Claim Dispute Resolution
E.J. Simonsen | Jul 1, 2016
Why Dispute a Claim?
There might be a time when you have to file a property damage claim with your insurance company, and you may disagree with your insurer over damages or home repairs. You have the right to disagree with the insurance company’s estimates and reject their settlement amount.
Claim disputes are common. If the insurance company refuses to make adjustments to the estimate, you can dispute the claim by using these methods.
Claim Dispute Resolution Methods
Most property insurance policies allow disputes over the amount or value of a loss to be resolved by requesting an appraisal.
Example of a policy’s appraisal language:
If you and we fail to agree on the actual cash value, amount of loss, or cost of repair or replacement, either can make a written demand for appraisal. Each will then select a competent, independent, appraiser and notify the other of the appraiser’s identity within 20 days of receipt of the written demand. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a district court of a judicial district where the loss occurred. The two appraisers will then set the amount of loss, stating separately the actual cash value and loss to each item.
Sounds complicated, but don't be intimidated by the technical terms. An insurance appraisal can determine the damages and the value of the loss.
Mediations have become the most common way of resolving a claim dispute. This method can help settle the dispute faster compared to a lawsuit. Mediations can be held privately, voluntarily, or court-ordered.
If the dispute is due to a denial or the policyholder believes they are being mistreated, the claim can be brought before the court system. This requires filing a lawsuit, conducting “discovery”, and presenting evidence or witnesses to a judge and jury. Then, the judge or the jury will render a verdict.
Filing a lawsuit provides significant leverage to the policyholders' negotiation position, and most cases are settled before going to trial. It is best to hire an experienced insurance dispute attorney, on a contingency fee basis.
What does this have to do with me?
In a perfect world, if a homeowner filed an insurance claim, the insurance company would pay a fair settlement, the homeowner would be happy and move on. Unfortunately, that does not always happen, this is why these methods were created. I hope you never find yourself battling your insurance company, but if it happens, you know you have options to resolve your claim dispute.
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