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Insurance companies are not quick to advertise that good faith claims standards require them to investigate your insurance claim in a prompt and reasonable manner. Nor can they force you into an unwarranted insurance dispute grounded in unreasonable delay tactics and excessive demands.

The purpose of a legitimate insurance investigation is to pave the way for a fair and reasonable claim settlement. In the minority of situations where a claim denial is warranted, that insurance claim denial must be based on a solid and impartial investigation.

But unfortunately, dishonest insurance companies find ways to deny claim settlements rather than pay them. And these shady practices are based on the chance that by forcing you to wait, by forcing you to bow to their demands, you will eventually give up.

The more frequent unfair claim settlement schemes include unfair policy interpretations, unfounded coverage decisions, unreasonable demands for supporting information, and the most frequent of them all, the “ongoing investigation”.

These practices are conceived to generate extensive insurance claim delays, all without justification, all flawed. Following weeks and months of delays, you are at their mercy, not knowing whether your legitimate insurance claim will be honored or unfairly denied. And that’s the plan.

Your only chance is to accept the challenge of the insurance dispute. To do this, you must arm yourself with the knowledge to seize power from the insurance company.

You can begin with these basic insurance claim help tips.

Chances are your state has adopted the universal “Unfair Claims Settlement Practices Act”. These standards have been legislated into the laws of most all states, placing restrictions on insurance company unfair claims practices. For example:

• Insurance companies must promptly acknowledge and act upon your insurance claim. In some states, actions are required within a specified time period.
• Insurance companies must implement and follow stringent standards for the prompt investigation of all insurance claims.
• An insured person must be kept up to date on the progress of the insurance claim
• Insurance investigations are required to be both reasonable and timely.
• Insurance claim settlements must be fair and reasonable, and must meet reasonable expectations
• The insurance investigation cannot include unfair, unreasonable, and repeated demands for documents and supporting data as a requirement for settling your insurance claim.

Consistent violations of these regulations set the stage for an environment of unfair claims practices. You must learn how to recognize these tactics, and how to respond. Your goal is to achieve a fair claim settlement, even if that means you must rise to the obvious insurance dispute.

What should you do if you are the recipient of an unfair insurance claim denial? How can you protect your interests? Begin with the documentation.

• How were you notified of the claim denial? Denials must be sent to you in writing, they must be clear and precise, and they must specify the precise policy provisions that resulted in the claim denial.
• Insurance policies are contracts of adhesion, meaning the insurance company must interpret language to the benefit of the insured. Were the policy provisions fairly applied?
• Claim denials must be conducted in a reasonable and timely manner. Does the claim denial document support that such an investigation was conducted in regard to your claim?
• The insurance company must be prepared to defend its interpretation of the policy. Is that interpretation fair, impartial and relevant?

Here are some additional insurance claim help tips.

Study the “Unfair Claims Settlement Practices Act” for your state. Educate yourself on the laws and regulations that apply to unfair insurance practices. While these laws include penalties for unfair insurance practices, the authorities cannot intercede on your individual claim. Instead, take your knowledge of those laws to intervene on your own.

If the claim denial was issued by your insurance company, carefully study your policy. You must understand what your rights are according to that policy. And look specifically for appeals and review processes detailed in the policy. Some policy conditions require that you must meet these conditions before you can take further action, including the filing of a lawsuit.

An insurance denial must provide the specific conditions for that claim denial. An insurance company cannot ignore your claim, or place such obstacles in your way that you cannot possibly satisfy the unreasonable conditions. To the contrary, the company must resolve your insurance claim, and that resolution must be based on fairness and impartiality.

This seems to be an ongoing question that I still get asked even though I’m not working in the Insurance Office any longer. I still have my friends and family call me up after an accident to ask me what they should do after they just had an accident. After an accident you should always notify the police, exchange information with the other person involved, and contact your insurance company. You do NOT want to admit fault or discuss your accident with anyone besides the police or your Insurance Agent/Claim Rep. So, today I’m going to go over the steps on what I feel that you should do after an accident.

Step 1 – Call The Police Regardless of how big or how small your accident may be, it’s always important to have a Police Report done. It does not cost you anything to have a police report done after an accident. If your in a parking lot, or busy highway you should always call. A police report is not always needed to enter an insurance claim but it helps to validate your story and provides information on all parties involved.

I am aware that sometimes if your incident happens on private property, the police will not come out, but you can at least call them and ask. If you tell them you need something for your insurance company they will usually come out or give you another option of what you can do. Some states require you to fill out an SR-22 form. I know in Indiana this is mandatory anytime your pulled over for just a traffic violation or if you have an accident. They usually give you 10 days after your accident to have the SR-22 form filled out and signed by your insurance company. This is to verify that you have current insurance. If you don’t return it within the 10 days, they will suspend your license.

If you do decide to enter a claim, the insurance company will usually obtain the police report for you. It usually takes a few business days after your incident to get the police report but usually your adjuster will handle that all for you. At the company I worked for that’s how it was handled. Now, if you did want a copy of the police report for your records, most times, if you asked your Claim Adjuster they would provide a copy for you. However, if you do not want to wait or if your company doesn’t provide them, you can usually get them from the police station yourself for $5 to $10 dollars.

Step 2 – Exchange Information You want to exchange information with the other parties involved in the accident. You will want to get the driver’s information, the vehicle information, and the insurance information. Make sure if there are any witnesses that you get their name, address and phone number as well. You will want to jot down some stuff about your vehicle too. List who was riding with you, where the damage is located, who was driving and which vehicle it was. You should also list some information about the Accident. Time and Date, where it happened, and what happened. You will also want to write down the police information. Which police department it was, the police report number (if given) and who (if anyone) received a ticket. Also make sure you list if there were any injured parties. List their name, address, and type of injuries they might have.

Step 3 – Call Your Insurance Company Even if you do not know yet if your going to enter the claim or not, you should always call your Insurance company next. They can put a note in their system of the date and time of the accident and a brief description of what happened. It’s easier to recall what happened right after the accident instead of hours or days later. So you should always call them after you finish up with the Police or while your waiting for them to get to the scene. Usually they will ask you what happened, who was involved, where did it happen, and a lot of the stuff that I talked about above. If you did list all the information down then it’s a fast process. If you do not have all of the information just give them what you do know and the rest they can get of the police report.

Step 4 – Get An Estimate Of Damage The next thing you should do is get an estimate of damage done to your vehicle. You need to know how much damage is done to your vehicle. It doesn’t matter if your going to be entering the claim on your own policy or on the other party involved. You need to know how much damage is done to decide if your going to pay out of pocket or enter a claim.

Most insurance companies have some time of program that they offer. Where I previously worked it was called a Service First Provider. If you use one of the insurance companies approved repair facilities it usually just speeds up the claim process. (if you end up entering one) Usually they take pictures, and handle everything for your insurance company and send it over to them electronically so you don’t have to do anything but take the vehicle in. They will also provide you with a copy of the estimate. Once you look at the total amount of damage you can move on to the next step to decide if you going to enter a claim.

Step 5 – Decide If You Want To Enter A Claim After you know how much damage was done to your vehicle, you can decide if you are going to enter a claim or pay it out of pocket. You will want to look at your deductible amounts compared to the amount of damage. I was asked by numerous people if they entered a claim would it raise their rates? Honestly, anytime that you enter a claim onto your policy, you run the risk of your rates increasing. Typically, Comprehensive claims don’t effect your policy as much as a Collision claim. But it can always increase after a claim. That’s why you want to weigh the risk of paying out of pocket vs entering the claim. The rule of thumb that I always used was if it was within $100 of my deductible and if I had the money to cover it at the time, I would just pay it out of pocket. But, If I didn’t have the money at the time I might go ahead an enter the claim.

The insurance companies will usually work with you. If you have a higher deductible and are having a hard time just getting the money around for that, let them know. Sometimes you can wait to enter the claim until you have the deductible money. Just make sure you tell the insurance company that what your doing so they can note your account. If you do this without them knowing, it’s going to look like you were hiding something. It’s a red flag when someone doesn’t enter a claim right after an accident. If your calling a few weeks or months after your accident the insurance company is going to wonder why your just now entering the claim or letting them know about it. Again, another reason why it’s so important to call them right away.

If you do decide to enter a claim, your insurance agent or rep should help you though the process. I always used to call the person weekly until the claim was resolved, but a lot of companies don’t do that. So it’s up to you to stay on top of them. I think industry standard is around 30 days from the time you enter the claim for it to be resolved. Some do go longer depending on the size of them claim and others are resolved in just a few days. It just depends. Bad claims experience is one of the top reasons why people change insurance companies. So if your having a hard time you just might want to start shopping around.

If you have any more questions on this topic please be sure to leave a comment and I’ll do my best to give you an answer.