Insurance Claims - An Inside Perspective

Insurance Claims – The INSIDE STORY

Insurance claims can be a first class PITA!

With that in mind, this little bit of INSIDE INFORMATION is offered.

EVERY CLAIM HAS:

1. An Adjuster (human type)
2. A File (either electronic or paper or both)
3. A Supervisor (also the human type)

The claim process looks like this (considering the three above items)

1. The Adjuster mediates and calculates the value of the claim.
2. The Adjuster documents The File. (Why? Because The Supervisor is going to check that file)
3. The Supervisor reviews the file. (Why? Because once a year, the state insurance commission will audit the insurance company and randomly review claim files to be sure that the money paid out was justified, documented and in accordance with state insurance law. When there’s an issue, the insurance company is fined — HEAVILY! )

Here is the extremely valuable information ! When you’re negotiating with the insurance company to settle your claim, remember while making you happy is important to them, passing the eventual audit is more important. A badly documented or poorly calculated claim can cost the insurance company — MANY MORE DOLLARS than giving you a couple hundred extra for your bent fender.

Generally, the adjuster does not personally care how much they pay to settle the claim. Let me say that again.

Generally, the adjuster does not personally care how much they pay to settle the claim.

I say generally because you will occasionally run into that young buck, fresh out of ‘ADJUSTER SCHOOL” who wants to save the world and treats the insurance company money like his own. THAT’S a discussion for another day. They’re paid employees with families, bills, problems, vacation plans, and a host of other issues just like you and I face everyday.

The claim adjuster doesn’t really care what he pays to settle the claim.
The claim adjuster wants to get the file closed as much as you do.

As long as he can document the amount paid, he’ll write the check now and be done with it.

THEREFORE……

Whatever assistance you can offer to document a better value for your claim, the faster you’ll get paid.

1. When you think your car is worth more than they’re offering, get some documentation that supports that additional value.
2. When your repair job exceeds the insurance company estimate, get a letter or itemized estimate explaining the difference.
3. When the replacement cost of your kitchen exceeds what the insurance company is willing to pay, get pictures of your old kitchen and an itemized bid from the contractor that clearly indicates that you’re putting yourself back as you were — No better, no worse.
4. When the ‘facts of the accident’ are not clear, get witness statements or police report clarification.

The more you’re willing to work WITH the claim adjuster to properly document their file to justify higher payments, the more you’ll get paid for your claim.

Please Contact Jason Shroot with Diversified Insurance Services @ 714-988-3325 and let us help you with your claim process - that's why our agency is here for you !