How Insurance Claims WorkDon't make costly mistakes. Understand how insurance claims work.
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“Understanding How Property Insurance Claims Work”
A catastrophic loss to your commercial property or home will create an unfamiliar environment and will immediately create excessive demands on your time.
Important decisions involving thousands and sometimes millions of dollars must be made and often made quickly and with little margin for error. Decisions like this must be made early in the insurance claims process, specifically whether you should take advantage of the professional expertise of a public insurance adjuster.
Time and again it has been demonstrated that when dealing in an area that is unfamiliar, the end result can be a loss in valuable time and money.
Large or small, commercial or residential… properly handling a claim involves a structured process that when followed, will ensure your claim is processed properly. We hope the following explanation will help you understand the process used by Abba Claims Consultants licensed public insurance adjusters and what to expect when dealing with a property damage insurance claim.
Step1: Initial Contact – Whether you contact us via phone (888)908-2042, email, or our free Claims Evaluation Form, we will respond to you as quickly as possible.
The more information you can provide us the better we can answer your questions and concerns. Upon review of your information we will call you to answer any additional questions and then schedule a meeting to inspect your damage.
The more information you can provide us the better we can answer your questions and concerns. Upon review of your information we will call you to answer any additional questions and then schedule a meeting to inspect your damage. For the initial inspection we should schedule a time when you can be present. During the meeting we will review your insurance policy to understand the coverage’s we have to work with. It’s of critical importance to have a plan in place based on the loss and the coverages. As an example: Are there enough limits available to hire a restoration company or are items and building components damaged to the extent that paying for the loss will use up your policy limits? There are a number of decisions that need to be made following a loss. These decisions will have a big impact on the outcome of your claim and your recovery. Our initial contact and the steps we recommend based on the facts of your loss and your policy coverage are going to be vital and critical to your recovery.
After the initial consultation, we hope you will realize the value of having a professional on your side. In order for us to be your representative and file your claim, you must appoint Abba Claims Consultants as your public adjuster. We will ask you to sign an authorization form allowing us to notify the insurance company. Our professional fee structure will be worked out with you based on your needs and coverages and is generally based upon what we are able to negotiate for you. That means that we are highly motivated to do all we can to make sure you are fairly compensated in your insurance settlements with consideration to your coverage and insurance policy limits. Typically, fees run 10%. One of the things we pride ourselves on is making sure fees and related expenses are understood upfront so there are no surprises.
Step 2: Investigation – Once we become your authorized public adjuster, the first step is the analysis of your policy provisions and stipulations as they relate to your loss. This in-depth review is used to determine the coverage, limits, exclusions, and other forms that may apply to your particular loss. In investigating and planning for the loss and damages documentation and presentation, an understanding of recent court cases, decisions from the Insurance Commissioner’s office, industry technical articles and opinions, and other factors that are likely to influence your standard insurance policy are all used to map a claims strategy. In many cases we have found the printed policy forms are contradictory to current practices and procedures of insurance adjusting in your area. Keep in mind that your insurance policy is a contract. While we do not dispense legal advice, given the nature of insurance disputes, we have seen instances where over the year’s court rulings may have an effect on the practice and procedures of adjusting property claims in your state. Thus what’s in a standard generic insurance policy may not be what the law of the land is where the loss occurred. We pride ourselves on staying current and in compliance with all issues that effect our profession through updated and current continuing education requirements required by the State regulators where we hold our professional licenses.
Step 3: Documentation of the Claim – As the insured, you are required under the insurance policy to conform to the “Your Duties After A Loss” provision contained in your policy. This can be an involved and detailed process requiring time and expense to meet the requirements. As your claim representative, your Abba Claims Consultants public adjuster will create an exact profile of your property so it reflects its true value and conforms to your insurance policy language. This in-depth process includes:
1. detailed construction estimates with supporting engineering documents if necessary.
2. detailed and verified inventory and contents schedules with correct valuation and supporting documentation.
3. in-depth business interruption coverage analysis which includes projections and forecasts.
4. the required technical and supporting documentation showing the current industry publications and authoritative papers supporting positions taken in the claim adjustment process.
Step 4: Presentation of the Claim – After the full extent of the loss has been determined and documented a schedule of losses is prepared and undergoes a complete review by our staff. The claim is then segregated into the separate categories which conform to the various policy provisions that apply. A thorough review of the documents is made with the client and, with final approval the property insurance claim is submitted to the insurance carrier.
Step 5: Negotiations and Settlement – Upon approval and submission, we initiate claims status follow-up on the insured’s behalf to expedite the processing of the claim. We also make ourselves available to answer any claim clarification requests posed by the insurance company which sometimes uses these as delay tactics. It is typical that there may be some negotiations regarding the claim, which many times boils down to justifying the value and legitimacy of the claim components. A well-defined position that is professionally documented should gain the respect of the insurance company representative. In addition Abba Claims Consultants expertise and qualifications in fielding any questions should lead to a fair settlement of your claim. It should be noted that no claim is settled without prior approval from the client who will be kept abreast of all negotiations as they proceed. We are also mindful of the negative financial impact of a loss to your property and we pledge to work diligently in resolving your claim in a timely manner. Our experience has been that perhaps one part of your claim can be settled faster than others and if this can be done we will certainly work to get you paid without jeopardizing the other parts of the claim.
Having a professional public adjuster on your side is extremely valuable and key to the success of your claim. Your insurance carrier has their representatives and adjusters working for them. Shouldn’t you?
Remember: NO RECOVERY, NO FEE. You have NOTHING to lose!
TEXAS PUBLIC ADJUSTER
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