewise begin payment before the final settlement offer.

Settlement offers are sometimes negotiable, such as a 3rd party liability claims arising from an auto accident.   Insurers and attorneys are constantly battling over injury settlements and, of course, insurance companies are typically portrayed as the bad guys.   The truth of the matter is that a consumer who understands the claim process can negotiate a settlement just as well as an attorney can (an attorney will very likely tell you differently).  The process of negotiating a bodily injury settlement, however, can be time-consuming.

Reservation of Rights Letter

You may at some point during the claim receive a “Reservation of Rights” letter from the insurance company.   These letters are often written in jumbled legalese and typically cite portions of the policy, specifically your obligations under the insurance contract and policy exclusions.   This letter does NOT mean your claim is being denied but instead that there is some question about at least a portion of the claim.   This letter is a signal to you the insurance company is seeking further time to investigate your claim and is asserting its right to raise a coverage defense.

The “Reservation of Rights” letters often creates confrontation between the insurance company and the policyholder, because the verbiage often sounds like an attempt at denying coverage.   Also, the letter is not expected by the policyholder and the intent of the letter is often not clear.   If you receive a “Reservation of Rights” letter, please contact us so we can discuss your claim with the adjuster and find out what potential issues have arisen.

Delays, Denials, and Disputes

The vast majority of insurance are settled without incident and to the complete satisfaction of all parties involved.   Hopefully, your claim falls into this category and we will do everything we can to make sure it does.   Occasionally, however, insurance claims are denied for varying reasons, or you experience a delay in payment or dispute over value.

We always recommend you contact your agent first and allow us to try and resolve the solution amicably. Safeguard Insurance is a large producer for most of our insurance company partners and we can often leverage our relationship to resolve a claim issue.   Sometimes we will recommend a customer contact the Nevada Department of Insurance, especially if we think an adjuster or insurance company is being unreasonable.

Our Pledge

There is no such thing a “good” insurance claim.  When you call us to report a claim it means something bad has happened and your life has been disrupted.   We understand that and our goal is to make sure you receive prompt service and that your claim is paid fairly and quickly.    It is important to Safeguard Insurance that you are a completely satisfied customer.   Please contact us if you ever need assistance filing or settling your insurance claim.

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