What to do when you’re Insurer Delays Payment on Your Claim

In a perfect world, a policyholder makes a claim to her insurer, the insurer investigates and processes the claim and then promptly sends the policyholder her payment. Unfortunately, we don’t live in a perfect world. Policyholders often have to fight tooth and nail to get their insurer to act, but there’s only so much you can do. If this should happen to you, it’s important to understand what works – and what doesn’t.

Be persistent, patient and firm

When your insurer doesn’t respond to a valid claim, it may be time to get tough. According to Bob Scott, an attorney with The Advocate Law Group, “When the process breaks down, policyholders should immediately stop dealing with their insurer over the phone and begin requesting written confirmation of any of the insurer’s requests. In addition, policyholders can send letters to their insurance adjuster and the President of the company informing him or her about the delay. Unfortunately, phone calls often get ignored; but letters tend to get more attention. No matter how frustrating the process becomes, policyholders should always be persistent and polite, but firm.” But what should you do when your insurer starts investigating YOU?

Case in point

A policyholder reported that his car had been stolen and cooperated with his insurance company every step of the way – being persistent, polite and firm. His car was found, but was badly banged up. Unfortunately for the policyholder, he did not have rental insurance and had to pay to rent a replacement vehicle while his insurance company processed the claim. He waited patiently. Then, he waited some more. His adjuster got back to him – but not with a resolution. Instead, he was asked to provide personal information such as credit card receipts, proof of income and even his mortgage information.

Clearly, the insurance company thought that this policyholder may have had something to do with the theft. However, what does his mortgage statement have to do with the claim? We don’t know the answer to that, but it smells of bad faith…

Taking it the next level

Sometimes, even being persistent, patient and firm doesn’t work. That’s when you need to take your claim to the next level. Consider speaking with your adjuster’s supervisor, the insurance commissioner or even the President of the insurance company. However, “Policyholders that find themselves in very difficult situations, such as a policyholder above who is himself being investigated, should contact a lawyer immediately”, says Scott. “Insurance companies must deal with their policyholders in good faith. It is their duty. This case certainly seems like bad faith to me. In fact, I don’t recall this type of aggressive claim response to a car theft. It is really outrageous.”

Policyholders simply don’t have to put up with this type of interrogation. It just isn’t reasonable. Contact an attorney who can advocate on your behalf – especially one who understands how insurers operate.

Consumer tips

• Deal with your insurance company in good faith – provide them with the information they request – as long as it’s reasonable.
• Be persistent, patient, but firm. You’ll know when too much is too much.
• Put it in writing – letters tend to get more attention and also provide you with a written record of the claim.
• Take it to the next level. Don’t be intimidated by bringing your claim to a supervisor’s attention, reporting the matter to the President of the company or contacting your state’s insurance commissioner.
• Seek the advice of an attorney. Don’t spend your life trying to get somewhere with your insurance company. Turn the matter over to a qualified attorney who will act on your behalf – especially when your insurer acts in bad faith.

To contact an insurance bad faith attorney, click here.

Case Studies: Dealing With Insurer Payment Delays

Case Study 1: The Delayed Home Fire Claim

Lisa Thompson experienced a devastating fire at her home, resulting in significant damage to her property and belongings. She immediately filed a claim with HomeGuard Insurance, expecting prompt assistance to recover from the loss. However, weeks went by without any response from the insurer.

Despite several follow-up calls and emails, Lisa received no updates or acknowledgment of her claim. Frustrated by the delay and financial strain, she sought legal advice and hired an attorney specializing in insurance claims. With the attorney’s intervention, HomeGuard Insurance expedited the claim process, and Lisa received a settlement to cover her losses.

Case Study 2: The Aggressive Auto Accident Investigation

Michael Rodriguez was involved in a car accident and promptly reported the incident to RoadSafe Insurance. However, the insurer’s adjuster took an aggressive approach to investigate the claim, questioning Michael’s account of the accident and suggesting he might be at fault. Feeling harassed and unfairly treated, Michael decided to escalate the matter.

He filed a complaint with the state’s insurance commissioner, citing the insurer’s aggressive tactics and potential bad faith practices. The insurance commissioner’s intervention compelled RoadSafe Insurance to review the claim objectively. The insurer reevaluated Michael’s case, acknowledged their adjuster’s inappropriate conduct, and offered a fair settlement for the damages.

Case Study 3: The Unresolved Water Damage Claim

Robert Johnson experienced a severe water leak at his property, causing substantial damage to his home. He promptly filed a claim with AquaSure Insurance, expecting swift action to mitigate the damage. Despite providing all required documentation and cooperating fully with the insurer, the claim process remained stagnant.

Robert grew increasingly frustrated with AquaSure’s lack of communication and delays. He decided to reach out to the company’s higher management, expressing his concerns about the unresolved claim. Recognizing the potential for reputational damage, AquaSure Insurance prioritized Robert’s case, and he received a settlement that covered the repair costs.