The Moon Law Firm

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Insurance Claim Basics: What to Do Now?

First off, I want to start this blog post by expressing how sorry I am to those of you who lost something or everything due to Hurricane Harvey. My thoughts and prayers are with you and your family. I am writing these articles because this is the best way I know to use my abilities to help people.

Water damage to your home can be expensive and time-consuming to repair. Homeowners insurance policies don't cover floods and might not cover other types of water damage. In order to have flood coverage, you must have separate flood insurance as home owner’s policies do not cover flood damage.

Homeowner’s policies may offer coverage for things like:

  • sewer or drain backup;
  • sudden and accidental water damage from a plumbing, heating, or air conditioning system; and
  • mold remediation.

It is very important that you read your policies to know what kind of coverage and dollar limits are in your policy. If you are having a hard time understanding your policy or need someone to help you read through it to determine what you are and are not covered for, call us at 713-999-9398.

What to do after the damage

It's important to stop any type of water flow or leak as soon as possible. Remove pools of water and start drying the area to prevent additional damage. Move wet items to a dry room or area with lots of fresh air. Pull up wet carpeting and rugs as soon as possible. If you move items outside, put them in a secure area to protect them from theft. If it is possible and safe to run fans in your residence, do so. It will help with airing out your home.

If you can't remove the water and dry the area quickly, consider using a service that specializes in cleaning up after water damage. Keep receipts from anything and everything associated with the clean up and give them to your insurance company. The insurance company might pay you back.

Also, take lots of pictures during the clean up process. Pictures are worth a thousand words and most of us have high quality digital cameras in our smartphones. Make sure to back up the photos to something like the app Google Photos so you will still have them even if your phone is destroyed.

Filing Your Claim

Even if you are unable to get into your home, try to notify your insurance company as soon as you can. There will be a number on your policy that you can call. If you don’t have your policy, try googling the name of the company and there should be a number that you can call and they will route you to the proper people to speak with. Most companies require you to tell them in writing, so follow up with a written notice with information about what happened.

The following tips can help the claims process go more smoothly:

  1. Review your policy, if you can. Make sure you understand the policy limits (dollar values for coverage) and what your policy does and does not cover. Keep in mind that Home Owner’s Policies typically don’t cover flood insurance, but they may provide other coverage that would be helpful to you. If you are having a hard time understanding your policy or need someone to help you read through it to determine what you are and are not covered for, call us at 713-999-9398.
  2. Have your policy number ready when you call your company, if possible. Be prepared to answer questions about the damage.
  3. Take pictures or video the damaged area and property before you make repairs. This is especially important if you make repairs before your insurance adjuster has seen the damage.
  4. Try not to throw away anything you removed from the house until your insurance adjuster has seen it.
  5. Make reasonable repairs to protect your home and property from more damage, but don't make structural or permanent repairs until your company says it's OK.
  6. Write down everything you spend on repairs and keep the receipts.
  7. Keep a log that lists everyone you spoke with at your insurance company. Note the time, date, name of the person, and what you talked about. Follow up with the company in writing to confirm important details. Keep copies of letters or other documents you and your company send each other. These notes and details could be critically important in the event that you need to file a suit against your carrier.

Claims Process

After you file the claim, you should hear from the insurance company within a few days. The insurance company will tell you about its claims process and any responsibilities you have. The company should give you the name of the person who will be working on your claim.

The company must start investigating your claim within 15 days after receiving written notice and may ask you for more information. If you need help sending this written notice, please call us at 713-999-9398.

Once you send the information, the company has 15 business days to accept or reject your claim. If the company says it will pay your claim, it must pay within five business days. If the company rejects your claim, it must explain its reasons for rejecting in writing. If the insurance company fails to follow these basic guidelines, call us at 713-999-9398.

As part of the process, the company will send someone called an adjuster to your house to look at the damage. It might be a while if there was a disaster and the area isn't deemed safe. If it is possible, try to be at your residence when the adjuster is there to show damage and ask questions. There are seveal types of adjusters:

  • Company adjusters are full-time employees of the insurance company.
  • Independent adjusters are independent contractors who provide claims services to insurance companies. They usually charge the insurance company a fee for each claim they handle.
  • Public insurance adjusters are independent adjusters who help people negotiate claims with their insurance companies. Public adjusters work for you, not the insurance company. They charge you a fee for their services. The fee is usually a percentage of the claim and is subtracted from any settlement you get from your company. You don't have to hire a public adjuster.

The company will tell you in writing if your policy covers the damage and will give you an initial damage estimate. Keep in mind that the estimate may change. The company might provide you with a list of contractors, but you don't have to use someone from the list.

Additionally, it might be in your best interest to hire a public adjuster who will help you negotiate with the insurance company. However, they also receive a portion of your claim, so be cautious about hiring a public adjuster.

Claim Payment

Your insurance company has five business days to send you a check after it says it will pay your claim. If you don't get your check within five business days, call your agent or company. If you think that the company is delaying payment on purpose, call us at 713-999-9398.

There are two types of coverage available:

  • Replacement cost is what you would pay to rebuild or repair your home, based on current construction costs. Replacement cost is different from market value and does not include the value of your land.
  • Actual cash value is what you would pay to rebuild or replace your property minus depreciation. Depreciation is a decrease in value due to wear and tear or age. If your home is destroyed and you only have actual cash value coverage, you might not be able to completely rebuild.

The insurance company will pay to repair your home with materials of like kind and quality to the original. If you choose to upgrade the quality of a damaged item, you will have to pay the extra costs yourself.

If you have a replacement cost policy, most companies pay claims with two checks. The first check  comes after the adjuster has reviewed your damage. This check will be for the estimated cost of repairs, minus depreciation and your deductible. A deductible is the amount of the claim that you're responsible for paying yourself.

The company will give you a second check for the balance of your claim after it receives the contractor's bill for the finished job. You must complete repairs or replace your property within a certain number of days from the date of loss. Make sure you keep all receipts, bills, invoices, estimates, correspondence and your own notes as they may be critically important.

ALE: Where Are You Going To Live In The Meantime?

Your insurance company might pay your additional living expenses (ALE) if you have to move from your home while repairs are made. ALE includes temporary housing, food, and other essentials.

If your policy covers ALE, you might be able to get an advance payment to help you move. Most policies pay up to 10 to 20 percent of the amount of the dwelling coverage on your house for ALE.

Your insurance company will only pay for additional living expenses up to your policy's ALE dollar limits. Because repairs on your home can sometimes take months, monitor your expenses carefully to make sure you have enough ALE to cover the entire time you’ll be out of your home. If you reach your policy's ALE dollar limits before your home is fully repaired, you’ll have to pay the rest of the expenses out of your own pocket.

Closing

As I said, I sincerely hope this helps. Going through a flood of this magnitude is beyond stressful. I am willing to help you through the process in any way I can. Just know that stuff is just stuff, it can be replaced. Making sure that you and yours are safe and protected is the most important thing. Hopefully, your insurance company steps up and helps you through this stressful time, if not, know that I am a phone call away and more than willing to help you out.