At Lane’s Insurance, we are always trying to build awareness of the ability of insurance brokers to locate the best coverage for our clients at the lowest possible rates. We can do this because of the great relationship we have built with our providers, with whom we have mutual respect for the role we each play in ensuring our clients are fully protected.
Many people don’t realize that insurance brokers are also experts at the claims dispute process. We can provide expert advice as to how to file your claim in accordance with the parameters set out by your insurance provider so that you have the best possible chance of quick and successful outcome. Depending on your situation, we may also be able to act as an arbitrator for you should there be a difficulty with processing your claim. We are thoughtful, thorough, and focused on a positive resolution.
Why Did My Claim Get Denied?
There are numerous reasons why your provider may refuse to pay out a claim you have made, but by far the most common have to do with irresponsible actions on the part of the policy holder. For car insurance, a few of the most common explanations for a claims dispute are:
- Not paying your premium.
- You have provided misleading or false information. This can range from where you live to the type of vehicle you drive.
- You have been using your vehicle for commercial purposes.
- There was a non-authorized or unlicensed driver behind the wheel.
- Your vehicle was being used for criminal activities.
- Your provider believes an accident could have been avoided or you did something to cause it.
Home insurance claims disputes most often arise around the following details:
- The value of the insured property that has been lost or damaged.
- The value of the property saved from loss or damage.
- The nature and extent of the repairs or replacements required.
- The amount of the loss or damage claimed.
Because of the fact that home insurance claims are most often disputed due to discrepancies between what an insurance company thinks your property is worth and what you think your property is worth, we always recommend that holders of home insurance policies be extremely diligent about keeping an up-to-date home inventory. You must also keep your insurance company apprised of any major renovations or upgrades you have made to your home. This will greatly simplify the claims process.
Claims Dispute Tips for a Fast Resolution
If you have a claim that your insurance company is disputing, read through your policy as carefully as possible so you are fully aware of your rights as well as the responsibilities of your insurance provider. Feel free to contact us for the clarification of any technical wording you don’t understand. If you believe that your insurance provider is not providing protection as set out through your contract, we recommend you follow these steps:
- Get as much information as possible from your insurer about why they are challenging your claim. There may be a simple misunderstanding that can be easily rectified.
- If that doesn’t work, ask to speak with your insurer’s claims manager. This is the person who most likely made the decision on the outcome of your claim.
- If your claim is still not being processed to your satisfaction, all insurance companies have what is called a Complaints Liaison Officer or Ombudsperson. This person’s role is to ensure the dispute resolution process is being properly adhered to. When speaking to the Complaints Liaison Officer or Ombudsperson, clearly state your concern and present all the pertinent information. Be sure to keep track of all communication, including who you talked to and what they said.
- If you have still not managed to reach a desirable outcome after speaking with the Complaints Liaison Officer or Ombudsperson, ask for a final position letter and contact the national General Insurance OmbudService, which is meant to be fair, impartial, and independent.
Additional Resources
Each province has its own claims dispute process for those who feel they have been treated unfairly by their insurance company. In Alberta, the Dispute Resolution Process is clearly set out in section 519 of the Insurance Act, which we are very familiar with. You may register your insurance company complaints with the Alberta Government’s Insurance Consumer Complaints department.
Trust Lane’s for All Your Insurance Needs
The experienced brokers at Lane’s Insurance excel at educating customers, answering questions and explaining coverage, so you know you have the best insurance for you and your family.
“At Lane’s, our goal is quite simply to work with you, our client, to determine your needs and ensure that you and your assets are protected. Specifically, we want to ensure that your financial plan incorporates the right insurance choices for your life today, and the life you’d like to live tomorrow.”
