If you are a homeowner who finds yourself in need of filing a claim, you may wonder what happens after you initiate the claims process. This particularly is the case if you need to pursue a claim for a more complicated situation like damage from major storm damage or remediating some type of biohazardous situation in your residence. This article is designed to assist you in better understanding what happens when you file a claim on your homeowners insurance policy.
Routine Homeowners Insurance Claim
If you are pursuing a basic homeowners insurance claim, like one for a broken window, the claim settlement process is relatively straightforward. You will need to obtain an estimate for addressing the damages, which you submit to the insurance company. An insurance adjuster may call you on the phone to confirm the elements of the claim.
If approved (and if it is something like a broken window that is covered by the policy, approval should happen), a check will be mailed to you or to the entity doing repairs (depending on the situation and the specifics of the claim).
More Complicated Homeowners Insurance Claim
If the claim is more complicated, the process for pursuing a claim itself becomes more detailed and even challenging. Examples of complicated claims include:
- Hail damage
- Wind damage
- Certain types of water damage (weather-related flooding is not likely covered by a homeowners insurance policy)
- Biohazard remediation (if covered by a homeowners insurance policy)
With a more complicated claim, an insurance adjuster will come to your residence and examine the scene. The adjuster will evaluate the nature and extent of the damages. The adjuster will take videos and photos.
You will also need to obtain appraisals or estimates of the costs to address the situation at your home. For example, if you need biohazard cleanup assistance, you will need to obtain an estimate from a reputable biohazard remediation service.
An Essential Three Step Process
At the heart of any homeowners insurance claim, an adjuster essentially undertakes a three step process. First, an adjuster ascertains if the claim you make is covered by the policy. The claim can be rejected based on a contention that it is not covered by the policy. If that occurs, you have the opportunity to appeal the rejection within a timeframe established in the insurance policy itself.
Second, an adjuster makes an assessment of the claim, in part to ensure that you’ve accurately reported a loss. With a routine matter, like a broken window, a photo from you with your claim is certain to be enough documentation. In a more complicated matter, an adjuster comes to your home and inspects the scene. An adjuster can conclude that some or all of the damages or losses you claim are not supported by evidence collected at the scene. This can result in a denial of some or all of your claim. Once again, you have the ability to appeal this decision as well.
Finally, an adjuster assigns a dollar value to your claim. This is a determination of how much your homeowners insurance company will pay for your claimed loss or losses. Yet again, if you do not concur with the determination made by the insurer, you have the ability to appeal that decision.
Contact the Insurance Commissioner or Insurance Department
If you find yourself having what you perceive as a significant issue with your claim, you can contact your state’s insurance commissioner or insurance department. All state insurance agencies maintain a consumer assistance division or office to assist people like you who encounter situations with insurance companies.
You can obtain contact and other information about your state’s insurance commissioner or insurance department from the National Association of Insurance Commissioners, through this link or at:
1100 Walnut Street
Kansas City, Missouri 64106-2197
The Business of an Insurance Company is Business
You must always bear in mind that the primary objective of a homeowners insurance company, or any insurance company, is to make money for stockholders. As a result, an insurance company has a sharp focus on doing anything possible to increase the financial bottom line.
One way in which an insurance company increases revenue (and profit) is to lessen the amount of money paid out each year in claim settlements. Therefore, you need to be aware that your homeowners insurance company is very apt to employ tactics of all types that are designed to limit the amount of money paid out to you in your claim.