FAQ - When is a Claim a Claim?

DRickard Insurance

607-843-8860

insurance@drickardinsurance.com

New York State

DRickard Insurance
"Your Favorite Insurance People"

DRickard Insurance

Your Favorite Insurance People

607-843-8860 insurance@drickardinsurance.com

FAQs

When is a Claim a Claim?

We hear several times a year that persons coming to DRickard Insurance have been unhappily surprised that when the called their insurance agent about various happenings on their properties that these calls were counted against them. Why did that happen?

Firstly, consider the definition of insurance agent. Basically it means the individual is an agent, not for the insured, but for the insurance company. So every time a call of a claim nature comes to her she is contractually obligated to advise the insurance company of the incident even if there is not a pay out or follow that is to be done on the call. What makes this worse is that many companies will cancel a policy after there have been three incidents of any type.

An insurance broker represents insured’s risks to insurance companies. His obligations are different and those of an agent. However he has the knowledge that if you do have an incident and you delay in contact your insurer about it, they have more of a reason to refuse to pay on your claim.

Perhaps an insurance consultant would be an advisable choice to go to in the event that you want a disinterest third party opinion on an issue. The down side to this is that insurance consultants easily cost more than $100 per hour.

That leaves calling the insurance professionals you work with and describe a hypothetical situation. We look into these all of time. However, the conversation will be memorialized. When that exact situation happens your agent is required to notify the insurer that you discussed this exact thing two months ago. When the inspector shows up and sees the damage is not a new current and sudden thing the claim may well be denied. Insured’s have a contractual duty to protect the property insured.

Even when a question comes up is something like flood covered because… and the policy is not a flood policy, therefore the claim is denied. It will still count as an incident.

When is a claim a claim? Every time you contact the insurer, or their agent, about any occurrence that has happened on the insured premises regardless of whether or not the insurer makes a loss payment.

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