What Should You Do If Your Insurance Company Isn’t Paying?
The National Association of Insurance Commissioners (NAIC) maintains a list of the most frequent customer complaints with their insurance providers each year. The list is made up of data from state insurance departments, which are one of the most important resources for people who believe an insurance provider isn’t treating them fairly.
Important Points to Remember
• You have choices if you’ve been denied an insurance claim, have been treated unjustly, or believe you’ve been cheated by an insurance company or one of its representatives.
• The National Association of Insurance Commissioners (NAIC) is a government institution that handles client complaints in the insurance business. Many states have their own agencies as well.
• Keep careful records of your contacts with the insurer against whom you are filing a complaint, as well as any supporting papers.
• In more complicated matters, you may wish to hire a lawyer who specializes in this sort of complaint.
Complaints
The great majority of complaints, predictably, concern the processing of claims, which is the primary reason why individuals get insurance in the first place. According to statistics from the NAIC report as of June 2021, policyholders faced delays in receiving claims, accounting for little over 18% of all complaints.
The second most common complaint was over an insurance company’s unsatisfactory claim amounts, which accounted for little over 13% of all complaints. A claim rejection accounted for about 12.5 percent of all complaints.
It’s also worth noting which insurance kinds get the most complaints. The findings are unsurprising, given that accident and health insurance disputes are the most prevalent, accounting for about 41% of all complaints. With just over 30.5 percent, auto is the second most popular sector, followed by homeowners with over 15 percent. After life and annuity concerns, which account for around 8% of all complaints, the list narrows down to relatively minor issues.
Consumers should be aware of which insurance categories have the highest number of complaints. When you have a health insurance claim to make, for example, be on high alert, and when you have an auto or homeowners claim, be similarly watchful. Here are four options to take if your insurance is delaying payment, has rejected your claim, or has made a low-ball settlement offer.
Ensure that your records are in tip-top shape.
When it comes to insurance claims, the work you completed before an accident might be crucial. When it comes to insuring your home’s contents, it’s a good idea to retain receipts and records of your belongings, particularly the more valuable ones.
According to one industry source, you should do a tour of your house with a video camera and film all of the items, then store the video somewhere secure outside of your home, such as at the office or in a safe deposit box. When challenging a claim, maintain meticulous records of who you spoke with, when you spoke with them, and what was said.
Insurance companies that are shady go out of their way to make the claims procedure difficult, thus having proof of their elusiveness may aid your case a lot.
Use the State Regulator to Your Advantage
Taking an insurance provider to court should only be done as a last choice since it may drag out a claim for years, delaying cash needed to repair a house or pay medical costs. The first step is to try to engage with your insurance agent or company provider directly in a calm, patient way while recording the whole process. Using the assistance of a state insurance regulator might help speed the process along if they prove tough to deal with.
Understand your insurance policy and your rights.
A comprehensive examination of a current or new insurance policy will provide some of the greatest information into what to anticipate if a claim is filed. There are details on what is covered, how to file a claim, how promptly a claim must be made, and how the procedure for estimating damage compensation amounts works.
Having an attorney present during a deposition when an insurance company examines you to get facts about an accident or the worth of your belongings in the event of property and casualty insurance may be beneficial, particularly if the sums involved are significant. Knowing your rights in the event of a dispute is also crucial, which should be outlined in a policy or discussed with your agent, insurance provider, or state regulator.
Be tenacious.
In the worst-case scenario, trying to persuade an insurance company to meet its claims responsibilities may be a very tedious and time-consuming procedure. The great majority of instances should be considerably more easy, and insurance companies handle most claims and disputes accurately and responsibly. Individuals must, however, remain on top of their insurance provider with regular follow-ups and complete documentation of the whole process if problems emerge.
Bottom Line
Again, most insurance claims are processed correctly and promptly, but it’s helpful to be aware of the obstacles you can face if things don’t move as easily as they should.