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Is My Claim Covered?

By August 17, 2020 September 14th, 2020 Insurance

First, we should note that we are not claims adjusters, we are insurance agents, so we cannot tell you whether you are covered or not, but we can tell you what coverages limits that you have purchased. Whether you have a home, auto, or business insurance claim, you should ask yourself 2 questions:

  1. Is the claim direct, sudden, and accidental?
  2. What is my deductible?

Your insurance policy will usually cover your property and liability for any specific accident and/or event that occurred. You must be able to identify a specific date and place of the “event”, such as a hurricane, lightning strike, falling tree, or pipe burst. In the case of liability claims, you must provide a specific action that caused the damage (collision with another vehicle or someone falling and getting injured).

Also, consider how much the claim may cost to repair. If the damage is only several hundred dollars, your deductible may be higher than the amount of repair, so you could have a claim filed that has $0 paid out. Although that may not sound like a big deal, if your rates go up and you have to shop your insurance again, a CLUE report (a claim report) will identify a claim and you may have to prove that the issue has been resolved and all repairs have been made.

The insurance policy is not a maintenance policy, so if you have an old roof that is starting to leak or an old water heater that is leaking, it is likely not covered. Your auto insurance would not cover you if you had engine failure because you did not add oil to your car. Similarly, your home insurance or business insurance policy will not cover you if your old roof is starting to leak or if your old water heater is leaking.

Who should I call if I have a claim?

Our recommendation is to call us or the company right away. The insurance companies handle claims 24/7, but if it is during business hours, we love to help our clients through the process by making the claims call together.

If you have any emergency situation that needs quick attention, you can certainly call a contractor to make temporary repairs right away. However, we don’t recommend signing any work orders or repair contracts until you speak to the adjuster. If you speak to our agency, or the insurance company, we are more likely going to be able to point you in the right direction and possibly save you money on your deductible. In fact, some companies use a specific contractor that they trust and may give you.

What should I do once a claim has been filed?

Your claims adjuster should guide you through the process from start to finish. If you feel like things are not progressing in a timely matter, call your agent. We don’t often deal with the claims adjusters at the insurance companies, but we do know many others in the organizations including management. If you are struggling to get things handled, sometimes we can contact a manager who will “light a fire” in order to get the claim handled quicker.

Now that my claim has been handled, is there anything I should consider?

Absolutely! Now that your claim has been handled and the contractor’s work has been completed, be sure to keep all receipts and invoices, and be sure to take photos (before and after would be best). You can forward this information to our office.

Likely, the company will ask for proof that the money they sent for claims repair was used for the repairs. For example, if the company pays for the roof to be replaced, they want to make sure that the money was used to replace the roof. Obviously, the company doesn’t want the client to patch the portion of the damaged roof and spend the rest on a vacation in Hawaii. If one portion of the roof has failed, other portions of the roof will fail soon.