does your insurance company have to pay you?

[bliss]

Re: does your insurance company have to pay you?

Well said.
Thank you and Merry Christmas!

 

[bliss]

Re: does your insurance company have to pay you?

K-haus you have a PM.

 

[freddyray21]

Re: does your insurance company have to pay you?

Well I've tried to stay out of these threads but too much misinformation is being bantered about..

I'm a insurance adjuster, have been for 26yrs. I work for a very large company that anyone with an IQ over 20 would recognize.

I have never met an adjuster who went into a claim with any intent of denying it. Denying a claim is a big "hassle" for the adjuster and adds to his workload tremendously.

A few "facts" about adjusters.

NO COMPANY pays bonuses to adjusters based upon their ability or success in denying claims, not one. What a PR nightmare that would be.

Our instructions from upper management are to pay any legitimate claimant every nickel he/she is owed and not one nickle more.

Certain very narrow issues of "negligence" can lead to a claim being denied. However this is very, very rare. In the case of the insured knowing a tree was a hazard and continuing to park something within it's range of falling IS one such case. Policies state this very clearly.

Thefts of big ticket items.... are always investigated before any payment is made. While true that most of these claims are in fact legitimate as many as 15% are not. That adds up to billions of dollars every year. That cost would have to be transferred to the company's other customers in increased premiums. People who are in financial difficulty, have criminal records or criminal associations are much more likely to commit this type of fraud. The pay now and investigate later thing is long over and for good reason... the money is almost never recovered.

Many big ticket item "thefts" are arranged.... and sometimes won't even be reported until the item is actually "missing" for a week or more giving the "thief" ample time to strip the item or ship it overseas.

Arson.... same as above. Homeowners or business people with debt problems are much more likely to commit these offenses.

Another poster mentioned the drunk driving thing... there is a clause in EVERY automobile policy that states there will be no payment made if the loss is caused by the insured committing a criminal act. They will pay for the damage you do someone else's property but not to your own.

The "bilge pump" thing.... likely more to that story than is being told. The adjuster may have talked to people at the marina who may have told him things that were contray to what the boat owner told him.... Or the owner himself may have told the adjuster something that led to the claim being denied. (see the post about the guy who told the adjuster he knew the tree was hollow.....).

I don't think I've denied more than a dozen claims in all these years and I've settled thousands upon thousands of claims. My life is much easier and less complicated when there's no reason to doubt the circumstances. Every adjuster I know feels the same way.

And as a side note only one of the few claims I ever denied was settled in the insured's favor. All contested the denials and a few of them ended up in jail before it was all over with.

Further, I know that a large percentage of insureds lie to me when I'm investigating their claim... claim they lost things that they never owned, or the TV that was burned to cinders was a $3,000.00 plasma when it wasn't... that the car that was stolen had a trunk full of christmas presents in it along with the reciepts (in sept...)...

If I don't feel I can prove they're lying I pay them. But I do put these doubts in my offical notes.... "footprint of the melted carcass where the TV was does not match claimant's statement".... etc. etc.

Those are the people that get "black listed".... gee I wonder why.

The vast majority of folks are honest and just want their claim settled fairly. Those folks get prompt and fair settlements.

I understand the guy not wanting to give his financial informatin to the insurance company... but is his attorney too stupid (or too greedy) not to realize that once suit is filed the clients records will be made available through court order????

The insured in this "boat theft" case is the one dragging this out. Even if his records show he's in financial difficulty that alone will not preclude his being paid... but imagine this... he is in financial difficulty and his records show an unexplainable large deposit around the time the boat goes missing???



I'll not get into any arguements with anyone over this... but the facts are usually much different when you have 2 sides of the story.

There is nothing here I disagree with you have actually given credence to my point that not all claims are paid. I agree the percentages are very small, but I was only refuting those whose think that all claims are paid if you make one.

 

[Tim Frank]

Re: does your insurance company have to pay you?

I do understand contract law. I also understand that there are exclusions that will not hold up in court. I also understand there are exclusions that will. My only argument here is that there are legitimate reasons where an insurance company can avoid paying. I am not saying that they will in the instance in the other thread. It was stated by some that the insurance company has to pay. I was only pointing out that is not true all the time. It is a simple case of logic.
If there is one instance in the world where a company has a legitimate hold up in court reason to not pay then the statement "they always have to pay" is false )[/(highlighted by responder not Freddy)

Some people just have little enough to do that picking fly poop out of the pepper is the highlight of their day.
This entire thread is just an "is not" ....."is too" bit of childishness over what is completely self evident to anyone with more than a room temperature IQ.

Yes Freddy, your insurance company does have to pay you......unless they have a reason not to, that will stand up if they get taken to court.

And it went on for Two + pages?

In the meantime, over in "that other thread" the same kind of well-meaning (I guess) but mostly inflammatory and ill-informed advice has turned what might have been a fairly straight forward insurance claim into what may be an ongoing disaster for the unfortunate victim.
When the blind lead the blind, they can all end up stepping in some nasty stuff.

 

[QC]

Re: does your insurance company have to pay you?

Take it easy guys . . .

 

[tashasdaddy]

Re: does your insurance company have to pay you?

this is going no where, just boxing.