Personal Finance Tips » Department Of Insurance

Insurance Claims – Notify the Insurance Company!

admin — Sat, 02 Oct 2010 10:32:06 +0000

Seems sort of obvious, doesn’t it? But, there are different ways to notify the company that you’ve had a loss. And when you notify the insurance company can make a big difference in how your claim is handled.

The first place to look for information is on your policy. Many policies will have a telephone number listed for reporting a claim. However, I’ve seen policies that require the policyholder to notify the company in writing. So, make sure that the method of reporting your claim is acceptable to the insurance company. Likely, your agent has his name and telephone number on the policy. If so, call him and report the loss also.

Sometimes, an agent will have settlement authority to handle small losses, such as homeowner’s losses under $2,000.00. In that kind of instance, the agent could handle the claim for you. I’ve found this situation to be rare, though. Occasionally, captive agents (agents that work for only one company, like Allstate, Nationwide or Liberty Mutual) will have a small amount of settlement authority.

The first thing you should remember is that the agent is licensed by the Department of Insurance in his state to be an agent. There is a separate license for claims adjusters. It’s actually a violation of insurance regulations for an agent to do claims adjusting. It’s not his job to handle your claim, but to assist you in buying the coverage that’s right for you. Agents can be very helpful by making calls on your behalf if you’re having problems in your claim. They can be helpful in finding out key names and phone numbers for insurance company personnel that are handling your claim. If the agent has a large number of policyholders with that company, and his clientele represents a large amount of premium to that insurance company, it can be very helpful to have the agent call on your behalf when you’re having problems.

After all, it’s all about customer service, and keeping the promises made in the insurance policy.

Sometimes, the agent or an office secretary/customer service representative will fill out a claim form (called an ACORD form), and submit the claim form to the insurance company on your behalf. In this age of the Internet, frequently the claim form is electronic, and the agent will submit the electronic form by computer.

If the agent notifies the company on your behalf, and uses some type of form, ask the agent to send you a copy of the completed form. Then, you’ll be certain that the claim was submitted, and the date the claim was submitted.

Many times, however, the agent will have to refer you to the claims department of the insurance company. Your policy may have a telephone number for the claims department listed on the policy, and instructions how to make a claim.

Your policy requires you to notify the insurance company “in a timely manner” after you’ve had a claim. What is timely? It varies policy to policy. But each state has statutes of limitation that limit the amount of time after a claim occurrence that a claim can be made. Check with your state’s Department of Insurance to determine the statute of limitation where you live…or where the loss occurred. You’ll find a list of all of the Insurance Departments of all 50 U.S. states and their phone numbers in the Appendix, and at the website address shown below.

For example: you live in Minnesota, and own a retirement home in Florida. The Florida house gets hit by a hurricane. The statutes for Florida would apply.

WARNING: If you wait more than a month after your loss to notify the insurance company, they will be instantly suspicious. In those cases, you should expect to receive one of two forms from the insurance company before they begin their investigation of the loss:

Non-Waiver Agreement. This basically states that the insurance company is going to do a thorough investigation of the claim, but that their investigation does not commit them to pay the claim. It states that they do not waive any of their rights under the policy, and that the insured does not waive any of his rights by cooperating with the investigation. The insurance company wants the insured to sign this form. However, if the Insured refuses to sign the form, the insurance company will send him a….

Reservation of Rights letter. This states basically the same thing as a Non-Waiver Agreement, but the Insured does not have to sign it.

Don’t forget to write in your claim journal the date, time, who you spoke with, the phone number you called, and what was said when you reported your claim. That information could be very valuable later if you have problems with your claim.

Most likely, you’ll receive a claim number from the company when you report the loss. Write the claim number in your journal!!! Don’t expect the insurance company to quickly send you a form that has the claim number on it. Sometimes, it may be many days before the claims department sends you any correspondence, and you will likely need to speak with them before then.

WARNING: What about a situation in which someone else is at fault, and you’re making a claim against the other person’s insurance company? This could happen in an auto accident, or if someone causes damage to your house, or your contents. EVEN IN THIS SITUATION, you must notify your own insurance company that you’re involved in a claim.

The reason is that third party claims don’t always turn out well for you, the claimant. Sometimes, the other person’s insurance company denies liability or denies coverage. Sometimes, the other person’s insurance company drags the process out. Sometimes, the other person’s insurance company makes a settlement offer far below the fair value of the claim. Months may pass, and you have suffered a financial loss that is not getting paid.

What if you, or someone in your family, is injured in the claim…and the other guy’s insurance company won’t accept liability?

Those things might occur weeks or months after a loss. In many cases, you can short-cut that process and make a claim against your own insurance policy to repair the damages. Then your insurance company will do something called “Subrogation.” That is, they will pay your claim, and then contact the other person’s insurance company and demand reimbursement, including your deductible.

So, if you don’t report your claim right away, the policy might allow that insurance company to deny your claim based upon late reporting.

Besides, your policy REQUIRES you to notify the insurance company “promptly” after you have a loss of covered property. That requirement is there no matter who is at fault for the damages.

Don’t get caught in this technicality! Don’t lose your right to collect what you deserve when you notify the insurance company.

Interstate health insurance myths

admin — Mon, 14 Jun 2010 10:46:44 +0000

The game played by politicians is to take an idea from their own agenda and then frame it in a way that sells it to the other side. When the politicians meet in the middle, bipartisan solutions to problems emerge. This reflects the fact there is no monopoly on good ideas, only simple good solutions to difficult problems. In the healthcare debate, one of the solutions proposed by the GOP was to allow people to buy their insurance across state lines. This sounds a good idea. As the law stands, every state regulates the sale of insurance within its own borders. This limits the size of the market. If insurers had to compete with each other on a regional or national level, the premium rates would fall and every citizen would get a better deal. Well, let’s look a little more closely at how it would actually work.

At present, every state has a Department of Insurance to regulate the insurance companies licensed to sell policies. This is a reasonably effective system for consumer protection. But if regional or national insurers could sell policies into many states, it would break the regulatory system. It would no longer be local supervision of local companies. Insurers would decide where to establish and would, of course, choose the states which had the weakest consumer protection regulations, i.e. where they could make the most profit. Think banks and finance companies. These companies broke the US economy and produced the recession because their sales of subprime mortgages and associated derivatives were unregulated. Now apply the same thing to interstate insurance. As a final thought on this issue, remember all US states have different laws and one state cannot enforce another’s laws. That is sovereignty for you. So the state where an insurer is based cannot protect consumers under another state’s laws.

Secondly, opening the market across state lines allows insurers to cherry pick the best people to insure. Without regulations to limit the right to discriminate against people for pre-existing conditions and to increase premiums as people get older and fall ill more often, insurers will just take their profit from all the healthy people and forget about the rest. Thus, instead of increasing consumer choice, it would have the reverse effect. Most insurance companies would close their branches in individual states. Those that remained would keep all the aging and less healthy people. As their claims rise, the companies will make a loss and close. Without a law to mandate regional or national companies to offer some health coverage, it is likely the number of uninsured people would rise.

When you add all this up, it is a good thing the GOP’s proposal was rejected. Health insurance plans are complicated enough without having to change a whole mass of federal and state laws to allow interstate sales. This is not to say that consumers might benefit if there was more competition in the insurance market generally. With a real free market, properly regulated, consumers would get a better deal both in the terms of coverage and in the premium rates they pay. As it is, you must get multiple quotes to find cheap health insurance. Anticipating their profits will take a hit following this reform, insurers have been raising their premium rates. You must shop around to find the most affordable policy.

Does every state need its own Department of Insurance?

admin — Wed, 27 Jan 2010 14:43:44 +0000

Insurance is a slightly nonstandard business in that all the major regulatory functions are left to the individual US states. Federal government has decided to abandon its normal role as the regulator of business to protect the consumers’ rights. Such regulation as does exist is down to the political climate in each state and the will of the lawmakers to take on the economic power of the insurance industry. That said, all Departments of Insurance start off equal. Their primary function is to license companies to sell insurance in their state. Unlike other businesses, an insurance company is licensed state-by-state. No company can sell a policy across state lines. That means every national insurer must establish separate subsidiaries in each state and each company must hold a license. There are also minimum capital holdings set by the Department to protect the solvency of the local companies. There must always be enough money held by each company to pay out on the claims made. Some states require actual cash to be available. Others have a formula to prove the availability of money as required. But, for the most part, this is historical. The major players established their presence in multiple states years ago and newcomers moving across state lines are rare. In fact, the general lack of competition in state markets gives no incentive for companies to seek new licenses.

Once all the players hold their licenses, the personality of the Commissioners in charge comes to the fore. Many view their role as political either to run the Department with the lowest possible level of regulation or to be an effective watchdog to protect consumer rights. You can tell which way your local Department is run by logging on to your state’s website. Some sites are very pro consumer, offering detailed help and advice on how to buy insurance and get a good deal. But the key test lies in the way complaints are handled. Without exception, all Departments accept complaints from people holding policies. In theory, they should all investigate these complaints and apply a judicial process to decide whether the insurer is at fault and, if so, what the remedy should be. For example, Road Island has just imposed a fine of $5,000 on a leading insurer. Following a traffic accident, the insured wanted the repair work done at his regular auto body shop. This was refused by the insurer because the shop was not on their list of approved body shops. Local regulations drawn up by the RI Department allow the insured a free choice of repair facilities. The fine of $5,000 and publicity for it represents a small penalty in itself. But if there were many such fines, the cumulative bad publicity would damage this insurance company’s reputation and its market share would fall.

The best Departments are completely open about the complaints process, publishing details of the complaints, the identity of the insurance company and whether the complaints were upheld. When you are looking for cheap car insurance, this gives you an excellent guide to all the companies’ performance in selling policies and handling claims. Sadly, the majority of Departments do not identify the bad insurance companies by name. The worst do not publish any useful information about complaints. This leaves you in the dark when looking for cheap car insurance with a reliable company.