Insurance claim help. What's the law?

[myconn2001]

Ok here it is... I am wondering if I need to get an attorney for this or if I should wait this out? I had a rental home in Nevada. I was going through problems with my old roomates and decided to move out after they all left me high and dry. That being said I felt it best to insure my items in case something happened while I was away from the home because the roomates were being disagreeable of what was mine/theirs. I bought the policy. When I returned home the next day the back screens were off and garage door was broken and ALL EVERYTHING was gone. Even the house appliances. It was so crazy. I called the police of course and also I filed my claim. Of course the insurance company raised questions as to why I bought the claim and filed the next day and I agreed it looks bad or fake or whatever but the fact is it happened. I said do whatever you need to investigate it go ahead. They assigned a special guy and he determined it was a valid claim. I kept check with them as to the status and it was always in some sort of que waiting for finalization. FINALLY 2 months later it was ready to be settled ect. Well I call today and the represenative that was finalizing it said it should be reviewed again by the special investigations team because she thought it to be odd the claim was filed the day after purchase. I'm so frustrated cause we already went through this!! Before it ever got to her for settlement it went through SI... SO she said well they should review it again. The SI guy has even said it already was reviewed by him. So to me it seems as this is just more delay? To ask a question now of fraud after we already handled that seems like why are we this far and why ask the same question again? WHAT do I do? Wait for them to go through this again which will be another 2 months? i can't do that I am still without any stuff1 Or do I hire a lawyer? What's the best way in dealing with this company? PLEASE help thanks a million

 

[ecmst12]

You need to be patient while they complete their investigation. The pushier you are, the more suspicious you will look.

 

[jj728]

Insurance Claims Help

Hi myconn2001:

Sorry to hear about your troubles.

I am an insurance adjuster with about 27-years claims experience. As you know, filing an insurance claim the-day-after you purchased a policy is extremely suspicious. So, don't be surprised your claim is being scrutinized so closely. This is normal handling, under the circumstances you've described.

In fact, you should have received a certified letter from your insurance carrier, called a Reservations of Rights Letter, about this loss. The RofR letter usually informs you that your ins. co. will undertake all actions to handle your loss; however, reserves the right to later deny your claim if a basis for denial is found during their investigation. The purpose of the RofR letter is so an insured party will not be misled by the investigation/handling of your claim, which may falsely lead them to believe the loss will be paid. (If you didn't receive such a letter, your insurance company may have waived its rights to deny your loss; but this is a question for the insurance laws in your state). I'm located in FL.

It appears you have cooperated with your insurance company in their investigation (if you haven't, make sure you do from this point forward).

Two months appears to be enough time for your ins. co. to complete its investigation and make a coverage decision. If your claim is denied, the basis will probably be that you purchased your policy after the loss occurred. And of course, your ins. co. must come-up with proof to support their conclusion about the date of loss.

At this point, I recommend doing the following:

1. Speak with the adjuster who is handling your claim and advise that you feel the company has had enough time to complete its investigation and make a decision about settling the claim. If the adjuster puts you off again, ask to speak with his supervisor.

2. In speaking with the Supv., make your case by letting him know that you've waited 2-months for them to investigate; you've cooperated with them during their investigation; you're being highly inconvenienced by the delay; and they must either deny or settle your claim immeidately.

If the Supv. is non-commital, advise him you are filing a complaint with the Dept. of Insurance in the State of Navada asking them to look into the handling of your loss. (This is a royal pain in the butte for insurance companies, because the Dept. of Ins. will usually send a written status request to the ins. co., which must be replied to in writing by a specified date. This puts the ins. co. under pressure to make a decision or subject itself to penalties or fines). If your insurance co. has not uncovered a valid, supportable basis for denying your claim, they will be under pressure to settle your loss right away.

If a complaint with the Dept. of Ins. doesn't work, get an attorney to represent you for your property loss and seek punative damages, in addition to, your property loss.

If I were in your position, this is the course of action I would take. Hopefully, it will work for you so you can get this matter behind you.

Good Luck!