Tips To Get Your Insurance Claim Approved

San Francisco, California – Insurance companies are in the business of making money. So consumers need to know these tips to avoid getting the runaround.
Charles Thomas still isn’t sure which was worse: The fire that broke out on the deck of his San Francisco home two years ago or trying to get his insurance company to pay up. “I explained to them and they could see that I was flooded,” said Thomas.
But according to Amy Bach, lawyer and President of United Policyholders it would have been better to avoid the word “flood.” United Policyholders is a non-profit organization that advises consumers on insurance issues. Bach said consumers need to be careful when calling insurers to file claims or ask if something is covered.
Bach said certain words like “flood” and “mold” trigger alarms inside insurance companies that can delay or derail your claim.
“We recommend you start out by saying: ‘There’s been an accident at my house, on my property. And my property’s been damaged and I’m filing a claim,’” said Bach.
Here are a few more tips. If you are in a car accident, Bach has these tips when you talk to your insurer. Stick to the facts, and don’t ever say “I’m sorry.”
Instead give a short, factual description of what you personally observed and keep it at that.
And watch out, before you utter the word “whiplash.” According to Bach, over the years insurance companies have gotten very skeptical about whiplash claims. They feel a lot of people have submitted fraudulent claims for whiplash.
Speaking of medical treatment, Dr. Jennifer Brokaw with Medical Consult and Advocacy Services said health insurers often need to be convinced to pay.
Brokaw said not to say words such as “non-standard” or “clinical trial” when it comes to treatments. “It’s important for your doctor and you to understand and present the case to the insurer. In your case, it is medically necessary.”
Dr. Brokaw said if that fails, consumers can and should appeal.
The lesson: Treat your dealings with your insurer like a business negotiation. Bach said even though claims are usually filed because of a stressful event, remain calm and don’t let your emotions get the best of you.
As for Charles Thomas, the San Franciscan whose home was underwater two years ago, he finally received a check from his insurer in early March. It took two and a half years.