Saturday, August 27, 2011

A Claim Delayed can become a Case Denied

The longer your "claim" is delayed, the better the odds that it will most likely be Denied.  Most, not all Insurance Companies train their adjusters to first look to verify coverage.  Then they are to look for possible "exclusions" or potential reasons to deny the claim.
While there are numorous reasons for the insurance companies to look first to deny the claim, you also have to understand the volume of claims they receive.  As with any business you need to filter out what you can so you can use your limited resources on those things that need your attention.  However, if the insurance companies would hire more adjusters and limit the number of claims each one handles, I'm sure the adjusters would be looking to find or provide coverage versus trying to deny.
My suggestion would be if you are going to file a claim, you need to read your insurance policy first.  This means that you should actually read the policy well before you need to.  You need to remember that the adjusters are trained to read the policies and you are not.  Make sure you know or at least have a good idea of what the insurance company will do when you present your claim.  If you are not surprised by their decision, you have done your homework.  Yes you need to report your claim timely, but you also need to read your policy and understand your coverage and exclusions.

Jeff

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