Is the insurance claim process gamed against the policyholder???

Filing a loss claim with the insurance company is often not an easy, straightforward task. Is the insurance claim process gamed against the policy holder?

Not in the strictest sense of the word, however…

1. Insurance language is subject to interpretation and often confusing to the average person. 

Many times, depending on how you describe the property loss, could determine if your policy covers it or not…  For example, call water damage flood damage, and if your policy doesn’t specifically cover flood damage, your claim may be denied.

2. Without proper guidance, there are plenty of ways for the insured to diminish the chances of a maximum settlement or have their property loss claims denied.

There are many instances when your claim can get denied if you don’t offer the required supporting evidence timely and accurately.  For example, you had a house fire, and the insurance company suspects the cause may have been an intentional action of yours or  negligence, as mandatory safety measures were ignored. This are grounds for your claim to be denied, unless you  satisfactorily prove your innocence.

Another area subject to interpretation and that needs to be paid particular attention to is  the calculation of the losses. An estimate of losses has to be made in order to get paid.  Following a reported property loss, the insurance company will also send a directly employed or under-contract insurance adjuster to inspect your property and assess the damages.

3. The insured and the insurance company are just not playing from an equal standpoint

Rarely is a homeowner or business owner versed in insurance law or has the full support of insurance professionals. The game is definitely not fair, but … You can turn things around and get a better settlement, quicker, by hiring a public claims adjuster.

Unlike the insurance adjuster sent by the insurance company to assess your damages, the public adjuster will be on your side. A public adjuster has the knowledge to interpret your policy, thoroughly document your losses, file the claim paperwork on your behalf and communicate with the insurance company.  Since they have knowledge of the insurance industry, this will not only expedite the payment but the amount collected can also be substantially larger.