Tips for a Successful Insurance Claim

jessica jensenBy: Jessica Jensen

As an attorney, I’ve worked with countless insurance companies and adjusters on a variety of issues – from personal injury claims to title claims to property damage claims.  My recent house fire gave me an opportunity to work with my own insurance company and adjuster from the perspective of a consumer.  Many claims can be handled without an attorney.  In fact, most attorneys will not take a claim that is less than $20,000 or even $50,000 in some cases because the cost of representation would exceed what the attorney could recover for the client.  In these cases you can prepare the claim yourself with some advice and assistance from an attorney along the way.  I thought I’d share some tips for working with your insurer, adjuster and behind-the-scenes attorney:

Your first task is to ensure you and anyone else involved in the incident is either okay or receives medical treatment.

Next, preserve the details of what happened as soon as you are able.  This may mean getting the contact information for witnesses or taking photos of the incident scene.  Write down or record what happened to preserve your story and the details.

Documenting your injuries and damages is the next step.  Insurance companies pay claims based on actual documentation, not on guesstimates or numbers pulled out of the air.  Organize and track your damages and expenses using whatever method works for you (computer, notebook, file folders).

If you received physical injuries, go to a doctor or other health care provider to assess and document your injuries.  If you need treatment, do what you are asked to do.  Make healing your priority.  You can claim mileage reimbursement for health care visits related to your injuries, so keep track of your mileage.  The current mileage rate is 23 cents per mile for medical.

You may claim pain and suffering damages if you had significant pain and discomfort related to your injuries and loss of quality of life is compensable too.  Pain is difficult to prove without a medical opinion, but loss of quality of life can be measured more easily the more active you are.  For example, if you bike 50 miles per week year round and it’s clear your injuries keep you from biking for 6 months, it’s easier to show how you have been impacted than if you were a couch potato before and after your injuries.

For property damage (such as a damaged vehicle, fence, or in my case fire damage), you will need repair estimates.  If the damage is beyond repair, the adjuster will typically provide a total loss value.  If you agree with the value, great.  If you disagree, you will need to obtain a written opinion from an expert or other source regarding the value of the item.

You can also claim any time you missed from work to attend to injuries, treatment, getting estimates and having damage repaired.  Even if you were paid anyway because you used sick or vacation leave, you are entitled to be reimbursed.  You will need a signed letter from your employer documenting how many hours or days you lost and your rate of pay.

When you have all of this information available, you are ready to submit your claim and, hopefully, settle.  This is where it’s usually worthwhile to work with an attorney to package your claim .  The attorney can also provide advice behind the scenes to help you negotiate a satisfactory settlement.

Expect to compromise your claim unless the liability (who is at fault) and your documentation are absolutely clear cut.  For claims under $50,000, if you can’t reach a reasonable settlement, you will need to file a lawsuit and request binding arbitration in most counties.

About The Author

Jessica Jensen is the owner of Jessica Jensen Law in Olympia – Attorneys for the Business of Life.  Her holistic general practice firm handles business, consumer, family law, personal injury, real estate, land use and wills, trusts and estates.  Contact her at 360-705-1335 or jessicajensenlaw.com.

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