Posted 6:30AM 08/29/11 Insurance
So, let's assume you did the right thing in getting insurance to protect yourself against those times when Mother Nature comes knocking. Your next challenge may be getting the insurance company to pony up the cash instead of trying to deny your claim.
"Families will have to dig deeper into their pockets, because insurers have been steadily increasing hurricane wind coverage deductibles and imposing other policy limitations," said J. Robert Hunter, director of insurance for the Consumer Federation of America and former federal insurance administrator and Texas insurance commissioner, in a prepared statement.
"This liability shift to consumers may take some by surprise, since disclosures are often buried in renewal paperwork that consumers may not understand or even read," he said.
"Because so many consumers experienced claims problems in the wake of Hurricane Katrina, we urge homeowners dealing with losses caused by Hurricane Irene to be vigilant with their insurance companies to ensure that that they receive a full and fair settlement," said Hunter.
How to Boost Your Odds of Getting Paid
If you want to increase the likelihood that your insurer writes that check, there is much to do.
Don't dillydally when it comes to reporting your claim: Insurance companies generally handle them first come, first serve, warns Hunter.
Once your claim is reported, get your claim number and write it down. Having that number will make your life -- and the insurance company's -- easier.
Find out a little about the adjuster who will come to your house to assess the damage. You want to know if he is an employee of the insurance company or an independent adjuster hired by your insurer. The answer matters: If the person is independent, get the name of the actual insurance company adjuster whom the independent adjuster is sending your information to, and find out whether they are authorized to make claim decisions and payments on behalf of your insurance company.
Beware of firms that demand up-front fees for services, regardless of the outcome they negotiate on your behalf with the insurance company. Public adjusters work purely on a contingency basis, ensuring that a homeowner does not pay anything unless he or she receives some form of settlement, says David Charles, president of Catastrophic Claims Consultants.
Build Your Evidence
Anticipate the possibility of push-back from the insurance company, and be ready to hit them with documentation. When you file a claim, CFA advises immediately starting a notebook detailing all your contacts with the insurance company. List the date, time and a brief description of what went down. If you need to amplify later, this will give you a leg to stand on. If an adjuster says he or she will not come out, for example, write it down. If an adjuster is a jerk, note that too.
Do, however, take photographs of the damage before doing any repair work to your home. Also, make an itemized list of all damage sustained during the storm and its aftermath, advises Frank Keaney, who specializes in homeowners insurance with Amity Insurance. Do all you can to minimize secondary damage: Your homeowner's policy requires that you "mitigate damage," says Kevin Lynch, an assistant professor of insurance at The American College.
You'll want to do some homework by getting a repair estimate from a contractor to help you in talking with the adjuster. Hang on to receipts for any emergency repairs, and costs such as if you have to stay in a hotel. This may be reimbursable under the "additional living expense" portion of your homeowners' policy, says Keaney.
If needed, you can use weather data provided by the Forensic Weather Consultants at www.weatherconsultants.com, a company of forensic meteorologists who can substantiate hurricane based insurance claims.
It should go without saying, but be honest. Claim inflation invites claim denial, says Michael Huber, partner with the law firm of Ver Ploeg & Lumpkin.
Fight Back
Make sure you follow up on your case: Don't just file the claim, sit back and wait for your payment. Check in regularly with your insurance agent or company on the progress of your claim, says John Egan, managing editor of InsuranceQuotes.com.
If your insurer denies your claim or offers a piddly amount, don't just accept it. CFA advises demanding that the company identify the language in your homeowners' policy that served as the basis for denying your claim or offering so little. The company may be right and you may not know it. Once the company pinpoints the key language in the policy, you should be able to make this determination. Then too, it could be that the company has craftily put new limitations into the policy and didn't make them clear to you. If you feel misled, weigh whether you want to contact an attorney.
For example, says Hunter, the introduction of percentage deductibles (up to 10% of the value of a home), will greatly shift the cost of Hurricane Irene from insurance companies to consumers, as compared to earlier storms. The practice of shifting the cost of previously insured events back to consumers is acceptable, as long as consumers are clearly given the option to select the level of coverage they want with fully informed consent.
Another new way insurers can pull a "gotcha" is by putting a limit on replacement cost payments, which might come into play in the event that a home is totally destroyed. A typical cap is 20% above the face value of the policy. According to CFA, if costs surge because of the spike in demand for materials or labor following a major storm like Hurricane Irene (or if the state does not monitor price gouging sufficiently) this limit might apply. For example, if a home was expected to cost $200,000 to replace and that amount was the limit on the policy, the insurance company would pay no more than 20% more, or $240,000. If the surge in construction costs due to extreme demand caused the price of replacing the home to jump to $300,000, the homeowner would be short $60,000.
Know Your Rights
The squeaky wheel gets the grease. Do complain to the powers that be in the insurance company if you feel like a denial was unwarranted or the reimbursement too little. Don't stop there. Complain to your state insurance department: It will make an inquiry with your insurer. See a lawyer if you want to take it a step further.
Once the insurance company tells you the reasons for its action, it legally can't produce new reasons for denying payment or making a low offer at a later time. You have locked them in -- a major advantage for you.
If you review the policy and find that, without stretching your imagination, it seems plausible that you should get the full amount of your claim, you will likely win if you go to court. The CFA notes that courts consistently rule that if an insurance policy is ambiguous, the reasonable expectation of the insured party will prevail since the consumer played no part in writing the language of the insurance policy.
Expect the worst, but hope for the best. Said Hunter, "Not all insurance companies handle claims badly, so go into the claims process with an open mind. Be vigilant though, or you run the real risk of being shortchanged."
