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Protecting Yourself When You Deal with Insurance Companies
by Ray Bourhis
Copyright © Nolo.com 1999
What to do now so that you won't have unpleasant surprises when you make
a claim.
Insurance companies go out of the way to advertise how fast, neighborly,
generous, kind understanding, patient and friendly they are--especially
when they are trying to sell you one of their policies. It continues to
be true for as long as you make your insurance premium payments on time,
without asking for anything in return. However, policyholders forced to
present a large claim often learn there are limits to insurer
congeniality.
Here are some survival tips which you may find useful in dealing with
your insurer about a homeowners, healthcare or commercial insurance
policy.
Before You Buy
Always take careful notes when you buy an insurance policy. Write down
what you are told by the insurance agent concerning the coverage you are
buying. Save your notes in a file with your policy. Also save any
promotional material you are given or shown when you buy the policy.
Insist on reading the completed application form yourself instead of
allowing the agent to read it to you. Be certain that your answers are
truthful, thorough and complete. If they're not, it could come back to
haunt you. The insurance company can rescind your policy entirely--after
you make a large claim--if it finds some basis for asserting that you
misrepresented a significant fact on the application.
Before you buy the policy, insist on seeing it. Make sure that you
really understand key points--things like deductibles, exclusions and
limitations.
When You Have a Claim
Now is the time to get out all those papers you saved so carefully.
Review your policy and notes before you speak with a company
representative. If you aren't prepared, you might say something that the
company could twist into a basis for denying the claim. That's a
possibility because the coverage, exclusion and limitation provisions
contained in all insurance policies are so complex.
But a few legal rules are on your side when it comes to deciphering a
policy. If a dispute over what should be covered goes to court, the
coverage provisions will be construed broadly, while the limitations and
exclusions will be interpreted narrowly. And because the company wrote
the policy, any ambiguities in it will be interpreted in your favor, and
against the company. The goal is to honor your reasonable expectations.
A Policyholder Should Never...
· Exaggerate any aspect
of a claim.
· Accept the insurance
company's expert's evaluations of your losses without getting your own
expert's estimates. The two can vary widely.
· Submit to an
"examination under oath" by the company without first obtaining legal
advice.
· Sign an insurance
company release or check unless you are certain that the amount you are
receiving is full and correct.
Article reprinted with permission from
www.nolo.com
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