Making the Claims Process Easier

Homeowners Insurance

Drawing of a House

Published by:
The Maine Bureau of Insurance
34 State House Station
Augusta ME 04333
207-624-8475
800-300-5000 (in Maine only)

The insurance claims process can sometimes be confusing and overwhelming under the best of circumstances. Understanding how to properly file a claim will help ensure that your claim can be handled in a timely fashion and that you will receive all the compensation due to you under the policy. The Maine Bureau of Insurance offers these recommendations to make the process as smooth as possible:

Know your policy. Before a loss ever occurs, be familiar with your policy and understand what it says. The policy is a contract between you and your insurance company. Know what is covered, and be aware of policy deductibles and what is not covered.

File claims as soon as possible. Notify the company’s claim hot line or your agent as soon as you are able after a loss has occurred. Generally, policies require you to give prompt notice of a loss.

Provide complete and correct information. Giving incorrect or incomplete information will only delay the processing of your claim. Be sure to give your insurance company all the information it needs.

Document your claim interactions. Whenever you communicate with your insurance company, keep a copy of all records and correspondence. Keep a log of your telephone calls and in-person contacts, including the date of the conversation, the name and title of the other person, and a summary of the discussion. Also keep a record of your time and expenses.

Take steps to protect property. Make temporary repairs to protect property from further damage. Homeowners policies generally will cover the cost of temporary repairs; keep a record of their cost. Permanent repairs must wait until the insurance adjuster has had a chance to inspect the damage, or the claim may be denied. If possible, take photos or videos of the damage before making any repairs.

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Document your loss. If you have damage to personal property, such as household contents, make a list of the damaged items. Making and maintaining a household inventory that is stored safely off premises before a loss occurs greatly simplifies this part of the process. Otherwise, you may have to rely on memory to list and describe your belongings. The company will need brand names and model numbers of appliances, electronic equipment, and tools, as well as when and where each item was purchased and its approximate cost.

Don’t forget seasonal clothing, sports equipment, and holiday decorations in addition to your everyday items. The more information you can provide, the faster your claim can be settled, generally.

Do not dispose of damaged items. The adjuster will want to see the damaged property first. Make sure the company no longer needs to review the property before you dispose of it.

Keep receipts. Even if you purchased Replacement Cost (RC) coverage, your policy will initially pay on an Actual Cash Value (ACV) basis, with depreciation applied. This means you receive the amount your property was worth when it was damaged, not what it costs to replace it with new property. With RC coverage, you can be reimbursed for the additional amount expended to repair or replace the property, after the repair or replacement is completed. Receipts and other documentation will be needed to verify the additional amount.

Document your living expenses. When your home is unlivable due to a covered loss, most homeowners and renters policies will cover your Additional Living Expenses (ALE). This requires you to document your normal household living expenses (mortgage/rent, utilities, heat, groceries, etc.) as well as the additional expenses resulting from the loss (hotel/rent, food, increased transportation expenses, etc.). Generally, the coverage is for the amount that exceeds your normal living expenses.

Ask questions. If there is a disagreement about the claim settlement, ask the company for the specific policy language that is in question. Determine if the disagreement is due to different policy interpretation, the scope of repair or the cost of repair. Cost of repair differences can be addressed by invoking the appraisal option of the policy. Scope of repair issues may be addressed by having your contractor meet with the adjuster to discuss the damages that are covered by the policy. In some cases, there may be some damage that is not covered by the policy or there may be a disagreement about the method of repair. If the disagreement is related to policy interpretation that results in a claim denial, make sure you obtain a written letter explaining the reason for the denial and the specific policy language under which the claim is being denied.

Appraisal provision. If you are unable to reach agreement on the amount of the loss, you may invoke the appraisal clause of your policy. Each party is responsible for the cost of its appraiser, and the parties share the cost of an umpire to make a final decision if the two appraisers are unable to agree on the amount.

Contact the Bureau of Insurance. If you have a dispute about the terms of the claim settlement or there is a claim denial, the Bureau of Insurance may be able to assist you.

The Bureau of Insurance, within the Department of Professional and Financial Regulation, regulates the insurance industry for solvency and consumer protection. It does so through its examining and licensing procedures of insurance companies, by licensing producers, by reviewing rates and coverage forms, conducting audits, and by sponsoring programs that enhance awareness of and compliance with State laws. The Bureau has statutory authority to enforce the State’s laws and rules pertaining to insurance, and it initiates investigations and holds hearings concerning possible infractions of them.

Visit the Bureau’s Website at:
www.maine.gov/insurance

September 2008

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