Jonathan Cooper is an attorney in private practice in New York. He represents small businesses and individuals in the trial and appellate courts.
In the wake of several tragic events, including the September 11 attacks and Hurricane Katrina, the insurance industry has been crying about their unfair burden in having to pay on all these claims. The truth is, however, that despite accepting and investing their insureds' premiums for years before, the insurance industry continues to seek any and all means to avoid paying on these claims. Unfortunately, it appears that the insurance industry's negative response to legitimate claims is not limited to tragic events, where the company is faced with claims that it may not be able to afford. Since I empathize with those people whose legitimate claims were and are denied, I have compiled the following list to help negate some of the most prevalent bases upon which insurers rely to deny claims.
1. Make sure you have insurance that covers this type of claim - before the claim occurs. Although this may sound overly simplistic and obvious, it is probably worthwhile to spend an hour or two going through all of your insurance policies to determine what is actually covered by those policies, and perhaps more importantly, what is NOT covered by those policies.
2. Make Sure You Follow the Policy's Claims Reporting Guidelines. Having taken your hard-earned money in insurance premiums for years, you would think that the insurers would step up and pay your claim promptly. Although that could happen, don't bank on it. A favorite insurance company gambit is to deny claims that do not strictly comply with their reporting requirements, such as the insurer receiving written notice of the claim on one of their own pre-printed forms. Moreover, it cannot be overemphasized that notifying your insurance broker (instead of the insurer) is almost NEVER deemed sufficient for notice purposes. That brings us to our next rule ...
3. Report Your Claim Promptly. New York's insurance laws and regulations generally allow insurers to disclaim coverage for claims that are not reported "as soon as practicable" after the claim arose. Although a definitive time period has not been etched in stone, this has been often interpreted as being no more than 30 days post-incident.
4. Photograph the Evidence. If your claim is for damage to your property or car, make sure to get your own photographs of the damage before these items are removed from your sight - forever.
5. Document All Damage. Spending one extra hour now will save you a lot more time and heartache 6 months or a year from now when you can't remember what happened to that favorite throw pillow you got from Aunt Phyllis. Perhaps one of the best (and easiest) ways to catalog your losses would be to download the free software at www.knowyourstuff.org.
One final thought: although many articles on these topics, particularly regarding the insurance industry suggest that even mentioning the word "lawyer" may hurt your relationship with the insurer, and hurt your chances to resolve your claim, consider this: if that were true, why aren't there much fewer trial lawyers?
The truth is, the insurers will likely pay an insured more money after they've "lawyered up" than before, if for no other reason than to avoid defending costly litigation.
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