If you’re a property owner with damages like bursted pipes from the winter storm, there are some key things to consider and expect from the insurance claim process. There are also some important things you can do now to help your claim along.
It is important to note that an insurance contract and state laws require an insurance company to treat you fairly and honestly, and there are certain deadlines a carrier must meet when accepting, investigating, and handling your claim. Although insurance companies have the right to investigate the legitimacy of your claim, they do not have the right to reject valid claims, misrepresent policy terms, or unjustly delay the processing. Insurance companies are prohibited by law from committing unfair or deceptive practices, also known as acts in bad faith.
During the investigation phase, you are responsible for cooperating fully with the insurance company. Many property owners do not need to hire an attorney at this early stage of the claims process. Unless the claim is large, complex, commercial, or your damages are substantial, you would typically only retain an attorney when there is a dispute. It is best to contact an attorney when you feel your claim was unfairly delayed, denied, or you are receiving a low payment.
Key Things to Consider in the Claims Process
1. Notify the Insurance Company Immediately
It is extremely important to contact the insurance company as soon as possible for multiple reasons. First, the insurance provider could have a time limit on accepting claims after a damage occurs (24-48 hours is not uncommon). Secondly, once you’ve notified the insurance company, it triggers deadlines that your carrier must follow to stay compliant with the law. They must acknowledge your claim and begin the investigation process.
2. Document, Document, Document
Although the storm was hard enough to go through and adding any added burden could be a struggle at this time, we cannot stress this point enough. Documenting everything that happens with your claim is extremely crucial. Having excellent or incomplete records can absolutely make or break your claim. We’ll list some key areas that will help build your case:
Fully inspect all areas of your property including commonly hidden areas (such as the attic or crawl spaces) for damage or moisture. See our list of common hidden storm damages.
Take photos and video of your damages, even if minimal.
Begin a journal or log of everything that happens, including dates and times, contacts you speak to, summaries of what happened or what was said, etc.
Start a file and keep any printed correspondence (such as letters, emails, or reports from the insurance company, repair/service quotes, etc.) as well as any purchase receipts for repairs all together in that same file.
If any of the contents of your home were damaged, make an inventory list of those items and include any purchase receipts you have saved for them (such as computers, TVs, appliances, furniture, etc.)
Get quotes on repairs from trusted contractors and service professionals which can be used to calculate your claim
Gather together invoices, purchase orders, policies, and other key documents that will be included in your claim
Send a follow up email with a brief summary of any verbal communication you had in-person or by phone
3. Cooperate with your Insurance
Once you’ve notified the insurance company of your claim, it is your responsibility to continue to cooperate with them by providing any necessary and reasonable documentation they request as they investigate your claim. Be present and make your property available for the adjuster that will be inspecting the damages. Provide the adjuster with information they need to perform their inspection, and make sure to point out any and all areas that sustained damages. Have the adjuster inspect all damages, even in tight areas like attics or crawl spaces. Be polite and courteous with the adjuster and do your best to answer questions, return phone calls, and send all documentation and pictures of damages to your property. Again, it is always best to send a polite summary email to the adjuster and to log your in-person communication as a brief record of what happened on the visit.
4. Your Rights in the Processing of your Claim
Insurance companies must follow the law and insurance codes to acknowledge, investigate, and process your claim. Deadlines are usually within 15 calendar days to acknowledge your claim and request documentation from you. Generally, they must approve or deny your claim, in writing, 15 calendar days after they receive your requested documentation. Once approved, the insurance company should process a payment to you within 5 days.
Important Note: When the Department of Insurance declares a freeze as a weather-related catastrophe or natural disaster, they offer deadline extensions of up to 45 days for the insurance providers to approve or deny your claim, and an additional 15 days to make payment to you – provided they notify you and give reason for the extension. This could mean longer wait times for an adjuster, claim acceptance, claim denial, or payment.
If an insurance company does not comply with the law, they can be held liable for statutory interest penalties.
What if your Claim is Delayed, Denied, or Underpaid?
Often many property owners find they have little trouble filing an insurance claim for their damages. Other times - usually when the stakes are much higher and the damages are more extensive - there is a greater chance for dispute. If you disagree with the amount of money the insurance is offering you, or you were denied coverage, you have a few options available.
You can provide a bid or quote for your repair from a reputable contractor or service company, and ask for the insurance company to reevaluate your claim. Sometimes an insurer will adjust the amount of your claim with valid quotes for the repair of your damages.
Another option is to hire a public claims adjuster. Public adjusters can be very valuable to help assess the full extent of your damages and negotiate for a higher settlement with your insurance company, but it is fair to note that they have no position of authority or legal power over the insurance company. Therefore, insurance companies have no legal obligation to accept a public adjuster’s report, and oftentimes disputes can still arise.
You could also contact an insurance claims attorney to review your case. An attorney can examine your policy, documentation, and insurance estimate to evaluate your options. They can send a letter to the insurance company to represent you on your claim, as well as generate a demand letter for the maximum settlement. They collect all important evidence, calculate accuracy in your damages, and will negotiate on your behalf.
Most attorneys, like you’ll find at Galindo Law, and public adjusters work on a contingency-basis, which means there are no upfront, out-of-pocket costs and any fees that are generated would be paid out of a settlement that is won for you (which would NOT include any original payment that was sent by your insurance company.) No win, no fees. This gives property owners a chance to understand their rights, and to pursue legal options to get a fair settlement on their claim without upfront or premium hourly attorney rates.
You might consider an insurance claims attorney when:
You have questions regarding your policy coverages
The insurance adjuster’s estimate is lower than expected
Damages are extensive and claims are more complex
Claims are delayed or denied
Call us for a free consultation at 832-225-4963. We're here to help.
You might also like to read Why Hire an Attorney vs. a Public Adjuster?