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Filing an Insurance Claim

If you have a claim, tell your insurance company as soon as possible. There should be a toll-free claims number on your policy. Most insurance companies require you to tell them in writing, so follow up with a written notice with information about what happened.

The following tips can help the claims process go more smoothly:

  • Review your policy to make sure you understand what it does and does not cover. If you're not sure, ask your agent or the insurance company to explain. Visit the Office of Public Insurance Counsel (OPIC) website to find coverage comparisons for most homeowners policies sold in Texas.
  • Have your policy number ready when you call your insurance company. Be prepared to answer questions about the damage.
  • Take pictures or video of the damaged area and property before you make repairs. This is especially important if you make repairs before your insurance adjuster has seen the water damage.
  • Don't throw away anything you removed from the house until your insurance adjuster has seen it.
  • Make reasonable repairs to protect your home and property from more damage, but don't make structural or permanent repairs until your company says it's OK.
  • Write down everything you spend on repairs and keep the receipts.
  • Keep a log that lists everyone you spoke with at your insurance company.
    • Note the time, date, name of the person, and what you talked about.
    • Follow up with the company in writing to confirm important details.
    • Keep copies of letters or other documents you and your company send each other.

Claims Process

After you file the claim, you should hear from the insurance company within a day or two. The insurance company will tell you about its claims process and any responsibilities you have. The insurance company should give you the name of the person who will be working on your claim.

The insurance company must start investigating your claim within 15 days after receiving written notice and may ask you for more information. Once you send the information, the insurance company has 15 business days to accept or reject your claim. If the insurance company says it will pay your claim, it must pay within five business days. If the insurance company rejects your claim, it must explain its reasons in writing.

As part of the process, the insurance company will send an adjuster to your house to look at the damage. It might be awhile if there was a disaster and the area isn't deemed safe. Try to be home when the adjuster comes so you can discuss the damage and answer any questions.

The insurance company will tell you in writing if your policy covers the damage and will give you an initial damage estimate. Keep in mind that the estimate may change. The insurance company might provide you with a list of contractors, but you don't have to use someone from the list.

About Adjusters

The person you deal with most often during a claim will probably be an adjuster. There are several types of adjusters:

  • Company adjusters are full-time employees of the insurance company.
  • Independent adjusters are independent contractors who provide claims services to insurance companies. They usually charge the insurance company a fee for each claim they handle.
  • Public insurance adjusters are independent adjusters who help people negotiate claims with their insurance companies. Public adjusters work for you, not the insurance company. They charge you a fee for their services. The fee is usually a percentage of the claim and is subtracted from any settlement you get from your insurance company. You don't have to hire a public adjuster.

Note: Adjusters must be licensed by TDI. To learn whether an adjuster is licensed, call the TDI Consumer Help Line or visit the Agent Lookup feature on our website.

Settling a Claim

Your insurance company has five business days to send you a check after it says it will pay your claim. If you don't get your check within five business days, call your agent or insurance company. If you think that the company is delaying payment on purpose, call TDI for help.

If you have a replacement cost policy, most insurance companies pay claims with two checks. The insurance company will give you the first check after the adjuster has reviewed your damage. This check will be for the estimated cost of repairs, minus depreciation and your deductible. A deductible is the amount of the claim that you're responsible for paying yourself. Review your policy or ask your agent or adjuster if you don't know how much your deductible is.

The insurance company will give you a second check for the balance of your claim after it gets the contractor's bill for the finished job. You must complete repairs or replace your property within a certain number of days from the date of loss. Review your policy or ask your agent how soon you must repair or replace your property.

Replacement Cost and Actual Cash Value

  • Replacement cost is what you would pay to rebuild or repair your home, based on current construction costs. Replacement cost is different from market value and does not include the value of your land. Ask your company if you’re not sure how much it would cost to rebuild your house.
  • Actual cash value is what you would pay to rebuild or replace your property minus depreciation. Depreciation is a decrease in value due to wear and tear or age. If your home is destroyed and you only have actual cash value coverage, you might not be able to completely rebuild.

Read your policy carefully to know whether it offers replacement cost coverage or actual cash value coverage.

The insurance company will pay to repair your home with materials of like kind and quality to the original. For example, if the carpet was damaged, the insurance company will pay to replace the damaged carpet with carpet of a similar grade and quality. If you choose to upgrade the carpet or change the type of flooring, you will have to pay the extra costs yourself.

If You Have a Complaint

If you have a complaint about the way your claim is being handled, first call your insurance company. Many complaints can be resolved by talking to the insurance company about your issue.

If you can't resolve the dispute directly with your company, file a written complaint with TDI. There are two ways to file a complaint:

  • You can use the Online Complaint Portal.
  • You can also fill out a complaint form that is available on the portal page or by calling the Consumer Help Line.

Additional Living Expenses to Relocate

Your insurance company might pay your additional living expenses (ALE) if you have to move from your home while repairs are made. ALE includes temporary housing, food, and other essentials.

Ask your agent or insurance company if your policy includes ALE. If it does, you might be able to get an advance payment to help you move. Most policies pay up to 10 to 20 percent of the amount of the dwelling coverage on your house for ALE.

Your insurance company will only pay for additional living expenses up to your policy's ALE dollar limits. Because repairs on your home can sometimes take months, monitor your expenses carefully to make sure you have enough ALE to cover the entire time you’ll be out of your home. If you reach your policy's ALE dollar limits before your home is fully repaired, you’ll have to pay the rest of the expenses out of your own pocket.

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