Insurance Claim Denied
The process to secure an insurance settlement can be both frustrating and exhausting… especially when your homeowner believes they have a legitimate claim that has only been paid partially or denied completely. [NOT LEGAL ADVICE!]
While their first instinct may be to hire an attorney, or fire off an angry letter to their state insurance commissioner or attorney general, there is a conflict resolution tool built into most homeowner’s policies to help mediate these uncomfortable situations.
While I’m not an attorney, my advice is for the insured to exhaust all policy provisions before filing a formal complaint with their insurance commissioner… namely, arbitration.
In order to exercise any available arbitration rights, your client will need to consult a copy of their homeowner’s insurance policy. The steps detailing the arbitration process, including how to get started, are spelled out in their policy.
While they may choose to hire an attorney to guide them through this process, the process is usually laid out step-by-step in laymen terms.
While each policy is different, the insured may be required to file a written request for arbitration and send it by certified mail to a specific address. They may also be able to complete the process by phone. If they have a good, local insurance agent, their agent may be able to help them through this process too.
Once your client’s insurance company acknowledges the arbitration request, they’ll select a representative and the insured will select a representative (often, it will be their roofing contractor). Here’s what happens next…
Together, these two representatives will mutually agree on an impartial umpire that will settle the dispute. The cost of the umpire’s service will usually be split among the parties. Both representatives will make their case to the umpire with the umpire’s decision being binding.
So, if your homeowner has exhausted their 1st and 2nd roof inspections, and they still believe they have a legitimate claim, their next step is to find their insurance policy and start the arbitration process.
In my experience, most claims are settled within the first two roof inspections or after a follow-up call to the desk adjuster. I have found in the overwhelming majority of cases that cooler heads prevail.
We’ve had three cases this week where the homeowner was not happy with the outcome of their final inspections. That is an unusually high number, but after coaching two of our guys through the process in the last 48 hours, I thought it may be helpful to share the process with you too.
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