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Policyholder Question: Insurance Claim Repair Delays

Policyholder Question: Insurance Claim Repair Delays

Q. How can we make sure our insurance company is moving ahead with our repairs, etc?  Right now, everything seems to be on hold until they can get a joint inspection with our contractor's insurance company. Our house has been sitting for over a week with no heat, no electricity, etc., while we wait for this joint subrogation inspection.

A.Great question. I’ll assume your contractor may have been at fault in causing this loss. It is not unusual in this type of situation to try and get all parties to first agree on the scope and price of the loss as it may help to alleviate problems and delays later on.

But as you are probably aware, you have a duty to mitigate your loss (keep it from getting worse) regardless of you or the contractor’s insurance company’s investigation.  One thing to understand is that insurance companies are required to post reserves, which is what they expect to pay out on a claim within 30 days of the loss.  So the first 30 days is usually the investigation and coverage determination period that is standard in the industry.  That however should not mean you are left on your own in a catch 22 situation. You need to be proactive and ask your insurance carrier what help they can offer you. You also should understand what their standard practices and procedures of claim handling are given the conditions of your loss. They should not withhold help and they should advise you particularly on emergency services to help you mitigate your loss. This is in the best interest of everyone to mitigate further damage.

Be firm and professional and demand action from the field adjuster from your insurance company. Remember your insurance company owes you a higher duty of service and care under a first party contract (your insurance policy) than a liability insurance carrier owes you as the insurer of the contractor.

If you don’t get satisfactory answers from your insurance company field adjuster, I would suggest you contact a reputable restoration company and ask them for an estimate with a detailed protocol to make the necessary and immediate repairs. Give it to the adjuster with a letter memorializing any conversations, questions, thoughts, or concerns you may have with the adjustment process.

If still not satisfied, send a certified letter to the president of your insurance company and copy the vice president for property claims operations. I just about guarantee you will get some action. As the old saying goes, it all roles down the hill! You may also want to mention that you are going to retain a public adjuster if nothing is done within three days of receipt of your letter.  Talk about pants on fire! Just the thought of a professional public adjuster involved on your behalf will get your carrier moving. If not, hire an experienced public adjuster. This is part of what public adjusters do for policyholders. He or she will get this moving in the right direction. Good luck.

If you have questions regarding any property insurance claim related issues please call 800.321.4488 or contact us to submit a question to one of our public adjuster or insurance claim experts.

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