The Expert Podcast

Anytime there's a major disaster and insurance claims become in the news, we always like to put the message out there to consumers about how to get your insurance claims paid. How do you make sure that if you're filing a claim for damages on your insurance, it goes through and gets approved? After all, you paid good money for your insurance, you’ve paid your policies, and you want to get your claim paid. Well, there are a couple of things to keep in mind to make sure your claim doesn’t get rejected or flagged.

First, start by reading your policy before you file a claim. Take out your policy. It’s not the most exciting reading in the world; it's very boring boilerplate language, but go to the section that has to do with the type of claim you're filing. Whether it's an auto claim, a windstorm claim, or a flood claim, you need to check what’s covered. For example, Hurricane Ian damaged tens of thousands of homes and vehicles, leading to various claims. Some of these claims will get rejected simply because the insurer didn’t read the policy and file the claim properly. It’s not that the claimants don’t deserve the money, but the claim has to be filed correctly to ensure approval. You deserve to have your claim paid, so start by making sure you file it properly and in the right category.

Don’t file a claim for something that’s an exclusion if that same thing is covered under a different area of your policy. We’ve seen many claims filed incorrectly, which results in denials, but if they had been filed correctly, they would have been approved 100 percent. Sometimes, there are different deductibles on different types of claims. If you file it under the right category, your deductible might even be lower. Remember, don't lie or change the facts. You’re just applying them to the right category to meet the standards of your policy. Avoid insurance fraud, because not only will your claim get denied, but you could get into serious trouble.

Make sure to document everything before you file your claim. Document the condition and damage, take pictures, get estimates—do everything you can to support the facts you’re representing. When you file your claim, you will have to sign a document under penalty of perjury, and your call will likely be recorded. So, ensure you have notes in front of you and are reading facts carefully, so you don't lose track of the details. For instance, if you file a claim saying you had 200 CDs in your collection and later report having 250, it might be an innocent mistake, but if the facts don’t match up, they might deny the whole claim because they think you're lying. Stick to the facts, keep your statements consistent, and take your time with documentation. If it takes you an extra day to file, it’s not the end of the world, and it won’t make a huge difference in your payout. Claim adjustments take time anyway.

If you're filing a homeowner's claim, be aware that the insurer will likely perform a title search on your house. The reason for this is to make sure you're still the owner and, if you have a mortgage, to include the mortgage company in the claim. This is beneficial because it ensures your mortgage is paid off. It also helps identify any extra liens on your property. Make sure your property records are in order when you file your claim so that all representations are factual and consistent from one statement to another. Many times, the Special Investigations Unit (SIU) of insurance claims will ask the same questions at different times or require you to refile a claim or fill out additional documents. They want to see if the facts are the same across all submissions.

With so many claims coming in due to catastrophic losses, insurers are going to be looking for exclusions, exemptions, and potential fraud, not because they’re trying to rip you off, but to ensure they’re not overpaying on claims. So, document everything and ensure that all of your facts are supported. Whatever opinion you may have about insurance companies, for now, focus on ensuring that your financial situation has the best possible result within the law and the contract terms of your policy. This way, you won’t lose out on money you're entitled to, and you won’t give the insurance company an excuse to deny coverage for something that should be covered.

Good insurance adjusting by an honorable insurance company is something they aim to do. They want to help their policyholders, but they also don’t want to overpay. Document everything, file your claim the right way, be consistent, and start by reading your policy to ensure that your submission matches the terms and conditions.