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Video on Health Insurance Claim Denied

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Health Insurance Claim Denied
Mark Decherd
You've poured over your policy wondering, "Will my insurance company pay for repairs?" Insurance policies are complicated and filled with jargon that's often difficult for the policyholder to understand. Even if you understood what the terms used actually mean, policies are also loaded with exceptions and exclusions. By the time you've read the policy from cover to cover, you're left with the same question - will they pay for it?
To further complicate matters, even if a loss is covered, the policy most likely includes a deductible as well as coverage limits. Depending on the nature of the loss, multiple insurance companies may be involved. For example, if a storm strikes and you have both wind and flood damage, you may have to file a claim with your homeowners insurance for the wind damage and another with the national flood insurance program (if you have flood insurance) for the water damage.
Depending on where you live, your deductible may be higher under certain circumstances. For example, in Florida, your deductible for hurricane damage is much higher than if your home was burglarized.
So, will your insurance company pay or won't they? Look at it this way, insurance companies DON'T want to pay. They are in business to generate profits and will need to be convinced BY YOU that the claim should be paid. The burden of proof lies on you, the homeowner. This means that you will need to prove your case and do it well. The better prepared and more organized you are, the better.
Start with documentation. You may need to take dozens of photos and provide your insurance agent with detailed estimates to counter against the insurance company's original settlement offer. You may need to demand to see how the agent depreciated your property and negotiate a more reasonable method. While your homeowner's insurance policy is a contract, the claims process does provide room for negotiations.
Your best bet is to be prepared for a fight. Your tools in this battle include a detailed home inventory, digital photos and video documenting the damage, estimates from local contractors, and a willingness to demand a better offer. You don't have to do this alone. In fact, many contractors are willing to be present during the insurance adjuster's visit to help point out damage that the adjuster might have otherwise ignored. In addition, public insurance adjusters act as advocates for the homeowner and work on your behalf to negotiate a higher settlement offer.
Arm yourself with knowledge, documentation, and real-world estimates while also considering professional representation and you'll be better equipped to answer the question, "Will they pay for it?"
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