Warning Signs There May Be Problems with Your Insurance Claim

If you have to file an insurance claim with an insurer, you want that process to go quickly and smoothly.  After all, the resolution of the claim could be the only thing that will help you regain normalcy or operations.  Any delays or challenges with your insurance claim can make your situation even worse.  This is why it is often recommended that you do not go it alone with your insurer and you enlist the help of a professional public adjuster.

Without a public adjuster to help you, it’s possible to run into obstacles that can result in delayed payments or sub-standard settlement.  Even worse, problems with your claim could result in claim denial. That’s why it is important to be aware of some of the warning signs that there could be problems with your insurance claim. 

The following are just a few of the most common:

Warning Sign #1 – Your Insurer is Investigating Your Claim 

Did you get a notice that your insurer is investigating your claim instead of processing it for payment?  This could be a sign that the insurer is potentially looking for a way to deny, delay, or diminish coverage benefits.  Sometimes investigations occur if the insurer thinks there may be issues with your claim.  The insurance company may be trying to prove that your incident should not be covered or that the claim amount is lesser than what you believe is owed.  A claim investigation generally will slow down your reimbursement and result in frustration and disappointment. 

Warning Sign #2 – You’ve Been Asked for a Recorded Statement 

Another common warning sign that there could be a hindrance to your insurance claim is if the insurer asks that you submit to a recorded interview or have a special investigations unit (“SIU”) involved. If you have been asked to offer a recorded statement, it sometimes may put you in a position where you may omit information critical to your claim resolution.  Making a mistake in your recorded statement could be used against you and cited as a claim for denial.  

For example, if you mistakenly say the incorrect time or date or do not list the items in your loss, it could be used against you. If you do have to give a recorded interview to go along with your report, then ensure you have your facts straight before recording your statement and providing it to your insurer.  Sometimes an insurer may demand an examination under oath (“EUO”). A EUO is an insurer’s contractual right to essentially take a sworn statement under oath similar to deposition and it is best suited for an insured to consult legal counsel if one faces this hold-up. 

Warning Sign #3 – You Have Not Heard Anything 

One of the b most troubling signs that you could have a problem with your insurance claim is not hearing anything from your carrier. Insurance companies are required to get back with you within a specific time period after you have filed your claim, although that time requirements depend on the specific state you are domiciled in.  Denial notifications and payouts are also required within a specific period from the time of claim submissions. There could be a hold up if your insurance company is taking a long time to get back to you or they have not complied with the deadlines.  Be sure you keep records of your interactions with the insurance company and inform anyone you speak to that you are disturbed by the amount of time it is taking to resolve your claim. 

Avoid These and Other Problems with a Professional Help

Instead of simply relying on the representatives that work for the insurance company, hiring a seasoned public adjuster can help you avoid these types of problems. A public adjuster works independently and has your interests in mind, so you can rest assured they will focus on what is rightfully due to you under your policy instead of thinking about the insurer’s bottom line.  Rely solely on the insurance company to advocate your best interests is not in your best interests. Put your mind at ease and retain professional help such as a public adjuster to assist you so that you have the best chance at a fair, equitable, and expeditious resolution. 

SunPoint Public Adjusters, Inc. Advocates Only for the Insured’s Benefit.

Our team of experts has been advocating on behalf of policyholders for decades. We have handled, managed, and successfully navigated claims ranging from homeowner losses; corporate losses in the hundreds of millions of dollars; disaster losses involving government entities and entire municipalities; agricultural and recall losses, and virtually any type of disaster claim that could be imagined. Our team of Public Adjusters, building cost consultants, inventory specialists, forensic accountants, equipment consultants, and many other experts make up a group unmatched in our industry. It is easy to be big. But it takes dedication every day to be the best – we have that dedication. Our goal is aligned with yours.  To obtain a free assessment of your specific circumstances and recovery please contact us to strategize your best means of recovery.

Masood is one of the Principals of SunPoint Public Adjusters Inc., which is one of the premier public insurance claim adjusting, valuation, and loss consulting organizations in the United States. His experience as a Public Adjuster, Attorney, Assistant General Counsel, and Executive Vice President for various companies provides him the tremendous insight to advocate on behalf of commercial professionals and homeowners who have suffered catastrophic losses and need a professional and dedicated expert on their side to level the playing field. Since 1992, Masood has helped numerous individuals and businesses recover from disasters such as firestorms, hurricanes, tsunamis, tornadoes, earthquakes, and other catastrophes throughout the United States, Asia, and the Caribbean. For a consult, please call him at 415.271.2612 or by email at masood@sunpoint.us.