Protecting Yourself When You Deal With Your Insurance Company

Avoid unpleasant surprises when you make an insurance claim.

Insurance companies go out of the way to advertise how fast, neighborly, generous, kind, understanding, patient, and friendly they are -- especially when they are trying to sell you one of their policies. It continues to be true for as long as you make your insurance premium payments on time without asking for anything in return. However, policyholders forced to present a large claim often learn there are limits to insurer congeniality.

Here are some survival tips that you may find useful in dealing with your insurer about a homeowners', health care, or commercial insurance policy.

Before You Buy

Always take careful notes when you buy an insurance policy. Write down what the insurance agent tells you about the coverage you are buying. Save your notes in a file with your policy. Also save any promotional material you are given or shown when you buy the policy.

Insist on reading the completed application form yourself instead of allowing the agent to read it to you. Be certain that your answers are truthful, thorough, and complete. If they're not, it could come back to haunt you. The insurance company can rescind your policy entirely -- after you make a large claim -- if it finds some basis for asserting that you misrepresented a significant fact on the application.

Before you buy the policy, insist on seeing it. Make sure that you really understand key points -- things like deductibles, exclusions, and limitations.

When You Have a Claim

Now is the time to get out all those papers you saved so carefully. Review your policy and notes before you speak with a company representative. Make sure you understand the complex coverage, exclusion, and limitations provisions to lessen the likelihood of saying something that the company could twist into a basis for denying the claim.

Gather Evidence

Start gathering materials to help you prove your claim. Photograph your loss and keep records of it. For example, if you are making a claim based on fire and smoke damage to your business or residence, you should photograph the fire-damaged areas and items before they are repaired or discarded.

What Not to Do

A policyholder should never do any of the following:

• exaggerate any aspect of a claim
• accept the insurance company's expert's evaluations of the losses without getting an independent expert's estimates
• submit to an "examination under oath" by the company without first obtaining legal advice, or
• sign an insurance company release or check without verifying that the amount is full and correct.

Keep a Log

It's a good to start a log concerning your claim. Write down the date, time, and a summary of every telephone or written communication with company representatives. Note the name, title, and direct telephone number of every person with whom you have contact.

This is important because insurance companies often switch adjusters on claims, sometimes more than once. You'll need evidence of what was said or done when, and by whom, throughout the handling of the claim. Among other things, keeping such notes can make it more difficult for the insurer to blame any delay on you.

If a Dispute Arises

A few legal rules are on your side when it comes to deciphering a policy. If a dispute over what should be covered goes to court, the coverage provisions will be construed broadly (in your favor), whereas the limitations and exclusions will be interpreted narrowly (in your favor). And because the company wrote the policy, any ambiguities in it will be interpreted in your favor and against the company. The goal of a court will be to honor your reasonable expectations.

To read and printout a copy of the Form please link below.

Sample Document: Breach of Contract Claim

You can download a free copy of Adobe Acrobat Reader here.

Copyright © 2007 Nolo

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DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.

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