What if your Insurance Company won't confirm coverage?

 
Insurance Claim Coverage

When you experience damage to your home, you want it to be properly mitigated and repaired as quickly as possible. Perhaps even more important however – you want to make sure that your insurance company is paying for it!

And that can cause a bit of frustration, as insurance companies can sometimes drag their feet when confirming coverage or outlining what specific coverages are applicable to your claim.

This can create significant delays and a tremendous amount of unease and confusion for homeowners & business owners, and we don’t blame you. So what happens when your insurance company doesn’t confirm coverage and what are your options and responsibilities? Let’s take a look.

You are obligated to mitigate timely

Your insurance company will likely stress that you’re obligated under your policy to act as quickly as possible to address the damage that occurred. This is important, as further damage may be your responsibility and will continue to worsen over time. For this reason, emergency work, such as Water Damage Mitigation and boardup services are regularly approved and performed without an estimate being prepared beforehand.

However, we completely understand your concern if you want to confirm coverage first. It’s perfectly reasonable for a homeowner to not feel comfortable writing a blank check not knowing if their insurance company will ultimately pay for the work being performed. While we often can contact the insurance company to verify coverage and receive approval for the emergency service work, sometimes the insurance company is unable to do so right away.

Your Insurance Company SHOULD confirm coverage quickly

When you experience an Insurance Claim, your insurance company’s primary job is to confirm coverage and pay for the work being performed. Most insurance companies and insurance adjusters strive to do just that and fully understand your hesitation to proceed with costly work without first knowing that the work is covered by your insurance policy.

Once coverage is confirmed the work should be able to progress without the fear of an unexpected out-of-pocket cost. Qualified mitigation and restoration contractors will be able to work with your insurance company to seek the necessary approvals and provide any required documentation in order to facilitate the process.

What if your Insurance Company doesn't confirm coverage?

While uncommon, sometimes things fall through the cracks and the insurance company fails to make a timely coverage determination. In other cases, they may require an inspection by a field adjuster before coverage can be confirmed.

It’s important to understand however that, regardless of their inability to confirm coverage, your insurance company will expect you to proceed with the mitigation services in the meantime and without knowing if the work is covered. This can be a scary thought for a homeowner or business owner and that’s completely understandable. As a result, we strongly recommend actively following up with your insurance adjuster for a coverage decision.

What can you do if your Insurance Company isn't making a coverage determination?

If you don’t feel like you’re getting anywhere with your insurance company and your mitigation company has been unable to confirm coverage with the insurance company, there are a few steps you can take.

1) Contact your local insurance agent to see if they can help.

2) Escalate your concerns to your adjuster’s supervisor.

3) Request assistance from your state’s Department of Insurance.

4) Hire a Public Adjuster to represent you.

We hope this information was helpful in answering some common concerns about insurance coverage. If we can ever be of any assistance, please do not hesitate to Contact Our Offices.

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