Would you let an insurance company handle a claim?

Question

I am doing and can see corruption I'm sure.

1st answer, you mention another extreme.

2nd answer - but you don't need me to tell you that corruption exists. I'm wondering if others have experienced corruption there.

Answer 1

You don't say what sort of claim and you don't say whether you are refering to insured (i.e those the insurance company paid you - or those paid to a third party) or uninsured losses.(policy excess, injury, time of work etc)

There are two main principles that insurance companies have to watch out for and obey.

TCF: Treating Customers Fairly - this is the paramount concern of the FSA at the moment. Insurers/ Intermediaries must treat their customers fairly - in a claim for instance they must pay out when reasonable to do so and make fair offers to re-imburse insured losses. If they are pursuing a claim for uninsured losses on your behalf then they must be careful not to prioritise their claim over your claim - this brings me to:

Conflict Of Interest. Insurers/ brokers must ensure that there is no conflict of interest whenever possible between their actions on behalf of clients. Thus: If you are sold a worse policy because the broker makes more commission then that is a conflict of interest - if your insurance company also insures the third party then that is also a conflict of interest. Possible conflicts of interest have to be disclosed and evidence provided of how the conflict was resolved in the customers favour.

If you are unhappy about the claims settlement process, I suggest that you make a formal complaint through the complaints process all regulated companies must have, outlining your concerns.

Another typical problem is if the third party claims damages for something that they are not entitled - i.e. inflated claims. This would not be your insurer's fault - the difficulty is in proving that the claim is exagerated - bearing in mind it is often one person's word against another.

There are other possible problems and if you could provide more information I can tell you how they should be best resolved.

Answer 2

I'm assuming that you are discussing whether or not to let a public adjuster handle the claim.

I would recommend a public adjuster in a situation where the claim could get really complicated. If it's a straight up situation where you have all of your receipts, it's usually not that hard for you to handle it yourself. If you own a business and you had substantial losses, hiring the services of a public adjuster may be a good idea.

If you feel that you are not being treated fairly in how your claim is being handled, you should talk to your agent. They can actually do a lot to help you. If you really feel like you're getting the shaft, report it to your Department of Insurance.

Answer 3

yes, if you want to get paid.

The claims adjuster's job is to negotiate, investigate and settle claims as appropriate. They consider the facts of the loss, physical evidence, policy language/terms and case law if needed. It's your agents job to sell the policy, the underwriter's job to develop new products and determine what risks to accept and the claims adjuster's job to handle claims.

With out more information on your situation, I can't tell you any more.

Answer 4

That's their job. It's what you pay insurance premiums for. And what sort of "corruption" do you think you see? I am so sick of hearing how insurance companies try to screw people. As opposed to just going along with the propaganda you hear everyday, why don't you let the insurance company do its job and THEN decide whether they were fair or not?

Answer 5

As opposed to letting the kid down the street handle it?? Um, yes. The insurance company claims handler is at least licensed to adjust claims.

Answer 6

If I wanted my claim paid, then yes. They're the one's that handle claims for the policies they write.

Answer 7

This is a very basic part of there job