Insurance Claims – The Acid Test for Insurance Policies

The acid test of the quality of an insurance policy is when we are in the unfortunate position of having to claim on them. This is when the insurance company is put into a position where it is being asked to pay you money rather than the other way around. How well a company handles this determines the real worth of their insurance policies that are being sold.

It doesn’t matter what type of insurance policy is being dealt with. Insure your car, home, cat, or life it will always be a sure sign of value if the claim is processed and paid smoothly and on a timely basis so that you can recover from the insured loss and get on with your life with the least amount of fuss and bother. carefully check a company’s insurance claims record before committing to buy a policy from them and avoid companies with a poor claims history.

Make sure you take the time to understand what your insurance policy is going to cover before you are in a position to make a claim. This will help you avoid difficulties later on and especially disappointment and complications. Make sure you know what you have to do in the event of a claim as delays in reporting a claim may invalidate the insurance cover. More than this, some policies such as car insurance have very strict conditions that attach to whether you should admit liability before the insurance company has had time to assess a claim. Make sure you educate yourself on what to do in such circumstances.

It also pays to realise that just because you pay a hefty premium, this does not mean that you are going to get good cover or a good claims handling experience when the time comes. Many insurance companies are reviewed not only on the basis of premiums but the features and benefits that they offer in terms of helping you through the administration of a claim. Good companies will have a structured and helpful customer claim process which provides good communication on a timely basis. Bad companies will usually try to hide such information from you so do not be diverted by slick sales talk when researching policies.

The cheapest premium doesn’t mean the best deal. Customer care does come with a price tag and very often a cheap deal does mean that when you claim, you are the one that has to do the running around in order to get the claim approved, settled and paid. It can make the difference between weeks or months of inconvenience when you need the money the most or a very easy, hassle free experience that let’s you recover the loss and move on with your life.

A claim is also an acid test of an insurance company’s financial position. If you are insuring an asset such as your life or your home, the sums involved can often be very substantial. You need to bear in mind that a claim has to be paid from the financial resources that are available to the insurance company. If a company was to receive the odd claim here and there, this may not cause any serious concerns. What if an insurance company was to suddenly receive a number of such claims at the same time, say because of a flood? Ask yourself if the insurance company can pay out all of those claims and if there is some doubt consider insuring somewhere else.

Insurance claims take place at a time of some distress or disturbance in our lives. A burglary of our home, a car accident, a health concern or a pet that needs veterinary treatment; life can be distressing enough when these things happen so we need the claims process to proceed smoothly and effectively to get us back on track. You can take responsibility for making sure this takes place by firstly, making sure you have proper coverage and secondly, by making sure you understand what the conditions are and what you need to do. A good insurer will help make things clear in both cases and will not hesitate to answer your questions if you are unsure. These are things to look for in a company when you are considering insurance in the first instance.

When you are claiming on a policy, do everything you can to document what has happened. Photographs are very helpful in many situations as are comparisons and keeping results and valuations for your insured items. The process of setting up insurance will often help you get these things organised to begin with, and never hesitate to ask your insurance company for help as after all, if you can make their job easier during the claims process, they will keep their own costs to a minimum and everyone wins.

Looking for information on health insurance policies? If you are looking for advice on life insurance or insurance claims, visit us now. Completely-Insurance.com is a goldmine for information on everything related to insurance claims and what to do in the event of having an insurance claim.

Insurance Claim Rights – Consumer Protection Against Unfair Claim Practices

What are my insurance claim rights? Is there any consumer protection against companies that abuse the consumer? The answer is yes! Every State has administrative entity that regulates insurance companies.

The 1945 Federal McCarran-Ferguson Act codified in U.S. Code Title 15, Chapter 20 gives the states the power to regulate the business of insurance as they see fit. This is the reason why all policies and regulations are different in each state. All states have enacted statutes that apply to insurance companies, agents, brokers, adjusters, and just everyone else that has to do anything with the business.

These statutes give power to the states to create the “Department of Insurance.” They also codify the claim rights a consumer has against an insurance company. For example, the Revised Code of Washington (RCW) 48.01.030 states “The business of insurance is one affected by the public interest, requiring that all persons be actuated by good faith, abstain from deception, and practice honesty and equity in all insurance matters. Upon the insurer, the insured, their providers, and their representatives rests the duty of preserving inviolate the integrity of insurance.” This language is common to all states with very little modification.

This language is very specific and sets forth the requirement of good faith and fair dealing. Most states define exactly what your consumer rights are or what claim practices are forbidden.

  1. Misrepresenting pertinent facts or insurance policy provisions;
  2. Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies;
  3. Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies;
  4. Refusing to pay claims without conducting a reasonable investigation;
  5. Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed;
  6. Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear. In particular, this includes an obligation to effectuate prompt payment of property damage claims to innocent third parties in clear liability situations. If two or more insurers are involved, they should arrange to make such payment, leaving to themselves the burden of apportioning it;
  7. Compelling insureds to institute or submit to litigation, arbitration, or appraisal to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in such actions or proceedings;
  8. Attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application;
  9. Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which the payments are being made;
  10. Asserting to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration;
  11. Delaying the investigation or payment of claims by requiring an insured, claimant, or the physician of either to submit a preliminary claim report and then requiring subsequent submissions which contain substantially the same information;
  12. Failing to promptly settle claims, where liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage;
  13. Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement;
  14. Unfairly discriminating against claimants because they are represented by a public adjuster;
  15. Failure to expeditiously honor drafts given in settlement of claims. A failure to honor a draft within three working days of notice of receipt by the payor bank will constitute a violation of this provision. Dishonor of any such draft for valid reasons related to the settlement of the claim will not constitute a violation of this provision;
  16. Failure to adopt and implement reasonable standards for the processing and payment of claims once the obligation to pay has been established. Except as to those instances where the time for payment is governed by statute or rule or is set forth in an applicable contract, procedures which are not designed to deliver a check or draft to the payee in payment of a settled claim within fifteen business days after receipt by the insurer or its attorney of properly executed releases or other settlement documents are not acceptable. Where the insurer is obligated to furnish an appropriate release or settlement document to an insured or claimant, it shall do so within twenty working days after a settlement has been reached;
  17. Delaying appraisals or adding to their cost under insurance policy appraisal provisions through the use of appraisers from outside of the loss area. The use of appraisers from outside the loss area is appropriate only where the unique nature of the loss or a lack of competent local appraisers make the use of out-of-area appraisers necessary.

For more information about your state insurance and tariff law, visit our site for the most common prohibited practices in your state

All the best,
Hector Quiroga
http://www.auto-insurance-claim-advice.com/

Hector Quiroga has a high interest in helping consumers gain knowledge of the auto insurance claim process for both property damage and bodily injury claims. He covers in great detail what a car accident investigation entails and share many helpful tips for dealing with insurance companies and adjusters. Learn how to protect your interest by visiting Auto Insurance Claim Advice.

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