Equifax

Finance Blog

How to Resolve a Claim Dispute with Your Insurance Provider

Written by Linda Rey on May 5, 2011 in Insurance  |   No comments

How to Resolve a Claim Dispute with Your Insurance Provider By Linda Rey I love getting to know my clients and working with them to provide an insurance portfolio that meets all of their needs, but some clients are more difficult than others. I’m sure…

How to Resolve a Claim Dispute with Your Insurance Provider
By Linda Rey

I love getting to know my clients and working with them to provide an insurance portfolio that meets all of their needs, but some clients are more difficult than others. I’m sure this is the case for anyone whose job has a customer service component. I refer to these more difficult clients as “accident prone.”

Some of my clients pay their premium when they should and go years without a claim. But then it seems like I hear from others every month.

When a client has a claim turned down or gets dropped by an insurance company, I often hear the same complaint: I pay my premium; I should receive the insurance benefit.

True, but the insurance companies are running a business. They try to figure out which claims are legitimate and covered by the insurance plan to avoid paying out for false or unnecessary claims.

I’m not saying you should never file a claim. It’s probably written into your contract to report any and all incidents. I want all my clients to receive the insurance benefits they deserve, based on the plans they pay for.

Sometimes all you need is a little bit of communication to solve a claim dispute or speed up a processing delay. We had a client who was told her claim was denied because of an oversight that needed to be reviewed with the underwriter. The client called us; we reviewed the file and discussed the case with the underwriter. Then the claims department reviewed the procedure and coverage and processed her claim.

Long story short, a good insurance agent can serve as an intermediary with the underwriter and help get your claims processed properly.

Here are some things you can do if you need to file a claim dispute:

  • Review your policy carefully to determine if your claim is indeed covered. The fine print can be tricky; you may need to review your plan with your insurance agent.
  • Keep track of all paperwork related to your policy and the incident requiring a claim. This may include police reports, medical charts, witness statements, damage estimates, and payment records. The more data you can provide to back up your claim, the more likely you are to receive payment.
  • Document all contact with the insurance company. Record dates and times of phone calls, as well as full names and extensions and outcomes of the phone calls. Save any emails or paper mail from the insurance company. Again, more proof will only help support your claim.
  • Keep calm. Problems with your insurance and claim disputes are never fun, but you’re more likely to get the outcome you desire if you stay calm, stay firm, and stay persistent.

Have you had to file a claim dispute? How did you deal with it? Did you receive the outcome you desired?

Linda Rey is a licensed insurance agent at Rey Insurance with a broad spectrum of expertise in life, accident, health, property and casualty insurance as well as retirement planning and college funding strategies.

Follow Linda on Twitter.

Read More:
Save Money on Your Insurance Premiums by Changing Your Deductible
4 Questions My Insurance Clients Never Ask—But Should
3 Things That May Not Be Covered by Your Homeowner’s Insurance— But That You Still Need!
Four Ways to Protect Your New Construction or Renovations from Liability
Check the Fine Print: Situations That Could Invalidate Your Insurance Coverage

No comments yet


Leave a Comment


Name :


Commenting guidelines

We welcome your interest and participation on this forum, but be aware that comments will be published at Equifax's sole discretion. Please don't use this blog to submit questions or concerns about your Equifax credit report or raise customer service issues. Instead, you should contact Equifax directly for all such matters and any attempts to do so in this forum will be promptly re-directed.

Some other factors to consider when commenting:
  1. Registration and privacy. While no registration is required to visit our forum, participants wishing to post a message must register by creating an account. All personal information provided by forum members incident to registration is governed by our Terms of Use and Privacy Policy.
  2. All comments are anonymous. We'll delete your name, e-mail address, and any other identifying information, including details about your investments.
  3. We can't post or respond to every comment - As much as we'd like to, we can't post every comment, nor can we guarantee that we will respond to each individual message. All questions or comments about your Equifax credit report or similar customer service issues should be handled by contacting Equifax directly.
  4. Don't offer specific legal, tax or financial advice. All of the materials on this Site are for information, education, and noncommercial purposes only and this forum is not intended as a means of expressing views or ideas regarding any specific legal, tax, or investment advice. While offering general rules of thumb is both permitted and encouraged, recommending specific ideas or strategies regarding investments, taxes, and related matters is prohibited.
  5. Credit Repair. This blog is not intended as a venue for the discussion or exchange of ideas regarding credit repair or other strategies intended to assist visitors and community members improve or otherwise modify their credit histories, ratings or scores.
  6. Stay on topic. Your comment should be concise and pertain to the specific post in question.
  7. Be respectful of the community. The use of profanity, offensive language, spam, and personal attacks will not be tolerated and egregious or repeat offenders will be banned from future participation. We encourage disagreement and healthy debate, but please refrain from personal attacks on our WordPresss and contributors.
  8. Finally: Participation in this forum may be terminated by Equifax immediately and without notice for failure to comply with any guidelines or Terms of Use. As such, you should familiarize yourself with all pertinent requirements prior to submitting any response through the blog or otherwise. All opinions expressed in this forum are solely those of the individual submitting the comment, and don't necessarily represent the views of Equifax or its management.

Equifax maintains this interactive forum for education and information purposes in order to allow individuals to share their relevant knowledge and opinions with other members and visitors. We encourage you to participate in discussions about personal finance issues and other topics of interest to this community, but please read our commenting guidelines first. Equifax reserves the right to monitor postings to the forum and comments will be published at our discretion. Do you have questions or comments about your Equifax credit report or customer-service issues regarding an Equifax product? If so, please contact Equifax directly. All opinions and information expressed or shared in blog comments are solely those of the person submitting the comments, and don't necessarily represent the views of Equifax or its management.


Insurance Archive

Stay Informed Sign up for our FREE Equifax email Newsletter