Where the Rubber Meets the Road – Claims

Even though you may have all of the insurance you need, it doesn’t mean much until you file a claim. This will set in motion the reason you bought the insurance. No matter what type of insurance you have, if the claim process is not handled correctly or the insurance company blinks even for a second, then no matter how much insurance you have, it doesn’t really matter what insurance you have.

Do you know anyone who has had bad claims experiences? What did they do? They dropped their coverage more often than they should. This was either because the insurance company finally paid the claim, or because the client got tired of dealing with the “red tape” of some insurance companies.

SIDE NOTE: One of the most important factors I consider when choosing companies to work for is their claims department. What happens during claims time is important to me. I want to be sure that the client is always first, and that everything is done in a timely manner to ensure that clients receive accurate and timely communication.

One thing is certain when a claim is filed: some kind of loss occurred. Loss can bring about many emotions and thoughts that are all mixed up in uncertainty. A person should not have to deal with someone in the claims department at a large insurance company. They will act like the client is a nuisance and slow to respond. Shame on anyone who is in an important claim position and behaves this way.

With these thoughts in mind, I will discuss claims from both perspectives.

1 – The claimant. This person has been paying premiums almost for a lifetime. They need to get help for something that has happened. They should be able to rely on the insurance that they have been paying for now. Some claims issues can start right here, sorry guys. The insurance company must usually follow a process and protocol. A claim cannot be filed if there is something missing in that process. Patient patience is also important for the claimant. It’s difficult, especially during a difficult time. Imagine someone pouring a mountain (often unorganized) of paperwork on you and telling you, “I need to make a decision by the end the day.” Realize that there are only so many insurance claims adjusters in the office, and that hundreds of claims come in every day. It takes time to do the right thing for everyone. The claimant should do all that is required to complete the claim. Be patient. Don’t be afraid of following up. Expect a claims representative to contact you every day with updates.

2 – The claims professional. You are the face and voice of the company, so here is a reminder. You are the light at end of the tunnel when you’re in trouble. Let me now say something about claims personnel. They will be able answer your claim in one of three ways.

– “Yes, you money is on its way!” This is the perfect answer that everyone seeks. It’s almost always the right answer (at least for the companies I work with), as long as everything works together and adds up.

– “I’m sorry. The policy doesn’t pay claims in that area.” All policies are not created equal and all policies do not pay for all losses. The claims professional must be fair to all parties. If the policy does not cover the claim in a specific area, they must deny the claim. Period.

– “We need more info and/or more times.” The claimant must do their job, as I mentioned above, in order for the claims process be completed properly. The claims professional must ensure that nothing is missing or does not add up.

Finally, please claim professional…be kind regardless of what. Keep the claimant informed. Keep the claimant informed. While there are some claims that are denied, you can make a difference in whether a person loses their coverage or keeps it.

Claims are a team effort. Claims professionals and claimants must collaborate and get to know each other. Each entity cannot work alone. Claims are “where rubber meets road”.

I’m happy to report that all claims I have been involved with have gone smoothly, even if they were not. It is as easy as being kind and understanding for all involved.