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SaveDOS AND DON'TS: Insurance Claims
THE DOs
DO call your agent as soon as a covered event takes place. As soon as you get home from the car accident, or even before you go to the doctor, call your agent.
DO review and understand your coverage before talking to your insurer or your agent. Read the "Coverage" and "Exclusion" sections of you policy in particular.
DO take and keep detailed notes of all conversations with insurance company representatives, and get names, phone numbers, and job titles of people you speak with, including their supervisor's name.
DO consider whether you might have insurance coverage under some other insurance policy as well. Many people have more than one policy that might cover a claim. In particular, look at homeowner policies, "umbrella" policies, and materials that came with your credit cards.
DO take pictures, if possible. That doesn't mean you should sneak a "PatientCam" into surgery with you, but take pictures of your destroyed vehicle, fire damaged home, or injuries if you can.
DO be honest and forthcoming with your insurer. Even if it is embarrassing, it is better if your insurer knows all the facts. Failing to be candid with your insurer might invalidate your policy or cause a denial of coverage.
DO understand the difference between replacement coverage and depreciated or actual cash value. If your policy provides replacement coverage, don't settle a personal property loss for "actual cash value." You may be required to replace the lost items before getting your full reimbursement if you have replacement cost coverage.
DO keep all receipts of meals, lodging, and purchases made in connection with time spent pursuing your claim or recovering from your injuries from the time of the covered event until final settlement with your insurance company.
THE DON'Ts
DON'T give any recorded or written statements to your insurer until you are sure you understand your coverage. Remember you are not required to allow the insurance company to record your telephone conversation. If you have doubts, do consult an attorney.
DON'T automatically accept the estimate or appraisal of your losses given to you by the insurer. Insurance companies will often try to get you to accept their estimator's or contractor's repair or replacement estimates, which might be a bit low. DON'T sign any releases or waivers of any kind until you obtain legal advice. A bad financial situation after a major loss may make it seem necessary for you accept a premature, inadequate settlement from your insurer. But you may remember destroyed items after you have signed a release as to payment for your personal property inventory or other claims. For these reasons, it is advisable to consult an attorney before signing a release or waiver. Be sure to read the fine print on any payment from the insurance company.
DON'T accept any check that says "final payment" unless you are ready to do so.
DON'T ignore time limits set by your policy. Most policies require a signed proof of loss within a certain time limit. Be sure you comply with this requirement unless you obtain a written waiver from your insurance company. Many policies allow you only one year from the date of loss in which to bring a legal action if your claim has not been adjusted fairly. If your claim has not been settled to your satisfaction eleven months after your loss, consult an attorney immediately. A failure to do so could result in the loss of your right to sue.
DON'T forget that you have a contract with your insurer. Your insurer has a legal obligation to provide the coverage it promised to you. Be insistent about enforcing that obligation.
Copyright 2002 FindLaw, Inc.