Insurance Claims

Tips and recommendations on filing claims are listed below.
Forms:
Auto | Business | Life | Home
 
  • Auto Loss Claim Form
 
  • Property Loss
 
 
  • General Liability Notice of Occurence/Claim
 
  • Workers Compensation
 
 
 

Auto Insurance Claims

What You Need To Do Before and After Filing an Auto Insurance Claim to Make Sure Your Claim is Paid in Full and Promptly
Be thankful you're reading this now and not after you've already had an auto insurance claim. Think ahead for a moment. You've just had an accident. You're not badly hurt, but you're not in great shape either, particularly mentally. Your car - boy, you love this car - has some significant damage, perhaps so much that you won't be able to drive it home.
There's a lot to remember to do, and very little time to do it. What information do you need to have from the other driver(s)? Are there any witnesses? Does someone need to call the police? Where do you take the care to have it repaired? What do you do about alternative transportation? Who do you call to make a claim? Your agent? The insurance company? The other person's insurance company?
 
 
 
You are basically overwhelmed.
That's understandable, but there are steps you can take long before you have an accident so that you are prepared and making a claim is not that difficult at all.

There are a few steps you should take right now, before you have to file a claim. With the right preparation, the accident will be a less traumatic experience because you'll know exactly what to do right after it occurs.

Have you read your auto insurance policy lately? Ever? Probably not. Few people do, in all honesty. But whether you read the policy or not, you should know what your policy covers - and what it doesn't. No policy can cover every possible situation, but most good policies cover just about every one. Sometimes, when they buy their policy, people decide not to have certain coverage. Maybe it's because some coverages are too expensive or not worth having because their car is fairly old.

You should know the situations in which you don't have coverage. Call your agent, or whomever sold you the policy, and ask him or her to explain what the policy covers, but, most important, what it doesn't.

But there's more to know than what the policy covers. Insurance companies have certain steps you need to follow in the event you have an accident. In the policy, these steps are called "Conditions." You should know what these conditions are.

You should also try, ideally before you have an accident, to determine what you will do with your car if it needs repairing - get 2 estimates for repairs. Most insurance companies have what they consider to be "preferred" auto body shops - shops that have good reputations and that insurers trust.

Ask your agent what to do and who to call when you need to report a claim.

Now, your car. Do you have anything in your car to write with and on if you have an accident? There's plenty of information you will need to have right at the scene. This is not information you want to have written on a candy wrapper or a gold scorecard. And what if you don't always carry a pen or pencil with you? You need to have a pad of paper and a pen or pencil stored in the car, just in case you're in an accident. In fact, keep at least two writing instruments in the car in case one of your pens runs out of ink. Keep the pad and pen(s) in the glove compartment or in the console next to the driver's seat. In addition, if your insurance company has a form that allows you to provide details of an accident, including a sketch of the scene, keep some of those forms in the car as well.

Now, you are prepared if you should have an accident.

What to Do After An Accident

You've just had an accident. At the scene, you need to do the following:

1. Stop the car and get help for any injured drivers or passengers. Give whatever help you can to the injured (covering them with blankets, making them comfortable), but don't move them. You could aggravate the injury(ies). Have someone call the police or highway patrol. Tell the police how many are injured and the possible extent of the injuries (whether they appear serious or not). The police can then notify the nearest medical units if they are needed.

2. Protect the accident scene. Try to prevent further damage to the vehicles involved by setting up flares or getting your car off the road.

3. Give the police officers whatever information they require, including your version of what happened. Do not, under any circumstances, admit you were at fault, either to the police or the other driver(s). Just give the facts as you see them. Ask the investigating officer how you can get a copy of the police report. You might need the report when you submit your claim to the insurance company. Stay at the accident scene until the police have left. (If it's a minor accident, the police may not make a report. In fact, they may not even come to the scene if there are no injuries or serious damage to any of the vehicles involved.) But insist to have a police report.

4. Write down the names and addresses of all drivers and passengers involved in the accident, as well as the license number, make, model and year of each car. Make a note of the driver's license number(s) and insurance information of the other driver(s). Write down the names and addresses of as many witnesses as possible, as well as the names and badge numbers of police officers and any emergency personnel.

5. Write down all the details of the accident that you can remember, either on the accident form from your insurance company or in your notebook.

6. If necessary, have your car towed to a repair shop. (It's a good idea to have a repair shop in mind before you have an accident; this way, you already know where you want the car towed).

7. Call your insurance agent or the local claim representative for your insurance company to report the claim. Do this as soon as possible, preferably from the accident. (You should probably make a note in your notebook, prior to the accident, of the phone number(s) to call to report a claim). Actually, it's a good idea to call your insurance agent in addition to the claim representative. If your agent is involved, it could help speed the claim process. You should also tell your agent if you are not satisfied with how your claim is being handled.

8. Ask your agent or insurance company representative how to proceed and what forms or documents you will need to support your claim. Your insurer may require you to fill out a "proof of loss" form, as well as supply documents pertaining to your claim such as medical and auto repair bills, and a copy of the police report.

9. Keep records of any expenses you have as a result of the accident, including any related to a temporary inability to work or perform basic household functions. Your policy may allow you to be reimbursed for such things as medical and hospital expenses, lost wages and some of the costs if you have to hire a temporary housekeeper.

10. Keep copies of any paperwork related to the accident for 5 years.

11. If you are not satisfied with how your insurer is handling/has handled your claim, make your feelings known to the company and to your agent, and see how they respond. Do not, at this point, use the word "lawyer." Once you raise the prospect of seeking legal help, that will change the way your insurance company deals with you. When you say "lawyer," you are basically threatening to sue your insurer. Don't make this threat until you are absolutely convinced that your insurance company will not resolve the claim to your satisfaction. If you hire a lawyer, no one at the insurance company will be able to communicate with you directly; they must go through your attorney.

Remember, while no accident is a pleasant experience, proper preparation and following certain steps can ensure that the claim process is resolved to your satisfaction. If your claim has the important documentation and all the key details, there's no reason it won't be paid in full and promptly.

But if you have trouble, please contact your insurance agent. We are here to help you and make sure your insurance policy takes care of you, as it should.

Business Insurance Claims

Insurance Claims Tips for Your Business

Unfortunately, even the best-run business can experience accidents, thefts or other losses. While we provide you with important protection in case of a covered loss, you can take some simple steps to protect yourself before and during the claim process.

Have Important Information Ready

Inspect and inventory your property. As a matter of standard business practice, take a full inventory of all your property - both stock and other business property. Take photos or videos to supplement your written records. Being able to verify ownership of your inventory and other property is key to any property claim. Inspect your property regularly to document conditions both inside and out, and document your findings. Maintain a file of original purchase invoices.
Keep insurance information handy. Keep your insurance policy number and contact information for our Claims Department in an easily accessible place, both at your business and somewhere off premises.

If You Need to Make a Claim

File the claim. Call your insurance agent immediately to report the incident. Claims professionals are experienced in helping businesses recover from a loss. They can provide helpful advice and guide you through the claims process.

In the Event of a Theft

If your business should experience a theft, taking note of the details can make your claim a much smoother process.

In Case of a Medical Accident

Get medical help. If there if a medical emergency, get immediate medical help for any injured person. If there is a doubt whether medical help is necessary, err on the side of caution.

Collect information. Obtain contact information of anyone who witnessed the incident to share with the proper authorities. Show genuine concern, but never discuss liability or fault. Take the time to observe the scene of the accident.

Take a picture. Pictures of possible defects or other property damage can sometimes make a big difference in adjusting a claim. Take a picture or make a video of the place where the incident occurred. Note possible contributing factors, such as weather conditions.

Protect the scene. Secure the scene of the incident to prevent people from entering the area. Redirect people away from affected walkways or parking areas.

Secure a defective product. If a defective product is involved in the claim, protect it so that it can be examined later. Make sure no one can use, remove, tamper with or alter it.

No business expects to have to make an insurance claim. But by being prepared – both before and after the unexpected happens – you can help to protect your business and make your claims process as easy and straightforward as it can be.

Life Insurance Claims

Tips On How To Make Life Insurance Claims

Life insurance claims can be paid quickly if there are no complications. In fact, one source states 90% of life insurance claims are paid within 30 working days.

When an insured person dies, it is the responsibility of the beneficiary to file life insurance claims to collect any death benefits. It is important to get the claims process under way as soon as possible because most policies have a time limit to file a claim.

Family members often don't file a life insurance claim because they don't even know that the benefits exist. A search for life insurance policies should be included in winding up any estate.

You may be able to track down a policy by checking the person's banking records of payments made to any insurance company. You can check with the agent for other insurance policies such as car or house insurance to see if there was also life insurance. Or you could check with employers about any group policies that may be in effect or to see if there are any payroll deductions for individual coverage.

Homeowner's Claims

For homeowner's, some preparations can make the process easier in case of a claim on your home. Insurance agents said that most people would not be prepared, put together seven steps to take now.

We will:
1. Have an inventory of all your possessions. Take pictures in each room of your home.
2. Keep your important documents in a safe place, including medical records. Make copies of them and keep them in a safe deposit box or off site.
3. Have an emergency phone list handy. You should know the phone numbers for your insurance claims, the authorities and for neighbors and family.
4. Back up data. That means saving digital pictures and important files on the computer on a separate disk.
5. Have your purse or wallet and cell phone in a safe and easy-to-find place.
6. If you know a storm is coming, put the vehicles in the garage. Also, put patio furniture and grills in the garage or shed. Loose items can fly away in a storm and do damage to not just your house, but your neighbor's.
7. Know what your insurance policy covers and deductibles. Know if your payout is in cash value, replacement value, and remember that flood coverage is a separate policy you may buy, as well as earthquake.

Settling Insurance Claims After a Disaster

What you need to know about• How to file a claim
• How the claim process works
• What's covered and what's not

First Steps
Contact your agent or company immediately. Find out:• Whether the damage is covered under the terms of your policy
• How long you have a file a claim
• Whether your claim exceeds your deductible
(the amount of loss you agree to pay before insurance kicks in)
• How long will it take to process the claim
• Whether you'll need estimates for repairs

Make temporary repairs: Take reasonable steps to protect your property from further damage. Save receipts for what you spend and submit them to your insurance company for reimbursement. Remember that payments for temporary repairs are part of the total settlement. So if you pay a contractor a large sum for a temporary repair job, you may not have enough money for permanent repairs. Beware of contractors whose bids are very low - they might cut corners and do shabby work. Don't make extensive permanent repairs until the claims adjuster has assessed the damage.

If you need to relocate, keep your receipts: If you need to find other accommodations while your home is being repaired, keep records of your expenses. Some homeowner's insurance policies provide coverage for the loss of use of your home if it is damaged by an insured disaster.

Prepare for the adjuster's visits: Your insurance company may send you a proof of loss form to complete or an adjuster may visit your home first. (An adjuster is a person professionally trained to assess the damage.) In either case, the more information you have about your damaged possessions - a description of the item, approximate date of purchase and what it would cost to replace of repair - the faster your claim generally can be settled.

• To substantiate your loss, prepare an inventory of damaged or destroyed items and give a copy to the adjuster along with copies of any receipts. Don't throw out damaged items until the adjuster has visited. You should also consider photographing or videotaping the damage. If your property was destroyed or you no longer have any records, work from memory.

• Identify structural damage to your home and other structures such as a garage, tool shed or in-ground swimming pool. Make a list of everything you want to show the adjuster, for example, cracks in the walls and missing roof tiles. You should also get the electrical system checked. Most insurance companies pay for these inspections.

• Get written bids from licensed contractors. The bids should include details of the materials to be used and prices on a line-by-line basis. This makes adjusting the claim faster and simpler.

• Keep copies of the lists and other documents you submit to your insurance company. Also keep copies of whatever paperwork your insurance company gives you and record the names and phone numbers of everyone you speak to.

Homeowners insurance policies usually don't cover flood damage. You need a separate flood insurance policy. If you have flood insurance through the federal government's National Flood Insurance Program your homeowners claim adjuster may coordinate claims for flood damage with other damage claims.
 

Factors That Determine The Amount Of Settlement You Get

Type of Policy

Replacement Cost and Actual Cash Value: Replacement cost policies provides you with the dollar amount needed to replace a damaged item with one of similar kind and quality without deducting for depreciation (the decrease in value due to age, wear and tear, and other factors). Actual cash value policies pay the amount needed to replace the item minus depreciation.

Extended and Guaranteed Replacement Cost: If your home is damaged beyond repair, a typical homeowners policy will pay to replace it up to the limits of the policy. If the value of your insurance policy has kept up with increases in local building costs, a similar dwelling can generally be built for an amount within the policy limits.

With an extended replacement cost policy your insurer will pay a certain percentage over the limit to rebuild your home - 20 percent or more, depending on the insurer - so that if building costs go up unexpectedly, you will have extra funds to cover the bill. A few insurance companies still offer a guaranteed replacement cost policy that pays whatever it costs to rebuild your home as it was before the disaster. But neither type of policy will pay for more expensive materials than those that were used in the one that was destroyed.

Mobile Home, Stated Amount: If you own a mobile home, you may have a stated amount policy. With this policy, the maximum amount you receive if your home is destroyed is the sum you agreed to when the policy was issued. If you opt for the stated amount, update your policy annually to make sure that the amount will cover the cost of replacing your mobile home. Check with local mobile home dealers to find out what similar homes now sell for.

Policy LimitsMost insurance policies provide adequate coverage because they include an inflation-guard clause to keep up with increases in local building costs. If you have replacement cost coverage, your insurance company will pay the full cost of repairing or replacing the damaged structure with a building of "like kind and quality." In other words, if you were adequately insured and lived in a three-bedroom ranch before the disaster, your insurance company would pay to build a similar three-bedroom ranch.

Most insurance companies recommend that a dwelling be insured for 100 percent of replacement cost so that you have enough money to rebuild if your home is totally destroyed.

You may not be fully covered, however, if you have made significant improvements on your house, such as enclosing a porch to create another room or expanding your kitchen, without informing your insurance company of the changes at the time.

Temporary Living Expenses
If you can't live in your home because of the damage, your insurance company will advance you money to pay for reasonable additional living expenses. The amount available to pay for such expenses is generally equal to 20 percent of the insurance on your home. Some insurance companies pay more than 20 percent. Others limit additional living expenses to the amount spent during a certain period of time.

Among the items typically covered are eating out, rent, telephone or utility installation costs in a temporary residence, and extra transportation costs. Insurance policies often discuss additional living expenses under the heading loss of use.

Rebuilding and Making Repairs
If your home was destroyed, you have several options.
• You can rebuild a new home on the same site.
• You can decide that you would rather rent.

If you decide not to rebuild, the settlement amount depends on state law, what the courts have said about this matter and the kind of policy you have. Find out from your insurance agent or company representative what the settlement amount will be based on.
Concerning repairs, if you downgrade, for example, replace an expensive wood floor with one using a cheaper product, you are not entitled to the difference in cash.

Other Factors
Compliance with current building codes: Building codes require structures to be built to certain minimum standards. In areas likely to be hit by the hurricanes, for example, buildings must be able to withstand high winds. If your home was damaged and it was not in compliance with current local building codes, you may have to rebuild the damaged sections according to current codes.

In some cases, complying with the code may require a change in design or building materials and may cost more. Generally, homeowners insurance policies won't pay for these extra costs, but some insurance companies offer an endorsement that pays a specified amount toward such changes. (An endorsement is an addition to an insurance policy that changes what the policy covers.) Information concerning this coverage is found under ordinance or law in the Section 1 exclusion part of your policy.

The use of public adjusters: Your insurance company provides an adjuster at no charge. You also may be contacted by adjusters who have no relationship with your insurance company and charge a fee for their services. They are known as public adjusters. If you decide to use a public adjuster to help you in settling your claim, this service could cost you as much as 15 percent of the total value of your settlement. Sometimes after a disaster, the percentage that public adjusters may charge is set by the insurance department. If you do decide to use a public adjuster, first check references and qualifications by contacting the Better Business Bureau and your state insurance department. Also contact the National Association of Independent Insurance Adjusters (www.naiia.com).

Compensation for Damage

Vehicles: If your car was damaged and you have comprehensive coverage in your auto insurance policy, contact your auto insurance company. If you car has been so badly damaged that it's not worth repairing, you will receive a check for the car's actual cash value - what it would have been worth if it had been sold just before the disaster. Kelley Blue Book (www.kbb.com) or other such publications can give you an idea of what your car was worth.

Trees and Shrubbery: Most insurance companies will pay for the removal of trees that have fallen on your home but they won't pay to remove trees that have fallen but haven't caused damage to your home. They won't pay to replace trees or shrubbery that have been damaged in a storm.

Water: Homeowners policies don't cover flood damage but they may cover other kinds of water damage. For example, they will generally pay for damage from rain coming through a hole in the roof or a broken window as long as the hole was caused by a hurricane or other disaster covered by the policy. If there is water damage, check with your agent or insurance company representative as to whether it is covered.

The Payment Process

Disasters can make enormous demands on insurance company personnel. Sometimes after a major disaster, state officials ask insurance company adjusters to see everyone who has filed a claim before a certain date. When there are a huge number of claims, the deadline may force some to make a rough first estimate. If the first evaluation is not complete, set up an appointment for a second visit. The first check you get from your insurance company is often an advance. If you're offered an on-the-spot settlement, you can accept the check right away. Later on, if you find other damage, you can "reopen" the claim and file for an additional amount.

Most policies require claims to be filed within one year from the date of the disaster.

Some insurance companies may require you to fill out and sign a proof of loss form. This formal statement provides details of your losses and the amount of money you're claiming and acts as a legal record. Some companies waive this requirement after a disaster if you've met with the adjuster, especially if your claim is not complicated.

The choice of repair firms is yours. If your home was adequately insured, you won't have to settle for anything less than you had before the disaster. Be sure the contractor is giving you the same quality materials. Don't get permanent repairs done until after the adjuster has approved the price. If you've received bids, show them to the adjuster. If the adjuster agrees with one of your bids, then the repair process can begin. If the bids are too high, ask the adjuster to negotiate a better price with the contractor. Adjusters may also recommend firms that they have worked with before. Some insurance companies even guarantee the work of firms they recommend, but such programs are not available everywhere. Make sure contractors get the proper building permits.

If you can't reach an agreement with your insurance company. If you and the insurer's adjuster can't agree on a settlement amount, contact your agent or your insurance company's claim department manager. Make sure you have figures to back up your claim for more money. If you and your insurance company still disagree, your policy allows for an independent appraisal of the loss. In this case, both you and your insurance company hire independent appraisers who choose a mediator. The decision of any two of these three people is binding. You and your insurance company each pay for your appraiser and share the other costs. However, disputes rarely get to this stage.

Some insurance companies may offer a slightly different way of settling a dispute called arbitration. When settlement differences are arbitrated, a neutral arbiter hears the arguments of both sides and then makes a final decision.

How you receive the money: When both the dwelling and the contents of your home are damaged, you generally get two separate checks from your insurance company. If your home is mortgaged, the check for home repairs will generally be made out to you and the mortgage lender. As a condition of granting a mortgage, lenders usually require that they are named in the homeowners policy and that they are a party to any insurance payments related to the structure. The lender gets equal rights to the insurance check to ensure that the necessary repairs are made to the property in which it has a significant financial interest. This means that the mortgage company or bank will have to endorse the check. Lenders generally put the money in an escrow account and pay for the repairs as the work is completed.

You should show the mortgage lender your contractor's bid and say how much the contractor wants up front to start the job. Your mortgage company may want to inspect the finished job before releasing the funds that exceed the balance of the mortgage. If you don't get a separate check from your insurance company for the contents of your home and other expenses, the lender should release the insurance payments that don't relate to the dwelling. It should also release funds that exceed the balance of the mortgage. State bank regulators often publish guidelines for banks to follow after a major disaster. Contact state regulatory offices to find out what these guidelines are.

Some construction firms want you to sign a direction to pay form that allows your insurance company to pay the firm directly. The firm then will bill your insurance company directly and attach the form you signed. Make certain that you're completely satisfied with the repair work and that the job has been completed before signing any forms.

If you have a replacement cost policy for your personal possessions, you normally need to replace the damaged items before your insurance company will pay you. If you decide not to replace some items, you will be paid their actual cash value. Your insurance company will generally allow you several months from the date of the cash value payment to replace the items and collect full replacement cost. Find out how many months you are allowed. Some insurance companies supply lists of vendors that can help replace your property. Some companies may supply some replacement items themselves.

After your claim has been settled and the repair work is underway: Take the time to re-evaluate your homeowners insurance coverage. For example, was your home adequately insured? Did you have replace cost coverage for your personal property? Talk to your insurance agent or company representative about possible changes.