Disaster Recovery - Filing a Claim


 

Filing a claim can be one of the most frustrating processes during a crisis or following a major disaster. It is critical that at these times, you are prepared with the information your insurance company needs.

 

Know where to find your information. Before you can file a claim, you will need to have: 

 

The name of your insurance company or insurance producer (agent)

Your insurance policy and policy number

The customer service line for filing a claim

 

Know your policy. Read and understand what your policy says. An insurance policy is a contract between you (the policyholder) and the insurance company. Know what’s covered, what’s excluded and what the deductibles are. If you have any questions about what’s covered, ask. Filing a claim is not the time you want to find out whether or not you’re covered.

 

File the claim as soon as possible. Some policies might require you to file a claim within a certain time frame. Once your insurance company has been notified of your claim, the company has 10 business days to furnish you with the necessary claim forms. Complete them and return them promptly with as much information as possible. Incorrect or incomplete information will only cause a delay in processing your claim.

 

Many companies respond within two days, some within 24 hours, after you report your claim. The insurance company will make arrangements for an inspection of the damage to your car, home or business.

 

When you file your claim, and throughout the entire claim process, it is important to

 

·          Keep a record of everyone you spoke to on the telephone, including names and date/time of the conversation, as well as any exchanges in writing.

·          Ask questions if you do not understand something.

·          Photograph and make a list of the damaged items.

·          Save any receipts for materials purchased for repairs.

·          Do not throw away damaged property until the claims adjuster advises you to do so.

·          Protect your property from further damage by making temporary repairs until your insurance company is able to advise you.

·          Do not have permanent repairs made until your insurance company has inspected the property and you have reached an agreement on the cost of repairs. If you do make permanent repairs before the adjuster has seen the damage, your claim could be denied. 

 

Settle the claim. After you file your claim forms and the insurance adjuster has made an inspection of the damage, your insurance company usually will respond in writing within a week. By law, the company must respond in writing within 15 business days advising you if your claim has been accepted or rejected. Unless there are problems with your claim, it should be processed quickly. 

 

If your claim is complicated or questionable, the company may request additional time. Your insurance company will notify you of the reasons for the delay. If the investigation remains incomplete, the insurance company must advise you of the status of your claim until it is settled 30 days from the date of the initial notification and every 45 days thereafter

 

If you don’t hear from the insurance company, call and ask for an explanation of the reason for the delay. It sometimes is useful to get the company to put in writing the information they need so that you are both clear on the issue.

 

Once you and the insurance company agree on the terms of the settlement, the law requires that you be sent payment promptly.

 

You and your insurance company may find it difficult to agree immediately on the settlement of your claim. If you can’t reach an agreement on the extent of the damage or the cost to repair the damage, review the terms of your policy.

 

If your claim is denied, make sure you obtain a written letter explaining the reason for the denial and the specific policy language under which the claim is being denied. If you are not satisfied, or if you feel you have not been treated fairly, you should contact the Pennsylvania Insurance Department for assistance.

 

Once you contact us and submit a completed complaint form, we will start an investigation on your behalf. Your complaint form should explain the reasons for the disagreement and you should attach copies of any supporting documentation, such as your insurance policy, who you spoke to and any correspondence you have received from your insurance company.

 

Our consumer service investigators will review your complaint to determine if your issue was handled appropriately under the terms or your policy. We will also determine if the insurance company, producer (agent) or any other party violated state insurance laws. No matter how strongly you may feel about your dispute, there are those cases where the company did not violate any insurance laws and therefore, no wrong doing was had on the part of the company.

 

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