Empowering Policyholders: Understanding Your Rights in Insurance Claims

Policyholders often feel overwhelmed when navigating the insurance claims process, especially in complex commercial and multi-family property cases. Many believe their insurers hold all the power and that they have no choice but to trust them, leading to widespread underpayments or even outright denials. However, understanding your rights is essential in leveling the playing field. From the right to dispute a claim to the ability to seek professional help from a public insurance adjuster, there are options available that can dramatically impact the outcome of your insurance claim.

This article will guide property managers, commercial contractors, and facility managers through their rights in the claims process, explain the crucial role of public insurance adjusters, and empower you to secure the compensation you deserve. Never trust the person who owes you money to pay you what you are owed.

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Common Pitfalls in the Insurance Claims Process

Insurance companies are notorious for denying, delaying, or underpaying claims. As noted by experts, these practices are part of a strategy to profit the carrier at the policyholder's expense. In a study conducted by the Office of Program Policy Analysis and Government Accountability, it was revealed that policyholders who used public adjusters received significantly higher settlements than those who did not. Yet, most policyholders don’t fully understand their rights or how to exercise them effectively.

Your Rights as a Policyholder

Understanding and exercising your rights during the claims process can dramatically affect the settlement outcome. Key rights that every policyholder should be aware of include:

• Right to a Second Opinion: If you’re unsatisfied with the insurance company’s assessment, you can request a second opinion from a public adjuster. This can often reveal discrepancies in the original estimate, especially in cases involving complex water damage or structural issues.
• Right to Dispute a Claim: If your claim is denied or underpaid, you have the right to file a dispute. Bill Wilson, author of When Worlds Collide, highlights how many denials are rooted in misinterpretation of policies. Reviewing your policy, gathering documentation, and engaging a public adjuster to advocate on your behalf are key steps in overturning unfair decisions.
• Right to Fair Compensation: As David Skipton notes in The Claims Game, insurance companies often aim to minimize payouts. Public adjusters negotiate with insurers to ensure that you receive compensation that fully covers your losses. Whether dealing with commercial property damage or more specific issues like vandalism or weather damage, fair compensation is your right.

The Importance of Documentation

Documentation is your strongest weapon when navigating the claims process. By maintaining thorough records and collecting evidence, you significantly strengthen your position in any dispute. Here’s how to approach it:

• Photographic Evidence: Take clear, comprehensive photos of the damage immediately after the incident, ensuring multiple angles are captured. For example, with water damage, ensure you're documenting both the source and the extent of the damage.
• Written Records: Keep detailed logs of all communications with your insurer, noting the date, time, and representative involved in each conversation. This creates a clear paper trail should you need to escalate your claim.
• Receipts and Repair Estimates: Gather estimates for repairs and keep receipts for any emergency repairs you may need to make. These documents can support your claim if the insurance company tries to offer less than necessary for repairs.

What to Do If Your Claim is Denied

Denial is not the end of the road for your claim. Follow these steps to fight back:

1. Review Your Policy: Make sure you understand the reasons for the denial and whether the denial aligns with your coverage.
2. Collect Additional Evidence: Strengthen your claim with more documentation, such as second opinions from contractors or additional photos.
3. Engage a Public Insurance Adjuster: They will help you assess the validity of the denial and work to reopen the claim with the necessary evidence to support a fair settlement.
4. File a Complaint with your state’s Department of Insurance: If the insurance company refuses to properly inspect, wrongfully denies, and/or underpays what they owe, filing a formal complaint with your state’s insurance department may prompt action.

Public Insurance Adjusters Will Help Strengthen Your Case

Public adjusters bring a wealth of expertise to the table, making them a valuable ally for property managers or facility managers overseeing large, complex properties like shopping centers, warehouse or office buildings, hospitals, or schools. Their services include:

• Damage Assessment: They thoroughly inspect the property, documenting all losses and making sure nothing is overlooked. Water damage, in particular, can be tricky, as its effects can be both immediate and long-term.
• Negotiation Skills: Public adjusters are adept at negotiating with insurance companies, leveraging their deep understanding of insurance policies to push for the best possible settlement.
• Claims Management: From filing paperwork to managing all communications, public adjusters handle the bureaucratic side of the process, allowing you to focus on running your property or business.

Hiring a Public Insurance Adjuster is the Smart Choice

Given the frequent underpayments, delays, and outright denials that plague nearly all insurance claims, hiring a public insurance adjuster is a proactive step toward protecting your financial interests. As Jay M. Feinman emphasizes in Delay Deny Defend, insurance companies prioritize profits, and their claims practices often reflect that. By enlisting the help of a public adjuster, you gain a trusted advocate to ensure you’re treated fairly.

Take Control with the Help of a Public Insurance Adjuster

Insurance companies often deny, delay, and underpay claims, leaving policyholders feeling powerless. But you don’t have to accept the insurer’s first offer. Understanding your rights and seeking help from a public insurance adjuster can transform your claims process from a frustrating ordeal into a path toward fair compensation.

Ready to ensure your rights are upheld? Contact Velocity Public Insurance Adjusters today to schedule a free claim and policy review.