What has been your experience with Insurance Claims?

Question

If you have ever had to make a claim, were you satisfied? Was the company helpful and reasonable, or did its performance leave something to be desired. Was a legitimate claim denied?

Answer 1

I worked as an adjuster, and saw first hand that many claims were denied for NO reason other than to stall and to delay payment.

Often it depended on who you were, what you are (Governor of Calif.? or a "nobody"), a stock holder with power, and for how much money, or if you had a hot-shot attorney or not.

Generally, you almost NEVER get what you think you should.
Generally you get less without an attorney and it takes longer.

Often, bigger claims drag on for months, and in some cases years. Some even have to go to COURT to be decided.

Good Luck--
=============================================

Answer 2

I also worked as a claims adj. I was an injury claims adj for a major insurance company. I have to say that my experience was the exact opposite of FL inventor. We never denied a claim unless we felt there was just cause - for example, a previously healthy person claiming permanent disability from a 2-mile per hour accident that caused no damage to either vehicle. There was no preferential treatment based on who you were or what attorney you had. We offered the same to person without an attorney as we would a person that had an attorney…well attorney might get a LITTLE more but not near enough to justify the 35% you pay them. Our supervisors were in our claims files all the time checking to see what could be done to move the claim forward and we were required to follow up on all files every 2-3 weeks.

In general I tried to make peoples claims experience as easy as possible. Some people just don’t get it. Claims take time. It can take 3 months to get records; there is nothing that can be done about that.

Answer 3

I smell a lawyer here pretenting to be a former adjuster. I have to seriously doubt the claim of a poster here that they have experience handling claims. The viewpoint that adjusters delay and deny just to get out of paying money is bull. Adjusters usually have too large of a case load to try to figure out how to delay claims. The saying 'a closed claim is a good claim' is industry standard.

As for the thought that getting an attorney speeds up the claim process, well the opposite is true. Attorneys send clients to many doctors, for multiple tests, and months and months of therapy. Many times when time and rest is the best healer. They then make outrageous settlement demands, knowing that it will take months of negotiations to get to a real number.

In general, how helpful your adjuster will be depends on how many claims they are working at that given time, and how nasty you are to them. Adjusters don't get an extra dime based on the amount of your settlement. If you are nice to them, they can help you with your claim. If you are mean to them, they can do the minimum required.

Answer 4

So far my claims' experience is very good. As I am an agent for a reputable insurance in the world.

Usually I will make sure all the documents are complete before I make any claims for my clients. This is very important because the claims department will based on the documents for processing.

Before making any claims, please fulfill the checklist provided by the insurers. With the checklist you can counter check what is missing.

Understanding what you have purchased, what are the coverage and exclusions are very important. These will set the right expectation from the beginnnig.

So far so good for me.

Answer 5

I've never had any real problems.
Occasionally, I have run into an idiot. You just have to know how to get around that idiot.
I too, worked as an adjustor, and many times I would have to ask for more info, and unfortunately, people would think we were trying to get out of paying the claim, when all we're tying to do is determine what is being claimed..

Answer 6

They are happy to take your money faster than you can snap your fingers. But making a claim is like pulling teeth.