Tips on navigating the insurance claim process

he Pennsylvania Department of Insurance recently issued the tips below to help policyholders there navigate the claims process:

  • Contact your insurance company immediately and follow the instructions given to you by claims personnel. Keep a log of the people you spoke with and ask questions if you do not understand instructions.
  • Separate damaged and undamaged property for the adjuster to examine. Do not throw away damaged property until your company’s adjuster advises you it is all right to do so.
  • Wait for the adjuster to arrive! Do not call anyone to repair or replace your loss without first getting instructions from your adjuster.
  • If your home is damaged, make only temporary repairs until a claims adjuster looks at the damage. Permanent repairs could trigger a denial of your claim.
  • Be careful when choosing a contractor to make repairs. Before signing a contract, check references to make sure you are working with a reputable firm.

Overall, these are good tips.

For Louisiana policy holders, though, I disagree with the advice about only making temporary repairs before the adjuster visits your property and following the adjuster’s instructions for making permanent repairs. The truth is that the law allows you to make permanent repairs prior to the adjustment and still be reimbursed — so long as you properly document the damages. Under La. R.S. 22:1892 and La. R.S. 22:1973, property insurance carriers are required to make a written offer to pay your claim within 30 or 60 days of receiving “satisfactory proof of loss” or else have to pay the policyholder penalties and costs, in addition to paying the insurance claim itself. (The pertinent parts of the statutes are quoted below.) Also, Louisiana Supreme Court case precedents have made clear that satisfactory proof of loss does not require any formal type of proof. Proof of loss merely has to be “sufficient to fully apprise the insurer of the insured’s claims.” See, for example, Louisiana Bag Company v. Audobon Indmenity Company, 999 So. 2d 1104 (La., 2008). This means that clear color pictures of the damages and repair receipts constitute satisfactory proof of loss, and so your property insurance carrier should reimburse you without delay.

I represent policyholders in South Louisiana, North Louisiana, and Central Louisiana. I also represent policyholders nationwide through association with local counsel. If you need assistance with your claim, feel free to contact me for a complimentary case consultation.

La R.S. 22:1892: “All insurers shall make a written offer to settle any property damage claim, including a third-party claim, within thirty days after receipt of satisfactory proofs of loss of that claim.”

La. R.S. 22:1973: “B.  Any one of the following acts, if knowingly committed or performed by an insurer, constitutes a breach of the insurer’s duties imposed in Subsection A of this Section:// (5) Failing to pay the amount of any claim due any person insured by the contract within sixty days after receipt of satisfactory proof of loss from the claimant when such failure is arbitrary, capricious, or without probable cause.”