Communication with your insurance company is an incredibly important part of the claims process. the insurance company may try to handle your claim over the phone, without records. Regardless of how your claim is handled, you need to make sure everything is documented in writing.
How you communicate makes a big difference in how much benefits you get and how quickly you get them.
We recommend that you:
- Document each communication with your insurance company in a notebook or journal so you can track the status of your claim.
- create a paper trail. Confirm representations and promises made in person or over the phone by insurance company personnel by sending them a brief follow-up email or letter.
- use good grammar, punctuation, and capitalization. respond promptly to letters and requests if they are unreasonable. if they are, say so in writing.
- Be proactive: Provide your insurer with proof of your losses and request the dollar amounts to which you are entitled. don’t wait for them to tell you how much they owe you.
- Use specific instances of misconduct by your adjuster or insurer as leverage to negotiate the settlement you need. your diary will come in handy.
- Don’t mistake a friendly claims adjuster for a friend. remember that you are in a commercial negotiation. keep it professional.
- Don’t use your insurance company as an outlet to vent frustrations and emotions related to the root cause of your loss.
- Remember that everything you write and say may be recorded in the insurance company’s records. Even if you feel frustrated, avoid saying or writing things that make you seem uncooperative or cause delays or problems.
- Do not sign a confidentiality or nondisclosure agreement without consulting an attorney. accepting a confidentiality agreement that is too broad or premature can significantly reduce your influence and your ability to obtain the full benefits of the policy.
- attitude is everything: be courteous, be prompt, be persistent
- unit manager, over multiple supervisors by line of business
- assistant manager, on unit managers, but not in all offices
- claims manager or vice president of claims, in charge of the local office
- regional vice president of claims, in charge of several offices in a region
- Head Office Statements: At Head Office, there are several levels:
- Field Management: Senior Vice President in charge of regional managers
- technical management: vice presidents in charge of lines of business, such as automobiles, general liability, property
- major claims such as asbestos, lead paint, claims with prolonged exposures, large and complex claims. (large being over $750,000.00)
resolve disputes, delays and complaints with your insurance company
When contacting your insurance company, start with the adjuster and work your way up as needed. what motivates an insurer to resolve a problem is a focused complaint that makes people above the adjuster pay attention. The higher up you are in the insurance company’s claims department, the better your chances of success in settling your claims.
When you raise a concern about how your claim is being handled or how much you are still owed, documentation is everything. If you write to an adjuster, send a copy to your supervisor and ask for a written response within a certain time (for example, “respond within 10 business days from the date of this letter”). When you send a letter requesting a response by a certain date, be sure to send it by certified mail so that you have a record of the date you sent it. follow up with a phone call to confirm receipt of your letter. if there is a problem with the coverage or the procedure, ask your insurer to point you to the specific part of the policy that explains it.
Your letters should not be threatening or long. They should be clear, polite and to the point. you must confirm how cooperative you have been and continue to be. be the good guy and put the ball in his court. if it’s unpleasant, your next contact may be an attorney for the insurer, which may prevent you from continuing to work with the adjuster.
If you’re feeling stuck or have run out of “self-help” options, it’s probably time to hire professional help. start in the help search section of our website. If you don’t want to hire professional help, you can file a complaint with your state insurance regulator.
Insureds United offers specific advice on how to get help from the government to resolve an insurance problem. start by reading the claim/coverage dispute resolution help. Some people fear that filing a complaint with a government agency will anger their insurance company and make the situation worse. in our more than 30 years of experience, it is just the opposite. insurance companies stand up and take notice when a customer complains to a state official, and they usually act quickly to try to resolve the issue. however, if there is a coverage dispute or a large sum of money involved, it is unlikely that a state agency will have the staff or authority to resolve it. In those situations, an experienced attorney or public adjuster is the most likely path to a successful settlement.
Portions of this publication were written by Mike Cerf and are reprinted with the permission of his widow, Judy Cerf. Contributions were also made by Stacy Lascala, Esq., and senior staff, including Karen Reimus, Amy Bach, Alice Wolfson, and Lucien Sonder. The information presented in this publication is for general informational purposes and should not be taken as legal advice. If you have a specific legal issue or problem, Policyholders United recommends that you consult with an attorney. you can find guidance on how to hire professional help in the “find help” section.
how a typical insurance company is organized
See also: Frequently Asked Questions
It is very helpful to understand how insurance companies are normally organized. Every person you deal with at an insurance company has an upper dollar limit of authority to settle their claim. As you move up the chain of command, that limit increases: adjusters typically have the lowest settlement offer authority limit; home office executives have the highest. claims departments are usually structured as follows: