How to Avoid a Disappointing Claims Experience
It’s a truism; insurers are glad to receive your premium payment, but not happy to pay your claim! The changes I have seen in my greater than 40 years of experience are not an illusion. Decidedly, there has been a gradual shift towards more stringent control of claims’ costs and less personal contact between insurers and their customers who experience difficulties in claims.
Technology will not be, contrary to the expectations of many, the panacea. It will not lead to greater contact between claimants and their insurers. The opposite will occur as technology enables insurers to “adjust” claims remotely and reduce empathy with the plight of the claimant. Today, use of drones, satellite and inspection services (even independent adjusters) all combine to ensure the control of claims and decisions on policy remain vested with a nameless in-house claims handler. The person who attends the property to inspect following a catastrophe is not the person who adjusts the claim.
The consequence of this approach to claims handling is a loss of communication between the policyholder and their insurer. When that happens, the claims experience can become both daunting and disappointing. A letter communication from the insurer arrives confirming someone inspected the damage or has reviewed the claim and sets out the adjustment of the loss. The inexperienced insured is left to decipher what damages are being covered, which are not, how much is offered and, what to do with personal or business property, additional living expenses or business income losses. The assistance that most insureds presumed they would receive, does not materialize.
🤷♂️ 🤷♀️ An insured that throws up their hands because they do not know what to do when dealing with a claim will face disappointment. The fact the insured may be disappointed or embittered by the experience may be as perplexing to the insurer as the insured. The insurer’s process depends on rigor, measurement of performance, average loss amounts, cost containment and policy interpretations that dictate their claims handling. Measuring the satisfaction of the claimant or ensuring the claimant fully understands the process is generally not a factor in the drive to control and close claims by the insurer.
Inevitably, some claimants will be satisfied, but increasingly, surveys find that insureds are disappointed following filing an insurance claim. Here are some common reasons cited over-and-over when we speak to claimants:
- It has been 3 months since someone came to see our property, but we have heard nothing;
- We received a letter telling us our claim is below deductible, but our contractor says the damages are severe;
- Our property continues to suffer more damage each day, but we are told we should not do any work until we agree on damages and costs;
- We don’t have the money to do repairs, move our family, or pay our other bills. When will they pay anything;
- Our agent has called the insurer but cannot get answers;
- The person who inspected our property won’t answer calls or answer any communications, but what they told us is not what is shown on the insurance estimate;
- We have sent everything they asked for several times, but they say it is not enough.
The comments above indicate frustrations that are commonplace. Good faith in claims handling practices is assumed by policyholders from their insurers and such aggravations can be disappointing and costly. Not everyone handles their own plumbing issues and there is no reason to assume everyone should be capable of handling their own insurance claim. There is also no reason to assume that in a transaction that can be as costly as an insurance claim to an insurer, that the insurer’s goal is to ensure the claimant’s expectations are met. Here are some things you might do to avoid a disappointing claims experience:
- Be skeptical. That is not to say that you must be completely circumspect or anticipate the worst. But if you are skeptical, you will be apt to be less disappointed when everything does not work out as you may have envisioned.
- Ask questions. Most people are novices in insurance and claims. It is neither offensive or bothersome to ask those employed by the insurer to assist you, to fully explain your policy and the claims process. You are entitled to be informed as you paid premiums for that privilege.
- Get things in writing. Don’t rely simply on verbal communications that can be misconstrued, misunderstood or denied. Always ask for documents, policies and communications in writing in case you need the record.
- Be prepared. Before you agree to an adjustment, even before an inspection, if possible, make your own list of the damages or engage a contractor to assist you.
- Don’t abrogate responsibility. The damaged property is your investment so don’t allow others to dictate what happens or assume control. There is less likelihood you will be disappointed if you remain in control. The insurer does not own the claim, you do!
- Engage experts. At the first sign of disagreement, do not get frustrated. Instead, recognize that disagreements are not uncommon and it within your rights to engage a Public Adjuster or Attorney to assist you. Hiring someone does not suggest failure; it does not suggest you are adversarial. It is a perfectly reasonable thing to do when protecting your rights and ensuring you receive the benefits to which you are entitled.
At Global Claim Advisors and Case Strategies Group, we understand the frustrations and disappointments felt by insureds who encounter a poor claims experience. Oftentimes, despite the best intentions of parties involved, lack of communication, failure to express or meet expectations and lack of understanding lead to intransigence and a complete breakdown of the process. We strive to restore balance and achieve positive outcomes.