How to Dispute a Home Insurance Claim Settlement or Denial
Insurance Claim Disputes Here In Michigan Are Fairly Common.
Most Homeowners here in Michigan that don’t have representation such as an Insurance Restoration Contractor, Public Adjuster or an Attorney discover the hard way after filing an Insurance Claim for property damages loses, that their insurance company is not on their side. In most cases, they send out inexpericensed Insurance Adjusters that have no idea of structural integrity, or what really is involved in restoring a home or business back to pre-loss condition. They wright up settlement offers way below what is expected or consider fair compensation for the damages.
Most of the time for small property loss claims you won’t need representation. It may not be worth it to go to great lengths to get what you think is fair, but on the other hand, when the loss to your property in question is a “large Loss” or Catastrophic Property Loss from a Fire, Flood or Storm, a less than fair settlement may bring the insured on the brink of financial ruin, as they wont have the funds needed to repair or rebuild their property.
It’s the large Loss Property Claims that the Insurance Companies are most worried about, as they too can suffer large losses as a result of a claim. Insurance Companies have a vested interest in trying to minimize the settlement amount they pay out to you the insured, and unlike you, they have large pockets and departments whose only job is to help them minimize their claims liability, at your expense.
Under such conflicting circumstances, you can hardly expect the insurance company to be an advocate for your interests. It is entirely up to you, the homeowner, to make the case for the losses suffered, quickly and effectively.
For The Most Part There Are A lot Of Good & Fair Insurance Adjusters Here In Michigan That We Work With On A Regular Basis That Do Care And Write Good Estimates.
Most people think that just having Homeowners Insurance is supposed to relieve financial stress after any damage to your home, but if a claim settlement offer falls short of your expectations, or your claim is denied altogether for not having the right coverage, it can leave you more frustrated than ever.
Disputes between customers and Insurance Companies over claim payments occur for many reasons, from fine print never explained in a policy to debate over the real cost to fix your house. If you think you’re getting a raw deal, you don’t have to accept it. Here’s a few tip’s to make your case and negotiate a better insurance settlement.
1. KNOW WHAT COVERAGE YOU BOUGHT
Sometimes Insurance Claim Payment disagreements are the result of confusion about what’s covered by your homeowners insurance. Know What Coverage You Bought!
Before you get riled up about a claim payment or denial, review your homeowners insurance policy to see if you’re covered for the damage in dispute and what the dollar limits are for your coverage. Knowing what you’re entitled to under your policy will also bolster your argument if you’re in the right.
2. REVIEW YOUR CLAIM
If you’re unclear about why the settlement was lower than expected, ask your insurance Adjuster for clarification, make them explain. If it cites an exclusion or other specific language in your policy, ask to point out the section in question, call your agent whom you bought the policy from.
Document in writing everything your insurer and/or claims adjuster tells you. Keep a log of dates, whom you spoke to and what was said. If you get information by phone or in person, send a follow-up email confirming what you heard.
Once you’re clear on your insurer’s position, prepare documents that can help prove your case. For instance, if your Insurance Company thinks it will cost a certain amount to repair your house but you think it’ll be more, get a written estimate from an independent contractor.
3. APPEAL YOUR SETTLEMENT OR DENIAL POLITELY
If you need to dispute a denial or low settlement offer, start by calling your Insurance Adjuster, writing a letter to your claims Agent. Briefly explain your point of view, including any evidence you’ve prepared that supports your side, and request that the adjuster review the claim.
Remember It is not over till it’s over, be patient.
Ask for a response within a certain period of time, say, 3 business days. To have a record of the exact day your letter is sent and received, choose the certified-mail option at your post office. Also send a copy of your letter and additional documents to your adjuster’s supervisor.
Remember it is not over till it’s over, be patient. Don’t threaten to hire an attorney. If you take an adversarial tone right off the bat, your insurer might decide to let its lawyers do the talking.
4. DEMAND AN AT-HOME VISIT, IF NEEDED
If there’s a dispute over the extent of damage to your home, ask your adjuster to inspect your house again. have an independent contractors or other professionals, such as an independent insurance adjuster or Restoration Contractor investigator or mold inspector, bring those people to meet with the Insurance Adjuster.
“Get everyone in the same room,” Determining the full scope of damage isn’t an exact science, it may bolster your argument if other experts can physically point to damage that your adjuster might have missed and address potential next steps.
5. NO RESOLUTION? YOU CAN FILE A COMPLAINT WITH THE INSURANCE DEPARTMENT
If your Insurance Adjuster won’t budge, file a complaint with the Michigan Department of Insurance.
Having the State Insurance Department on your side can give you powerful leverage in negotiations, Unfortunately, State Insurance Departments often don’t have enough resources, such as attorneys and construction experts on their team, or the power to resolve certain disagreements between insurers and policyholders.
The department of insurance will help if possible, so it’s certainly worth a try, especially if you want to avoid shelling out for a lawyer.
Appraisal Process
Appraisal is a common Process used in disagreements between customers and Home Owners Insurance Companies over Property Damage. Both sides pick an appraiser to represent them. Typically, you would hire a lawyer or a Public Insurance Adjuster
The two appraisers review the damage to your home and belongings and try to agree on how much you’re owed. A neutral party, called an umpire, breaks any deadlocks between the appraisers.
Here’s an example of the kind of language about appraisal to look for in your homeowners policy:
- If you and we fail to agree on the amount of loss, either may demand an appraisal of the loss. Each party will choose a competent appraiser within 30 days after receiving a written request from the other. The two appraisers will choose an umpire. The appraisers will separately set the amount of loss. If the appraisers submit a written report of an agreement, the amount agreed upon will be the amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of loss.
The biggest downside to appraisal is that it determines only what was damaged and how much that damage amounts to, not whether your insurer actually has to pay that much. Appraisal won’t resolve disagreements over your coverage, the language in your policy or other issues holding up your claim.
Mediation Process
Mediation involves hiring an impartial person, or mediator, to work directly with you and a representative from your insurance company to help you come to an agreement.
You and your insurer split the cost for mediation, unless your policy states that your insurer must pay. The mediator can be court-appointed or a private professional whom both sides agree on. You can also go through a state-sponsored mediation program, which you typically can find through your state’s department of insurance website.
Mediation typically is fast, but it’s nonbinding.
Mediation typically is fast, but it’s nonbinding, so you or your insurer can pretend the whole thing didn’t happen if either side doesn’t like the outcome.
Among the downsides: The insurance company’s rep likely will be trained for the process, while it will be brand new to you. Your insurer might also use mediation simply as a way to feel out the strength of your case, meaning you could waste time and money but get no closer to a resolution.
The Last Resort: File A lawsuit
Suing an insurance company can be a long and expensive process. Before you start a lawsuit, try the strategies outlined above. In addition, bringing in a Public Adjuster or certified Insurance Restoration Contractor to help you navigate the process at the beginning of a large claim can pay off at the end.
If your home or business has suffered from an unfortunate disaster, the team at Select Restoration is here to help. Our expert claim consultants will analyze the property damage, provide the necessary repairs, and work as a liaison with your insurance company making sure you get a fair an equitable settlement to recover the funds needed to make the restoration process go as smooth as possible.
Let Select Restoration Put You On “YOUR ROAD TO RECOVERY”
Once the insurance claim is fully processed and finalized, our certified team will provide a thorough construction management timeline to ensure that your restoration and reconstruction project stays on schedule and on budget!
