Claims Process Explained

This article will breakdown the process of filing an insurance claim from start to finish. After reading this, you should be able to understand how your insurance claims process will likely go. Let's go with the assumption that your home or business recently took on damage from a natural disaster that passed through your hometown. Enough damages, that it will cost a significant amount to repair or replace the damaged items in your home or business. Assuming you have a valid insurance policy, this is typically when you would put that to good use. The process of filing that claim will vary by insurance carrier & state, however, it will generally look something like the following.

1- Filing the Claim- You as the policyholder will contact your insurance carrier to report the damages to your property & file a claim. This is typically done via a phone call or in some cases there will be an online portal for you to submit a claim as well as supporting documents, like photos of the damages for your insurance adjuster to review.

2-Acknowledgment- Your insurance carrier will then acknowledge receipt of the claim, via a phone call, an email, and or physical letter in the mail. They will typically provide you with a claim number at this stage. Keep this for your records. This is what you will use for future reference to discuss the status of your new claim.

3- Investigation- During this stage, you will meet your first adjuster. You will have two adjusters throughout this process, one of which is your “field adjuster”. They will schedule to come out to your property and inspect your property to determine exactly what was damaged and document the damages. Their primary purpose is finding the approximate cause of the loss, documenting & examining the damages to confirm.

4- Evaluation- Once your field adjuster has completed their inspection, they will put together an initial estimate to determine the value of the loss. This estimate is typically broken down by structure, room & specific line item. This estimate provides details as to exactly what items are damaged and in what quantity. Once completed, they will then submit it to the insurance for them to make a decision on your claim.

5- Adjustment- During this phase your Insurance carrier will review the estimate provided by your field adjuster, as well as all supporting documents including photos. They will then make a decision for approval or denial. This may take weeks, as they are usually dealing with an influx of new claims being processed every day because of the storms that just passed. At this point when receiving updates on the status of your claim, they will typically come from your second adjuster, your “desk adjuster ”. They will be your point of contact throughout the rest of the claims processing. If the claim is accepted, the insurer will pay promptly after notifying the claim will be paid. If denied, the insurer must explicitly state its reasoning for denial.

When you have an RCV policy, the insurance will typically will pay out an ACV amount first, withholding back the depreciation until proof is shown of the repairs being completed to the property. Once the repairs have been completed and you submit them to your desk adjuster they will release the depreciation to you in a second check, usually mailed to you.

If you are unsure at any stage of this process and need one of our dedicated concierge to help you through this process, simply book a consultation call, and we will get you moving in the right direction. 

**PRO TIPS: 

+ At any stage of this process, you are able to get quotes from contractors to get an understanding of how much it will cost to repair or replace those items at current market value. We recommend as soon as possible, as many local contractors will be inundated with the very high demand for their services with the storm that just passed. It is best not to be stuck waiting weeks or even months before someone can come out and give you a quote. Preparation is key in keeping your insurance claim moving forward.

+ Insurance companies have a time limit in which you as the policyholder have to make a claim. It is typically six months to a year from the date of the incident or storm that caused the damage. If you believe that, you have legitimate damage to your home or business from a natural disaster, it is imperative to begin your claims process as soon as possible. Check with your insurance carrier to confirm what that time limit is. If the time allotted passes before you file the claim, the insurance will not be liable to cover those damages and you as a home or business owner will have to pay full retail price out-of-pocket to restore your property.