Identifying and Overcoming Fire Insurance Claims Obstacles

There are several common obstacles in the claims process that can be frustrating. Here's what you can do to overcome them:

What to do when:

Your policy was destroyed in the fire. If your policy was destroyed in a fire, contact your insurance company, broker or agent immediately to obtain a copy. Your policy is a contract between you and your insurance company, so it's important to have the policy to know what's covered, what isn't and any conditions that must be met before payments are received.

Your insurance company doesn't respond. Insurance companies must respond to your claim. As a policyholder, your insurance company has a duty to act in good faith in handling your claim. If they do not respond, consider these options:

  • Put your request in writing and send it to the claims adjuster. If the claims adjuster does not respond, send the same letter with a cover note to the president of the insurance company with a copy to the adjuster.
  • Contact your state's insurance department or insurance commissioner directly.
  • If the above measures do not get an adequate response, contact an attorney. An attorney whose practice focuses on insurance bad faith knows how insurance companies work and may be able to obtain results on your behalf.

Your insurance company denies your claim. If your insurance company denies your valid claim, it's important to dispute that claim – in writing. Keep in contact with your claims representative to let him or her know that you disagree with the findings and are not going away until the matter is resolved. If your insurance company still refuses to pay your claim, it is time to consider retaining an attorney to represent your interests.

Your claims representative isn't doing his or her job. If your claims representative isn't doing his or her job, don't wait to address the problem. Although claims representatives are often responsible for hundreds of claim files at any given time, that doesn't mean that your claim should not be processed within a reasonable amount of time.

The old adage, 'the squeaky wheel gets the grease' certainly applies in this case. Adjusters are more likely to respond to policyholders that they know will follow up on their claim than those who do not. Be polite, but firm and don't hesitate to ask to speak with the claim representative's supervisor if you just can't get anywhere.

Your insurance company's damage estimates are too low. You do NOT have to accept the estimates that your insurance company provides you. Find out what it will cost to rebuild or repair your home and provide your insurance company with documentation showing those costs. Again, if resolution does not seem possible, you should consider retaining an attorney.

You can't get a contractor to repair or rebuild your home. Finding a contractor to work on your home can be a challenge even in the simplest of situations. It's even more difficult when thousands of claims are made in the same area – such as the fires in Southern California. Insurance companies often bring in contractors from other areas to assist in the rebuilding backlog. However, you may still find yourself on a waiting list. If this happens, it's important to communicate with your claims representative and stay on top of the process. Again, the squeaky wheel gets the grease…

You don't agree with the estimates provided in repairing or rebuilding your home. If you can't agree with your insurance company about what your home is worth, check your policy to see how their appraisal procedure works and what it consists of. Most homeowners assume that an appraiser will come to your home, but that's not always the case. Find out how the process works.

If you're not satisfied with the answers to these questions, tell your insurance company – in writing – and request additional investigation. You may be able to pay for your own appraisal and/or request a second appraisal from your insurer and have an average cost calculated. Consulting with an attorney at this point is highly recommended.

You are requested to attend an examination under oath. If your insurance company requests that you attend an examination under oath, we suggest you retain an attorney to represent you in this process. This testimony is taken under oath and recorded by a court reporter and therefore, it is important to understand the procedures.

Fire Insurance Claim Manual for Homeowners

  1. Fire Insurance Claims Manual Forward
  2. The Basics of Homeowners' and Fire Insurance
  3. How Fire Insurance Policies Work
  4. The Fire Insurance Claims Process: A Step by Step Review
  5. Identifying and Overcoming Fire Insurance Claims Obstacles
  6. Tips to Make the Fire Insurance Claims Process Work Smoothly
  7. Fire Insurance Lawyer - How to Hire