COMMON ISSUES IN CLAIM PROCESS

How long does my insurance company have to pay my claim?
It depends on your state and the type of insurance. Some states set specific time frames for when claims should be acknowledged, while others only specify that they should be paid within “a reasonable time.”

When states do designate a timetable, it often falls somewhere between 30 and 45 days. Longer than 60 days is generally considered a delayed payment. These designated payout periods apply mainly to homeowner’s and auto insurance; different kinds of insurance may be subject to different regulations.

However, if you believe that your insurance company is intentionally stalling your claim and delaying payment, you may have grounds to take legal action.

What is a Sworn Proof of Loss?
It is a form that is requires most property insurance policies. It serves as official notice to the insurance company that you are making a claim. It provides information to the insurance company about your claim, and is typically required to be submitted in a specified period of time. A lawsuit may not be permitted if the insurance company has requested this form and you have not completed it. Its submission also generally establishes a set time frame for the insurance company to pay your claim.

If my insurance company underpaid my claim what are my options?
A claim that is not paid in full can be as bad a s a denial of a claim. It is not unusual and certainly not something you have to live with. The policy often allows you to demand Mediation, or invoke a process known as Appraisal. In addition you always have the right to sue your insurer and if you win they could very well be made to pay your attorneys fees and costs in bringing an action.

What is a Public Adjuster, and what can they do for you?
A public adjuster is a person who can act on your behalf to try and resolve a claim with your insurance company. A public adjuster is not a Lawyer. Only a Lawyer may represent you in any legal proceeding.

A public adjuster cannot:

  • File a lawsuit on your behalf.
  • Take the deposition of the insurance adjuster or the insurer’s “experts.”
  • Represent you in a sworn statement or a deposition.

Insurance companies know the limitations of public adjusters.

You need to carefully read any proposed agreement with a public adjuster. In many cases, if you have an agreement with a public adjuster, you may have to pay them for money the insurance company has already agreed to pay you, and you may remain responsible for paying the public adjuster long after you hire an attorney to represent you.

Beware of adjusters who come to your home unsolicited or who pressure you into signing their agreements.

What is an assignment of Benefits and is it something I should consider to get repairs done?
An assignment of benefits transfers your claim to another party. They are most often used by “first-response” vendors such as water mitigation companies. However, any contractor who performs services pertaining to your property may ask for one.

Because assignments transfer your rights under the policy, you should have an attorney review the document before signing it. We are aware of situations where they assigned all of the insured’s rights, and it prevented the insured from suing an insurance company.

You should carefully read all documents that are presented to you by anyone who will assist in repairing your property and avoid signing anything that has language that assigns your insurance benefits.