How to Dispute An Insurance Claim Payout

What can you do if your insurance claim is less than you need?

Insurance is complicated at the best of times and, in the height of loss, it can be hard to settle on a dollar figure value for belongings with great sentimental value.

But what happens if the reimbursement decided on by the insurance company doesn’t cover your loss in a way you deem adequate and fair?

There certainly are options.

Pete Karageorgos, manager of consumer and industry relations for the Insurance Bureau of Canada – the industry trade association – walks us through the steps for disputing the results of an insurance claim.

Start From The Bottom

The first step is to try and work it through with the adjuster or broker – whoever it was that handled the initial claim.

“I’ve been in the insurance industry now for almost 20 years and inevitably the majority of disputes and problems arise out of shortcomings in communication,” says Karageorgos. “Sometimes it may be a simple misunderstanding or the insurance company may need more information.”

One of the most common causes for dispute is the value of the lost/stolen items.

Take a $1,000 set of golf clubs for instance.

Inevitably when you go to determine the clubs’ value there’s going to be some question about what make and model the clubs are and how old they are.

“Say I spent $1000 on the golf clubs 10 years ago, would they be worth $1,000 now? Probably not,” says Karageorgos. “Over time things will depreciate in value and part of the problem is people’s understanding of what the value is that was lost.”

The deductible – the claimant’s buy-in for the insurance – needs to be taken into account as well.

If that deductible is $500 and the 10-year-old clubs are now valued at $700, the claimant will only end up with $200.

Escalate Up The Ladder

“If your concern is now, well maybe they should be valued more and you can’t resolve that issue with the adjuster, the next level is with that person’s management or claims supervisor,” says Karageorgos. “If you can’t get anywhere with the claims people ask for the contact name of the company’s complaint officer.”

The complaint officer is responsible for reviewing your complaint and coming up with the insurance company’s final position on the claim. Some insurance companies may have additional services built into this level – for instance, the Canadian insurance co-op The Co-Operators recently launched a Service Review Panel, consisting of clients, to asses claims and dispute processes.

Seek Out The Ombudsman

“At the end of that day you may still not agree with the company’s position and your next step then is to go to an impartial body called the General Insurance Ombudservice,” Karageorgos says, adding that a majority of insurance companies belong to this ombudservice. “The GIO will investigate and mediate between the parties to try and find a resolution.”

If you go through that process and are still dissatisfied, the final step in to take the dispute to the courts and the judge will make the final binding decision.

“There are a few steps to follow and it’s not an overnight process by any stretch,” adds Karageorgos. “But it is simple in the sense that most these steps any individual can do on their own without seeking a legal representative.”

Use Technology To Your Advantage

While many disputes relate to the value of the items or whether or not they were actually in possession, there’s a simple solution to help bolster your claim – virtual proof.

“To move your claim forward you need to have a lot of proof – not just a list but photos receipts, etc…” he says. “But in this day and age, the nice thing about technology is you can shoot a quick video of each of the rooms in your home, highlighting what’s in your closets and your home and then upload it to the cloud or something.”

This proof could be key in helping you settle the dispute and get reimbursement for your loss.

 

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