If you were one of the many Massachusetts residents whose home was recently hit hard by water damage, you might soon find yourself drowning in paperwork. Even if you have a great insurance agent to help you with the claims process, you still need to be legally savvy. And that starts with pulling out your homeowners and/or flood insurance policies and reading the fine print.
While it would be great to think that your insurance company is going to respond to your claim by agreeing to pay for everything you ask for, it probably isn’t going to be that simple. Take a careful look at whatever insurance contracts you have and read them over carefully. You need to try and identify what is covered by each policy and what isn’t. The more you know about your coverage before you call your agent or insurance company to report a loss, the better off you are. Under the National Flood Insurance Program you have 60 days to file a Proof of Loss.
When you call to file your claim, ask when you can expect an adjuster to come out to your house to evaluate things. The more prepared you are for the adjuster’s visit to your home, the smoother the claims process will go. If an adjuster hasn’t been assigned to you within several days of filing your claim, call back! Getting ready for the adjuster is also critical to your claim. Separate damaged items from undamaged items. If local officials require you to dispose of certain items, keep a swatch or other sample for the adjuster. Otherwise, keep all damaged property until after your claims adjuster says it’s okay to get rid of it. Take photos of any water in the house and damaged personal property.
The adjuster is going to need evidence of the damage and the damaged items to prepare a detailed repair estimate. Make a list of all the damaged and lost items including their age and approximate value. If you have receipts, be sure to provide copies. Think of yourself as an attorney pulling together the “evidence” you’ll need to “prove your case” regarding why and how much your insurance company should pay you for your losses. You should do whatever it reasonably takes to protect your home from further loss or damage, including repairs. Just remember to take some “before” pictures, make a detailed record of what you did, and keep receipts for everything you bought. You also can ask the adjuster for an advance or partial payment on the claim.
If you don’t agree with the adjuster’s estimate, ask your adjuster explain how he or she came up with their figure. If they deny coverage, ask them to point out the part of policy that applies to their decision. In other words, ask questions – lots of questions. And if you aren’t satisfied with the adjuster’s answers, get the contact information for your adjuster’s supervisor. If you still aren’t in agreement after speaking with the adjuster’s supervisor, see if your insurance agent or insurance company representative can help.
If after following the above, you feel the amount offered by your homeowner’s insurance company isn’t fair, you can demand an appraisal under the terms of your homeowner’s policy. If coverage is being denied outright and you think what you are claiming should be covered under your contract, you can file a complaint with your state’s Division of Insurance, file a claim in small claims court, or hire an attorney to represent you.
In the case of a claim under your flood insurance policy, if you have unsuccessfully tried to resolve your issues with your adjuster, his/her supervisor, and the insurance agency or company, you can send an appeal letter to the Federal Emergency Management Agency (FEMA). There are very specific things you need to include in your appeal letter in order for it to be considered so be careful and be detailed. For example, you’ll need to list the dates and contact details for each person with the insurance company that you’ve spoken to about your claim. You also need to send FEMA copies (not originals) of all contractor estimates and supporting photographs, other relevant photographs to support your claim, and a detailed list of the damaged property and the value of individual items.
If you discover additional property damage after you file your claim with the insurance company, you should contact your insurance agent or company right away so that you can file the necessary Supplemental Claim forms. Remember, that while there are a number of consumer agencies and government agencies out there to help homeowners wade through the insurance claims process, you need to be a strong self-advocate. And that starts with understanding your legal rights under your insurance contracts, and if necessary challenging your insurance company’s decision.