Denied Insurance Claims Advice and Examination Under Oath
Post Denied Insurance Claims Advice and Examination Under Oath Question (below)
Or, for in depth advice and techniques on how savvy public adjusters get various types of denied insurance claims covered, consider one of several eBooks from UClaim.com . View the UClaim eBooks entitled “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP – DELUXE VERSION (W/APPENDIX)“ description and table of contents and
“DENIED CAR AUTO TRUCK BOAT INSURANCE CLAIM ADVICE AND HELP DELUXE VERSION (W/APPENDIX) description and table of contents.
There are also eBooks devoted to the topic of Examination Under Oath, which often accompany denied claims. They are in terms that both the professional and average person can understand. View the UClaim.com eBook entitled “EXAMINATION UNDER OATH (EUO) INSURANCE CLAIM ADVICE AND HELP – DELUXE VERSION (WITH EXTENSIVE LEGAL RESEARCH“ description and table of contents. There is currently a free 2nd eBook offer at UClaim.com.
If your claim involved arson or theft, you may not get a denial letter until months after the loss. Just because they advanced you some money and may be paying for additional living expenses or business extra expenses does not mean your claim is covered. If your claim is later denied, a low quality insurer will ask you to return the money it advanced. In the meantime, all you can do is proceed as if your claim will be covered.
Reopen Old and Denied Insurance Claims
1. A signed “Proof of Loss” form is not a “Release”. If an adjuster says you cannot reopen your denied insurance claim because you signed a Proof of Loss, he is wrong. Some adjusters will try to make you believe that because you listed dollar amounts and signed the form, that you cannot make a supplemental claim. They hope you don’t call back. A Proof of Loss is not a Release form (Insurers have separate forms for that called a “Policy Holders Release and Settlement of all Claims”). The unwritten words on the Proof of Loss form are “to the best of your current knowledge” when filling out the form. The policy requires you to submit a “Proof of Loss”. The policy does not require you to sign a “Release”. If you sign a release, it is strictly voluntary and you should use it to your advantage. You can find a detailed discussion on how to use a “Policyholders Release” in a UClaim eBook on denied insurance claims advice above) .
Note, some low quality insurers will insert a “Release” clause into a Proof of Loss form and only give one place to sign at the bottom of the paper. I have seen this in both automobile and homeowners/business owners claims. Some companies even boldly put the word “Release” in the title of the form. Other companies will bury the release in the text body of the form. This practice is deceptive, misleading and most of all coercive. If the insurer insists that you signed a release and refuses to reopen your claim, now you have good evidence in a bad faith lawsuit.
2. Your claim is not necessarily dead if you have not filed a lawsuit. If an insurer quotes policy language saying you only have one or two years to file a lawsuit against them, they are misleading you. Most states statutory and case laws override the policy and give 3 or 4 years or more to file a lawsuit for property damage, breach of contract and bad faith. If you go into small claims court, you will need to know these laws, because some judges will attempt to throw your case out implying your policy is a “stand alone” contract and not subject to the law. In California, for example, there is a case called Prudential LMI … that extends the statute to file a lawsuit by 3 or 4 years from the date of the claim denial, not the actual date of loss (the theory being that there is no loss until and unless the claim is denied). You can check with your local plaintiff’s attorney (the auto accident lawyers) or a local government small claims court advisor for a quick answer, often without a charge. Telephone the small claims court clerk (where you file small claims lawsuits) and ask “how much time do I have to file a lawsuit for damage to my property?” While most clerks will say “we can’t give legal advice”, they will tell you some of the basics and help you fill out the application form for a small claims lawsuit.
An adjuster may say to you “your file was closed long ago and it can’t be reopened.” So why would an insurer reopen a claim at all? Well, the motivation for them is that as long as there is a window for you to file a lawsuit, they must consider your claim, even if you previously gave up the fight.