When your insurance claim doesn't go as planned
If you’re researching how to file a complaint against an insurance company, you’re probably not happy with the service you’ve received from your insurance provider. Since each state has specific rules regarding how insurance companies operate, you should take time to investigate the laws and see if you have the grounds to make a complaint. Usually, there are many routes you can take to resolve issues you have with your insurance company. First, of course, you can always reach out to them to try and resolve the problems on your own, but if they don’t budge, you might want to look into filing a formal complaint.
When Would Someone Consider Making a Complaint Against an Insurance Company?
In the majority of cases, insurance companies can be helpful in times of crisis. However, sometimes the service they give isn’t sufficient for the needs of their customers. Some reasons complaints are filed against insurance companies are:
– The payout received from the insurance company is too low, and they refuse to reconsider or offer a good reason behind it.
– The insurance company takes excessively long to settle your claim, respond to your queries, or refuse to engage with you.
– Your claim has been denied outright with no warranted reason.
– The insurance company has sabotaged your claim or lost substantial evidence, which affects the amount paid out.
Despite these sounding like rare occurrences, they occur daily across the country, and insurance companies sometimes act in bad faith when it comes to their customers. It’s essential to know your rights as a policyholder, as many often accept decisions made by insurance companies as they feel that there is nothing they can do. In addition, many consumers are unaware that an insurance commission oversees insurance companies on a state basis.
What is an Insurance Commissioner?
In the United States, each state has a designated insurance commissioner. They are a public official who is responsible for regulating insurance companies in that state. If there is an issue with the insurance industry or companies misbehaving, it’s the commissioner’s job to investigate, and if there is an issue, they resolve it. As a policyholder, you have a right to make a complaint to the commissioner.
As their job is to enforce the law, they’ll take a close look at the insurance company’s conduct and see if they’ve broken any laws. The benefit of this is that they can hear your complaint and take action where necessary, making them a one-stop-shop for insurance complaints.
For example, many states require that insurance companies respond within a reasonable time. Thus, if these rules are broken, the insurance commissioner will help you get through to the insurance company and take steps to ensure that this doesn’t happen to other consumers. They can do this by penalizing the insurance companies and making them pay claims or taking other actions to adequately resolve a policyholder’s complaint.
Examples of Complaints an Insurance Commissioner can Handle
– How an insurance policy was advertised or presented to consumers
– If an insurance company dealt with claims or policyholder’s improperly
– Any disputes between the insurance company and the policyholders. This includes matters concerning complaints and how they were handled, denied, or resolved.
If any of these sound familiar, you might want to file a complaint. Once you’re ready, almost all states have an online system to file complaints. A Google search for your state’s insurance commissioner will be enough to point you in the right direction.
How to Prepare a Complaint Against an Insurance Company
When filing a complaint, it’s best to be organized and have all your evidence gathered, ordered, and in writing to show the insurance commissioner. It’s helpful to take these steps from the outset of your claim as it can help avoid the need to file a complaint.
Firstly, ensure that you keep all communications between you and your insurance company. This includes emails that you’ve sent and any responses (or lack thereof). Once you have a record of these attempts at contact, it will be harder for an insurance company to deny that they didn’t receive any emails from you. Next, screenshot the time and date and save them in a designated folder in case you lose access to your emails. If you receive or send any letters, make sure to take photos and add them to your file to ensure you’re not searching for them later. It would help to name the files with the date and time for easy organization. Once you gather your evidence, you can print off all the documents in one easy go.
If you have any records of phone conversations with adjusters at the insurance company, this will also help establish your case. This can be your phone bill statement or through call logs on your phone.
Be sure to include any photographs or videos of the damage, so anyone reading the complaint has a more accurate representation of the damage. The more information you include in your complaint, the more likely you will succeed, so attach everything.
Next, if the insurance company isn’t engaging with you sufficiently, it’s a good idea to ask to speak to a person in charge. This might be management or a complaints resolution team. Always request a report number if they have one to help keep track of your complaint. Asking for agent names will also help keep a log of the interaction you’ve had with the insurance company.
What Happens After Filing the Complaint?
After collecting your evidence and filing a complaint online with the insurance commissioner, you might be wondering what the next steps are. Simply put, the insurance commissioner’s office may contact you and ask for more information about your complaint. They might also require more evidence and confirm some of the information you’ve sent. Once that’s done, the commissioner will reach out to the insurance company to gather more information. Your insurance company is required to respond to the commissioner within a set amount of time.
The insurance company is required to set out their reasons, justifying their actions that caused the complaint. If their answer isn’t good enough, then a designated person from the commissioner’s office will take over the case, who will help you resolve the complaint. However, if the insurance company has a valid reason for refusing your complaint, then your complaint may be dismissed.
Hiring a Public Adjuster to Manage Your Complaint
You might consider hiring a public adjuster to help with your claim. They are a wealth of information and can help you with your claim, file a complaint, and guide you through the entire process. Since they don’t work for an insurance company, they will be working with your best interests in mind. Crestview Public Adjusters have managed millions of dollars worth of complaints in the Tri-State Area. Contact us today to learn more about your options.
The Crestview Advantage
Crestview Public Adjusters has millions of dollars worth of experience in managing insurance claims. Crestview has seen it all and knows how to manage the claims, whether it was a loss due to fire, frozen pipes, or cyber damage. Do you have a claim that you think the insurance company should be paying for? Call today for a free consultation.
