Insurance Claim

A request made to an insurance company asking for payment on a loss that is covered by a policy. If a claim is approved, your deductible will be subtracted from the covered amount.

What Is a Claim?

A claim is a formal request to your insurance company to pay for a loss your policy covers.

How Do Policyholders Make a Claim?

Most home insurance policies include a section called “Conditions” that lists your duties as a policyholder. This is where you’ll find instructions for making a claim. Policies and providers may have different requirements, but most want you to:

  • Promptly report claims to your provider or agent.
  • Provide information, like your name, policy number, and details about the loss.
  • Give the names of any witness or people who may have a claim against you.
  • Send legal documents associated with the loss, like police reports.
  • Assist with the investigation and/or lawsuit.
  • Authorize them to review medical records and reports if someone is injured.

Prompt reporting of a loss is essential. Depending on the situation, a delay may mean your insurance company can deny your claim — leaving you on the hook for repairs, medical bills, and lawsuits.

Once you alert your insurance company about the claim, it will most likely send you claims forms. By law, you have to return them to your provider’s claims department within a certain number of days. Review these and fill them out carefully to avoid delayed claim payments.

Your insurance provider might also send an insurance adjuster. This person investigates your loss and offers you a settlement for repairs based on your policy terms and coverage limits. For example, your settlement offer may take into account:

  • Your deductible. This amount is deducted from your claim payout.
  • The type of coverage you chose. Opting for actual cash value (ACV) coverage means your insurance covers the depreciated value of your property. A replacement cost policy pays out more, covering what it costs to replace your property with a new item of similar quality.
  • Your mortgage lender. Many lenders require you name them in the policy as a loss payee. That means claim payments go to you and your lender. Condo owners, your management company may have similar requirements.

Your adjuster may pay your claim the day they investigate. Even if you accept that settlement, you can still reopen your claim if you find additional damage. Most policies give you a year after the loss event to file, but ask your agent to be sure.

5 Tips for Filing an Insurance Claim

Filing a claim can be daunting if you don’t know what to expect. These tips may help make the claims process easier:

  • Plan ahead. Ideally, you’d never have to make a claim, but be prepared in case you do. Create a home inventory that includes serial numbers, important receipts, and appraisals. Keep this and a copy of your insurance policy in a fireproof safe.
  • Talk to your insurance agent. You already know you need to report a claim quickly. However, your agent can also help you decide if you want to file a claim. Claims can make your premium go up, and multiple claims can make insurers think twice about offering coverage.
  • Only make necessary repairs. You want the adjuster to see the damage as it is. If you have to make repairs to keep people safe or to stop additional problems, be sure to take pictures or video first.
  • Consider hiring your own adjuster. An independent adjuster offers you an objective opinion. Plus, they can help you show your losses, get estimates for repairs, and negotiate your settlement.
  • Keep your receipts. If you spend money on temporary repairs or housing, hold on to your receipts. Your policy may cover them.

Preparing for trouble helps you get back to your life faster. Get more risk management tips here.

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