Common Insurance Claims Questions – FAQ
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Common insurance claim questions below are answered by contributor Ron Cercone of UClaim.com, a do-it-yourself insurance claim eBook website. Ron is a semi retired licensed public adjuster representing policy holders (not insurers).
At UClaim.com you will find 28 eBooks for your particular claim issue. View the most popular UClaim eBook entitled “HOMEOWNERS INSURANCE CLAIMS ADVICE AND HELP – ALL ASPECTS – HOW TO PLAY THE GAME – DELUXE VERSION (W/APPENDIX)“ table of contents and description. There is currently also a free 2nd eBook offer at UClaim.com. And, you also get personal consultation and confidence building time with author Ron Cercone (a $150.00/hour value).
1. Which Insurance Company – “Do I turn in my claim to my own insurance, or the other driver’s insurance company?”
Both. See who offers the better settlement. Let them both send out their vehicle damage appraisers. Don’t worry, you won’t get paid twice. They will both check to see if the other has already made payment. If a payment was already made by one adjuster and the other adjuster was going to pay more, then the second adjuster will only pay the difference. It will all get ironed out in the end. If your company pays you first and it turns out the other driver was at fault, your company will collect back from the other drivers insurer and get the appropriate portion of your deductible back for you also.
If you think that you should not make a claim to your own insurer (if the other driver is at fault) in order to avoid a premium increase, you are wrong. You should not be charged any premium increase if you are not at fault (at least in California). But double check this with your sales agent. If you don’t report it to your own insurer, they will find out anyway since most insurers report all claims to a couple of national data banks in Georgia and New Jersey.
Although you should turn it in to both insurers, you have more legal rights and opportunity for a better settlement against the other drivers insurance company. The other driver’s insurer cannot force you into a “Policy Appraisal” if there is a dispute over your vehicle’s value. The other driver’s insurer cannot limit your rental car expense to some predetermined policy limit such as $10.00/day. While the other driver’s insurer may treat you with less respect, they are still subject to Unfair Claims Practices Settlement Regulations. Also, while you may have more legal rights to sue your own insurer for “Bad Faith” and breach of contract, the odds are thousands to one that you will end up in a higher court for a “damage to your vehicle” claim.
2. Cashing the Check – If I cash the insurance check is my claim closed?
No, not if the check is from your own insurance company. If the check is from another party’s insurer (as in an auto accident where your claim is against the other driver’s insurer), it may have a release on the back of the check, or you may have signed a separate release paper.
In California it is against the law for your own insurer to put a release on the back of your check, but some will do it anyway. Other insurers are trickier, and will put a release on the front of the check. While that is legal, they hope that you will think it means it is a release, and therefore will not pursue the claim any further. A release may be on the back of a third party claim check (or uninsured motorist claim check from your own insurer), but should specify the portion of the claim, for example, automobile damage versus injury, etc.
Note – most people think it puts “pressure” on their own insurer to settle the claim fairly if they don’t cash the check. This is not true. The insurer could care less if you cash the check or not. In fact, it allows them to draw interest on checks not cashed. They owe the “undisputed amount” whether or not you, the insured, agree with the insurer’s valuation. And the claim must remain open for the “disputed amount” to be settled.
3. Supplemental Claim – How much time do I have to pursue my claim?
You can pursue your claim for as long as you have the right to file a lawsuit. This is called ‘Statute of Limitations’ in legal terminology. (Learn more insurance related legal terms ). After that period expires, the insurer can tell you to go fly a kite.
In California, you have three years to sue your insurer for property claims and four years for a ‘breach of contract’ cause of action (your insurance policy is a written contract). You have two years on bodily injury claims in California.
Although most property policies say you only have one year to file a lawsuit, the policy is overridden by local, state and federal law. Insurance adjusters will usually advise you in a letter that accompanies their ‘final’ payment that if you don’t like the settlement, you have one year to bring a lawsuit. Legally, they are wrong. The average property adjuster is kept ignorant of much insurance law that benefits the policyholder and overrides the insurance policy.
If it has been a year or two since your claim was supposedly ‘closed’, just fax a letter to the adjuster or claims department saying you want the claim ‘reopened.’ Allow them a couple of weeks to retrieve their file or to assign it to a new adjuster.
So, when does the three year clock start ticking? In California, it is from the time they either:
- deny further payment
- deny the whole claim in writing
- issue the ‘final’ check
- ‘when negotiations end’ or they cease to respond to your communications.
Most policies will say you have one year from the date of the loss. But this is over ridden by the law. Fortunately, most insurers allow their adjusters to know this law and you will have no problem getting your claim reopened.
4. ‘Proof of Loss’ form – I signed a Proof of Loss, can I still pursue my claim?
A Proof of Loss is required by your policy. However, it is NOT a release.
Adjusters will attempt to make you believe that it is. They will say, ‘You can’t reopen your claim because you signed a Proof of Loss.’ The main purpose of a Proof of Loss form is to give the insurer an opportunity to void your policy and thereby deny your claim if you intentionally lie or give false information on the form.
As far as our contributors are concerned, it’s a worthless piece of paper. You can supply the information required on the Proof of Loss on a roll of toilet paper if you want to show your adjuster that you are not intimidated.
In his fee based eBooks at UClaim.com, Ron Cercone offers simple instructions on how to safely deal with a Proof of Loss form if the insurer presents one to you, whether it be for property contents or structure or automobile.
5. Release – I signed a release, can I still pursue my claim?
Your insurance policy does not require you sign a release.
We have never seen a homeowners, business or auto policy which required a release. However, at least one major insurer – CSAA (AAA of Northern California) – has used trickery to make their policyholders with a total loss auto claim believe they signed one. They put a release form on the same piece of paper as a Proof of Loss form that had only one signature for the entire page. That form was entitled ‘Proof of Loss/Receipt and Release ‘ (see You Are The Enemy number 3, page 2, on the Considerations page at Uclaim.com for an example).
From contributor Ron Cercone:
I had the experience of standing in line with a client at a AAA office in Visalia, California for the purpose of signing one of these forms. It was much like a line in a bank where you approach the teller behind a wall to get your money. You stand up at the ‘tellers wall’ as people stand in line behind you, impatient, waiting to do the same thing. When my client asked if he could take this Proof/Release form home, for an attorney to review before signing, he was told that no one was allowed to take these forms from the building before signing. My presence as a public adjuster (and witness) made no difference. Amazing! When my client asked if he could go sit down and read it over before signing, the clerk said he could, but that he would have to go to the end of the line and wait his turn to get back to her window. Amazing! Well, my client, being in a hurry, decided to just read the document at the window. He spent about two minutes as the clerk, a large intimidating lady, stood across from him, her face not 20 inches from his, and looked straight at him the entire time. Add to this a line of disgruntled people behind us.
Consumers can be faced with things like this, even from respected names like AAA. You may want to check out our list of consumer-friendly recommended insurers .
Note – You may legitimately sign a release under the following circumstances:
- You can volunteer to sign a release with your own insurer. You can do this with a heavily contested claim to assure the insurer that you will not surprise them with any more supplemental claims. This will sometimes get them to pay more than they would otherwise. You can also use it as a tool where the insurer does not think the claim is covered by the policy, but they may pay the claim as a ‘compromise settlement’ or for other reasons, such as to avoid litigation. But this is rare in property claims.
- If your claim settlement is with some one else’s insurer (called a ‘third party’ claim), you may be required to sign a release, whether it is for bodily injury or property damage to your automobile.
6. Acting as Your Own Contractor – I’m going to ‘sub out’ or do my own repairs. Any pitfalls here?
You better believe it, and don’t expect the insurance company adjuster to tell you. You could lose 20-40% of the value of your claim by doing your own repairs. You may think you’re saving money, but you will get stung in the end.
Ron Cercone offers advanced tips on this topic in his fee based eBooks at UClaim.com. The information is included with structure, contents and business personal property claim eBooks.