Typical Claims Process

STEP ONE:

Prompt Notice of Loss

After you suffer a loss, contact your insurance provider, and notify it of your loss promptly. You can ask your insurance company for a copy of your policy on the specific requirements for providing notice because certain policies have specific deadlines and requirements when providing notice.

STEP TWO:

Document Your Loss

Immediately after you provide notice, begin gathering information on the damages such as photographs, estimates, and invoices. It is important to have your own documentation and professionals provide you with an opinion as to the extent of the damages in case you dispute the insurance company’s assessment of your loss. 

STEP THREE:
Mitigate Your Damages

In the event temporary repairs are necessary, Inform your insurance company you must make these repairs prior to making them, take photographs of the damages before the temporary repairs are started, and keep all receipts for work completed. Temporary repair costs may qualify for reimbursement under your insurance policy.

STEP FOUR:

Information Requested

After the claim is submitted, the insurance company typically provides written notice that it received the claim and may request additional information. It is important to follow the prior steps to timely provide the information they request.

STEP FIVE:

Property Inspection

Next, your insurance company should send an independent insurance adjuster to your property to inspect the loss.  They will ask you questions regarding the loss during this time.  Allow the adjuster to do a thorough and full inspection of your loss. Do not limit access to the adjuster. It may also be beneficial to have estimates and photographs of the damages ready to show the adjuster during the inspection.

STEP SIX:
Coverage Decision

After the inspection and after you have provided the requested documentation, your insurance company should provide written notice of its coverage decision.  If your claim is denied, the insurance company is required to timely respond and list their reasons for denial, as well as cite the portion of your policy that excludes coverage.  If your claim is accepted, the insurer could offer a lower amount than you were expecting. 

when to seek legal advice

Underpayment, Delay or Denial

If you believe your insurance company underpaid your claim, the adjuster or insurance company has delayed your claim in any way, or if any portion of your claim was denied, call now for a free consultation.


Record Statement or Examination Under Oath Requests

If your insurance company requests your recorded statement or an Examination Under Oath (EUO), it may benefit you to consult with an attorney prior to participating in it. Call now for a free consultation.


Policy Review

If you are unsure what your insurance policy covers, it may benefit you to have an experienced insurance attorney to review your policy to ensure you are properly insured. Call now for a free consultation.

Frequently Asked Questions

  • How do I know my insurance claim was accurately assessed and not unfairly denied or under-paid?

    Work with reputable contractors or other experts to provide you independent evaluations of your damages and the costs associated with repairing those damages. Having more than one estimate or opinion to compare will help you better determine if your insurance company adjusted the claim fairly.  Review all letters received from your insurance company to ensure they provided you with a valid explanation for their determination of coverage (whether the claim was approved or denied). For peace of mind, ask an attorney with experience in handling insurance claims. 

  • How do I know if I have the proper coverage that insures me against my loss?

    Policies will vary, so even though homeowners and commercial owners’ policies cover many different types of losses, you’ll want to review your policy thoroughly to see what your coverages show. Here are some things to be aware of: 

    • Endorsements: Your policy may have specific endorsements that either limit or even exclude certain coverages altogether.  
    •  It is also important to know if you have a RCV (Replacement Cost Value) or ACV (Actual Cash Value): The difference between these 2 policies could greatly impact what is owed to you before and after repairs are completed. Some RCV policies require you to repair the damages within a certain period of time in order to get full policy benefits.  
    • Your insurance policy is a contract and each policy renewal is a new contract, with new policy limits, and new or varying coverages.  Therefore, it is important to request a full copy of your policy, including the declarations pages, and endorsements in effect on the date of the loss. 

    We understand reading through insurance policies can be complicated and our extensive experience in interpreting insurance policies can help you determine if you have coverage for the loss you have experienced. CONTACT US if you need additional guidance regarding your policy or insurance claim.


    Additional Resources:


    Texas Department of Insurance - Homeowners Insurance Guide


    Mississippi Insurance Department - Homeowners Insurance


    Kansas Insurance Department - Homeowners Insurance Guide


    Colorado Division of Insurance - Homeowners / Renters Insurance | DORA Division of Insurance


  • When should I consider hiring an attorney?

     In most cases, you should allow the insurance company the opportunity to fulfill their obligations under the policy through the claims process.  When the insurance company fairly and promptly compensates you for a loss, there is no need to hire an attorney. However, once the insurance company has made its decision and you feel they have wrongfully denied, underpaid, or delayed your claim, then it is time to consult a reputable insurance attorney. CONTACT US today for a free consultation. 


    Additional Resources: 

    Typical Claims Process

    When Should I Seek Legal Advice 

  • How much would it cost to hire the Law Offices of Michelle C. Le?

    In most cases, we work on a contingency fee basis, which means you pay nothing unless we get you a recovery. In many states, you can recover your reasonable and necessary attorney’s fees from the insurance company if you prove your case. In addition, our law firm will hire industry experts to help maximize your recovery, and will advance most costs prior to settlement of your claim. For more information specific to your case, please CONTACT US for a free consultation.

  • When consulting with the Law Offices of Michelle C. Le about my options, what information should I be prepared to provide to review my dispute?

    To better assist you with evaluating your legal options, please provide the following for any Residential or Commercial Property Claim:


    • Copy of your full insurance policy (including endorsements), and declarations pages in effect at the time of your date of loss. If you do not have a copy of your policy, you should request it from your adjuster or agent.
    • Any and all correspondence with your insurance company (i.e. notice of loss to carrier, acknowledgment of loss letters, insurance company’s acceptance/denial letter, emails, etc.).
    • Any insurance adjuster estimates and reports discussing the damages (e.g. engineering reports). 
    • Any independent damage expert estimates or reports (Contractors, Public Adjusters, etc.).
    • Any photographs/videos of the damages.
    • Any invoices or receipts for temporary or permanent repairs.

Additional Questions?

To find answers to your specific questions, please contact us at 210-491-2054 or fill out the form here.

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