Insurance Claims

Orlando, Florida Insurance Attorneys

Orlando Insurance Claim AttorneyHomeowner’s insurance covers loss, damage, or injuries which occur at a private residence. When a homeowner’s insurance policy holder pays an insurance premium, the transaction is made with the understanding that the insurance company will financially assist the home owner if events occur that fit the policy terms. This reassurance or transfer of risk is what policy holders purchase when paying homeowner’s insurance premiums.

Homeowner’s Insurance Claims

The process for filing an insurance claim may vary depending on the specific scenario. If there is any danger, the home owner should first focus on preventing damage or injury. This may involve leaving the home, securing damaged areas, or seeking medical attention. Once safety is restored, the home owner should contact the insurance company in order to file a claim.

Claims Process

While insurance claims processing may vary slightly between companies, home owners can generally file claims online, over the phone, or in writing. The insurance company will need basic information about the homeowner, the type of claim, and the nature of the incident that caused the damage, loss, or injury. Once this information is gathered, the insurance company must assess the value of the loss.

Loss Assessment

Home owners may be asked to give a listing and estimated valuation of the loss. Depending on the nature of the claim, an insurance adjuster may be sent to the residence to make an assessment and provide an estimate for the loss or damage. Home owners may benefit from having a contractor evaluate and assess the damage or loss, so that there is a point of comparison for the insurance adjuster’s assessment.

Claim Acceptance

If the homeowner’s insurance claim is accepted, the amount to be paid will be determined and a check will be sent to either the policy holder or a specified individual or entity. If there is a mortgage on the home, the mortgage company may opt to be named on the check in order to oversee and ensure repairs or rebuilding. If a home owner must live elsewhere during the reparation process, an additional amount may be paid by the homeowner’s insurance company for living expenses. The home owner may contest the amount paid for the claim if it is deemed to be unreasonable.

Claim Denial

If an insurance claim is denied, the homeowner’s insurance company will typically provide a written explanation for the denial. Most insurance claim denials are the result of a lack of coverage for the specified service, disaster, or other reason for the claim. However, simple errors may also cause a claim to be denied, in some cases. If the policy holder believes that the claim should have been covered, it is possible to file an appeal. Most appeals do not successfully change the insurance company’s decision to deny the claim, however, so it may be helpful to hire an attorney for assistance.

Payment of Insurance Claims

When an insurance claim is filed, the insurance company takes money that has been paid for multiple customers’ premiums and uses that money to pay the policy holder for the amount of the claim. This process is called pooling. This process can be risky, however. In the case of a disaster where many policy holders file insurance claims at one time, the insurance company may have a difficult time covering all claims. If the loss is too great, this may bankrupt the homeowner’s insurance company.

Fraudulent Insurance Claims

In some cases, policy holders may submit an insurance claim that is fraudulent or may intentionally destroy property in order to cash in on a homeowner’s insurance policy. This practice is illegal and may result in criminal charges and penalties. An individual may also have a difficult time purchasing insurance after engaging in insurance fraud.

Impact of insurance Fraud

Filing fraudulent insurance claims can not only be detrimental to the individual that gets caught, it can be detrimental to all future policy holders. Insurance fraud costs homeowner’s insurance companies money, which is often compensated by raising insurance premiums. High payouts may also be compensated by separating insurance coverage or by lowering the amount that is provided for legitimate homeowner’s insurance claims.

Sources:

“Homeowners Insurance Claim Settlement Process.” Homeowners Insurance Settlement Process. Rocky Mountain Insurance Information Association, 1 Jan. 2014. Web. 2 June 2014. <http://www.rmiia.org/homeowners/Walking_Through_Your_Policy/Settlement_Process.asp>

“Office of Insurance Regulation.” Office of Insurance Regulation. Florida Office of Insurance Regulation, n.d. Web. 31 May 2014. <http://www.floir.com/>