What Are My Responsibilities After Filing An Insurance Claim?
Duties after a loss
Every policy has a different language, but most have the same basic requirements. An insured or homeowner will always have specific language in the policy that puts certain duties or responsibilities after a loss on the insured or homeowner to comply with. You should always know what they are before a loss occurs. And as you read this article, you will understand why it is so important that you hire an Experienced Public Adjuster.
Most homeowners insurance policy will require:
- That you promptly notify the insurance carrier of the loss-(Remember in most cases you are not a General Contractor, Construction Expert, Mold Hygienist, Electrician, Electrical Engineer, Professional Engineer, Water Restoration Technician, Insurance Adjuster, Insurance Agent, or Claims Specialist. The insured that calls in the claim is typically the standard homeowner specializing in her or his own field of work. Remember that when you call in a claim that the insurance company is going to record the call and ask you questions to try and get you to answer things that will benefit them and, in my opinion, look for reasons to deny your claim or get you to say things you are not qualified to be answering so they can use it against you to underpay your claim. Just like going to court, you should always have a representative by your side, and having an Experienced Public Adjuster with you to make the call with you can limit them from asking you questions that you are not qualified to answer, or they may ask you are leading questions that you do not have an obligation to answer. Furthermore, the claim just happened and, in most cases, is still under investigation, which is why when they ask you questions about the extent of your damages, you should advise them that they have experts, and you will hire experts if needed to determine the extent of the damages. The only goal of the call to open a claim is to promptly notify them of the loss, which is your duty after the loss. And the goal of the conversation is to get the process started and to get a claim number. Their goals are much different, and remember, they operate for profit. Hence, no matter how nice anyone is to you during the claims process on behalf of the insurance company themselves, they are not your friends. They are not there to, in my opinion, ever pay you fairly. In most cases, the person who comes to your property is usually an independent adjuster who is just there to take photos, ask you questions, measure your home, document the loss, and estimate their perception of the damages. What they write and what the insurance company pays may be two completely different things. The field adjuster that comes to your property, except a few carriers, has no power regarding the money that will be paid to you, and they usually do not have the power to grant coverage. It is, in our opinion, never a good idea to open a claim without a qualified, extensively trained, educated, and experienced public adjuster by your side. If you want to learn more, click on this link to learn more about “What is A Public Adjuster.”
- Protect Your Property-This can be written in many policies in different states with a slightly different language, but it all serves the insurance carrier the same purpose. They are transferring the burden of damages onto the insured or the homeowner or business owner. Why might you ask would they do this? So they have a defense in accusing the insured that they did not do their part as a requirement of the policy language stated in their duties after a loss to complete emergency repairs to protect the property and take all reasonable means necessary to protect the property from further loss. If you are filing a hurricane claim and water is coming in from your roof, they may say that this language required you to immediately hire someone to put a tarp on the roof to protect the home. “CONTRACTOR WARNING, DO NOT SIGN ANYTHING ANYONE TELLS YOU TO SIGN EVEN IF THEY SAY THEY WERE SENT BY THE INSURANCE COMPANY OR THEY ARE A PREFERRED VENDOR OF THE INSURANCE COMPANY.” Why? Because depending on the contract’s language, if it is an assignment of benefits, work authorization, or direction to pay, you may be giving up rights, assigning rights and payments, leaving yourself susceptible to a mechanics lien, and much more. It would be best if you always had a Public Adjuster by your side to review these documents and always advise you that you have the right to have an attorney review the contract before signing the contract. Each state has different laws about contracts and rights to recission. Hire a local public adjuster who knows the industry in your state. Also, always consider the use of an attorney that specializes in 1st party property claims. Everybody has a friend of a friend that can help you out, or you know your brother’s neighbor’s sister was in the industry 15 years ago. Please make sure you hire someone or only get advice from an expert in the industry from your state and is still practicing in this specific insurance claims field to get advice. And when it comes to contracts, it is always best to seek the advice of an attorney. Experienced Public Adjusters knows all the bad actors in this industry and all the tactics that could leave you with a home that is demolition or improperly documented, or a contractor that drops fans or dehumidifiers in your home that does not get paid for, and they may or may not have been told to remove the equipment, and they do not care because depending on the contract they may have the right to put a mechanics lien on your property and have a collection agent come after you. We are not advising you ever to do these repairs yourself; we would actually advise against it. Hiring the right ethical licensed individual to document, photograph, and complete the emergency repairs, mitigation, water demolition, mold remediation, turning off the power if there is a fire hazard, shutting off the water at the street until a licensed plumber or leak detection company can determine the cause of the loss, remediating the loss with a state license remediators license, and we could keep going on, but there is an expert for all repairs that may be required and that expert is not you unless you happen to be licensed and qualified to do the repairs. We would still recommend you use a 3rd party as they are unbiased and do not have a vested interest in the outcome. This will provide the insurance company will no reason to accuse you of any improprieties. Water losses will cause, in most cases and climates, mold to grow and continue to grow, which is also part of your requirements and duties after a loss to mitigate. You should always hire a qualified and if your state requires it a State Licenses Mold Assessor, and in order to remediate the damages and mitigate the loss, you should again, if the state requires a license, hire a State Licensed Mold Remediator. Again we recommend you have an insurance claims expert, which is a Public Insurance Adjuster that is licensed by The Department of Insurance or The Department of Financial Services in your state that’s sole purpose is to protect the public’s best interest. The rule we suggest you follow is to find one advocate or a company with a team of advocates for you, such as a Public Adjuster or a Public Adjusting firm you trust and do not trust anyone else during the claims process as the insurance companies, as I stated before operating for-profit. Their goal is to maximize shareholder value or owner equity.
- Do not do their job for them. It is their job to assess the loss and pay the claim fairly. However, you should again, and I stress, photograph, and videotape everything you think could be damaged from the loss that occurred. Do not throw anything out,, do not let anyone take anything off the property (For example, a repaired pipe, keep the old pipe.) If you need to remove wet or damaged materials, put it in the garage until the insurance company adjuster arrives at the property and documents everything. And make sure you never leave the adjuster alone and take notes of everything the adjuster does and does not do. For example, if you have a wind claim or hail claims, it is crucial to document if that insurance company adjuster takes the time to crawl your attic, used a ladder to get on your roof and document and photograph your entire roof, walk the entire exterior of your property, investigate every room in your home, every window for potential damage. Do not be shy or worry about a room is a mess. Your job is to provide full access to every inch of your home for their investigation. Again we can’t stress this enough. You should have a licensed Public Adjuster hired from the start to ensure that your claim is documented and handled properly, hopefully before you even call in the claim.
- Some insurance companies request that you submit a proof of loss upon request, and some require it upon opening a claim. Usually, the policy language provides you 60 days to submit a notarized proof of loss. Proof of loss requires that an estimate supports it. How this is written is so important. Not missing the deadline is crucial, or they could use it as a reason for not paying a claim. There are many conditions in the policy they can invoke once you submit this proof of loss. They may be able to invoke an option to repair clause or invoke an appraisal clause. This is a very complex game of strategy, and they know exactly how to play it to pay you as little as possible, and the policy is never written to benefit the insured (Homeowner.) So we implore you to hire a Public Adjuster.
- They will normally have language that requires you to sit for an examination under oath. We do not see this use that often, but it is used more often than you would think. This is not something to take lightly, and this is when consulting an attorney is not just a suggestion but a requirement. This is one of the few situations where we, as Public Adjusters, would not be acting in your best interest if we did not advise you to consult an attorney. An examination under oath is an earnest request by the insurance carrier, and they will attempt to ask you to bring documents and ask you questions that you are not required to answer in many cases. Only an attorney can object and argue on your behalf and also protect you from answering questions under oath that you do not have to answer. Also, not responding and acknowledging the EUO or Examination Under Oath request is time-sensitive. The best advice is to advise them that you are in the process of considering a consultation, which may lead to you retaining legal counsel, and you promise to get back to them shortly after speaking with an attorney.
- Reminder to keep all receipts, photographs, damaged items, damaged parts, videotape recordings. Every out of pocket expense you should keep on the same credit card or keep the receipt someplace safe as you will need them: the more documentation photographs, the better. You should treat every claim from the moment it happens as if there is a chance you may end up in litigation and if you think like that and has a representative that knows that is a possible outcome, then if it ever does reach that as your only recourse to reach a successful outcome to be paid and treated fairly, you will be prepared from the beginning of the claims process with a well-documented file that is ready to hand to an attorney for them to file suit and because you treated the claim this way from the onset of the insurance claims process we promise you that you will have a higher percentage of reaching a successful outcome.
- You are also required to allow them access to inspect the property as many times as they desire. (That is something that can be disputed depending on many things and the current case law and state states. Usually, what is “reasonable” is the consideration to be considered. Ultimately it may be a decision for a judge to make if you feel you have given them more than enough unhindered access and time, and you would like the privacy of your home returned to you and your family.
- As we stated, each policy is different, and there may be additional responsibilities or duties required after your loss specific to your policy. Please ask your insurance agent to review these with you, or if you would like, you are welcome to call Experienced Public Adjusters.
Please do not be the type of person that wants to fix, or mitigate, or repair things on their own. We know that many people are handy with tools and have a common sense of limiting the loss. Again, we implore you to use experts to make sure you have an individual who has no vested interest in the financial outcome document everything so that you are not your own worst enemy. We realize you think you are helping and doing what you think is the right thing to do. But we promise you depending on the circumstance, having a licensed expert guide you, document the loss, and knows the insurance claims process is your best avenue if you want the best possible outcome. Please don’t mistake what we are saying for not doing common sense things. If your house is flooding, if you know how to shut the water off from the street, please do so. If you have a fire or life-threatening loss, call 911.
We at Experienced Public Adjusters work as a team so that you have the support of a larger company with many resources at our disposal to help you reach a successful outcome. We are license in many states throughout the United States, and feel free to check out our reviews online as we are one of the highest-rated public adjusting firms in the industry. We are highly selective about who we hire, and our training process is probably the most extensive in the industry. We currently operate and have licensed Public Adjusters in Mississippi, North Carolina, South Carolina, Montana, Florida, and Georgia. We pride ourselves on our ethics and integrity, and we make every decision based on asking ourselves one question, what is in the best interest of the insured? We have grown our business by following that philosophy and doing the right thing at every step of our client’s process. We feel what has allowed our company to grow exponentially and allow us to be one of the best rated public adjusting companies in the United States.
We are always available for free advice, a free onsite consultation, claim evaluation, and always happy to provide a no-cost claim review. Experienced Public Adjusters is open 24 hours a day/ 7 days a week to serve the public, including holidays.