BIGGEST ERRORS IN FILING A CLAIM

By Raymond A. Altieri, Jr, CPPA

Filing a property insurance claim can be a very complex undertaking. In all regards, you are asking a multi-billion-dollar corporation to pay you money for something you own that has become damaged. It is natural for those with the money, in a circumstance such as this, to be frugal, responsible, and sometimes even suspect of those who would make claim.


With this concern in mind, it is crucial for those who make claim to be sure they are forthright, honest, accurate, and transparent in dealing with an insurer. To not be any of those characteristics could be cause for denial of your claim, or worse if those making claim were to misrepresent or conceal information vital to the insurer’s ability to warrant payment.

If we were to discuss some of the most common mistakes made by policyholders in filing property damage claims they could be boiled down to the following:
  • Not being detailed in item count, description, or price to replace today
  • Failing to list items damaged they perceive to be of little or no value
  • Using someone other than a licensed public adjuster to represent them to the insurance company
  • Allowing the insurance company to determine your loss value
  • Giving all rights to your claim settlement monies to a contractor or other party

 

Number 1 above, “Not being detailed in your count etc,” is just what it says. The more detail you provide to the insurance company adjuster about your claim lists and costs, the more information they have to pay you what you are claiming.
Number 2 above, “Failing to List, etc,” is a common omission because people have the natural tendency to think “letting certain items go” by not listing them gives them credibility or endears them to the adjuster to make up for it somewhere else in the claim. You get no credit elsewhere in the claim from a carrier for not listing items and their costs that are damaged, regardless of how small or trivial you think that damage is. If it is damaged, you list it, price it accurately, and ask for payment.

Number 3 above, “Using someone other than a Public Adjuster, etc”. This is a major mistake because only State Licensed Public Insurance Adjusters are trained and allowed by law to represent property policyholders on their claims to an insurance company. Many times, unsuspecting policyholders are coerced into hiring contractors to handle their claims with their insurer because the contractor will indicate they can do the same thing as a public adjuster. THAT IS NOT, NOR HAS IT EVER BEEN THE CASE. Licensed public adjusters are trained in adjusting and estimating techniques from the perspective of the policyholder, using the insurance policy to their favor. Public adjusters are state licensed, submit to FBI background checks, and are educated in insurance policy analysis. Public adjusters are experts in using the insurance policy language to benefit their client. Contractors are not allowed to perform such activity by law and cannot discuss insurance policy coverage with an insurance company.
This means when an insurance company adjuster wrongly proclaims to a contractor that your claim or a portion of it is not covered, there is no ability for that contractor to rebut the adjuster. Your claim is then dead in the water. Use the contractor for mitigation or construction. You use the professional Public Adjuster to advocate for you in the claims process.

Number 4 above, “Allowing the insurance company to determine loss value.” In comparison, imagine telling the IRS to let you know how much you owe them in taxes! It is always best for you, the policyholder, to make your claim to the carrier. The carrier should be “adjusting” the claim you present to them, not the other way around. It is your home, your building, your business. It is your obligation to present the claim to the carrier. The insurer only performs this activity in advance of the policyholder to control the payment outcome. How could the damage evaluation process by the party with the checkbook, be best for the party getting paid? Human nature and simple business theory would dictate otherwise. Use your own adjuster, a public adjuster, to evaluate and negotiate your claim for optimum results in payment.
Number 5 above, “Giving up all your rights to settlement monies, etc.” It is a major mistake for a policyholder to hand over the rights to their claim payment to a contractor by signing away all their natural insurance policy rights as the policyholder, to a contractor or other third party. You should maintain ownership of your claim, its proceeds, and the decision on how to rebuild, for how much, and with what materials. It is your property plain and simple. Handing over full authority to a contractor or anyone else eliminates you from having authority over the claim, its money from the insurance company, and even if your contractor decides to sue your insurance company. Maintain possession of your claim, its money, and how you wish to spend that money once it is received.