How to Make an Insurance Claim
Do I have a Claim?
Policies have specific coverage’s and exclusions. Review your policy Coverage’s and Exclusions. Read the endorsements and changes to see how they apply to your claim. If you are unsure if a claim is covered under your policy, call us for free advice.
Take note that Water Damages, Pipe Breaks, washing machine overflow, Burst Water heater, Shower pan failures, Faulty drain pipes, HVAC Backup, Burst Ice maker lines and appliance leaks, etc. Many policies have exclusion similar to the following prompt reporting is necessary.
“We do not insure for loss caused directly or indirectly by: Constant or repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture or vapor; which occurs over a period of 14 or more days”.
Reporting a Claim
*Read your Policy including all forms and Endorsements*
How is the claim is reported can have serious consequences on your claim, the speed of settlement, amount of recovery or your claim could be denied entirely. It is your responsibility to report the claim and the insurance company’s responsibility to investigate the claim you reported.
Some Very Important Pointers
Don’t limit your claim! Perform a complete and thorough investigation of all property or have a professional investigate the damages so that your claim can properly be reported. We are continually advised that damage is confined to one room or area and our investigation finds just as much or even more damages in an adjacent room or area as no one had looked.
Be very careful in explaining the damages and your expectations; an example would be the adjuster asks, “Is there any damage to the furniture?”, your reply is: “See the damage on that table leg”. A few weeks later your receive the adjusters’ summary and it contains $50 to refinish the table’s leg. Can the table leg even be refinished?
The proper way to make claim on this table:
– Is the table part of a pair or set such as a dining set? If so, advise that the table is part of set and you are making claim for the set.
– Contact the store of purchase or a reputable furniture refinisher and see if a repair can be done. Advise the contractor of your requirements i.e. to match and restore if the entire set to its condition prior to the loss, refinishers rarely can guarantee total restoration without refinishing the entire set and may not even be able to restore in even attempting the set.
Be very careful of your wording when making claims as words can a have specific definition in accordance with the policy.
Flood, by policy definition in many insurance policies is rising ground water and not covered under an ordinary policy. We have seen many claims wrongfully denied just because the ponding occurred due to a covered loss which is covered under the policy, but the claim was reported as a flood and therefore denied.
Report the claim to your Insurance Company and/or agent. The decoration page of your policy and/or the policy itself provides information for making a claim. Some policies require claim to be made directly to the Insurance Company and not the agent. It is your job to report the claim. It is the Public Adjuster’s job to investigate the claim.
Mitigation and compliance with your duties after a loss
*Read your Policy, Your Duties After Loss
1. Comply with all of “Your duties after Loss”
2. Take the necessary action to prevent further damages. There is an obligation of mitigation under our policy.
If temporary repairs are needed, they should be completed as soon as possible. Do not make permanent repairs before an insurance adjuster inspects the loss. Make only temporary repairs necessary to protect from further damage and possible looting. General contractors are recommended for any jobs that requires three or more trades. Trades men/Specialty contractor/Handy men are not entitled to receive profit and overhead, are not licensed for multiple trades and do not offer a consumer protection as afforded by licensed general contractor.
3. Make a list of all damaged items and take pictures of everything
Many insurance policies require documentation of the age of the item, purchased price, actual cash value of the item at the time of the loss and current replacement cost value.
– Pictures/Photos of damages, pictures/photos before the loss (as many as you can)
– Make a list of all damaged items including the value of it (for the best of your knowledge)
– All receipts, invoices, checks and any expense you have occurred
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Disclaimer: Insurance Assurance Inc. has prepared this website for informational purposes only. It shall not constitute legal advice and should not be construed as such. The information on the website is provided only as a general information that may or may not reflect the most current developments. Your specific needs are unique, and will depend on facts and circumstances that may not be addressed in this website.