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Fighting an insurance denial or settlement

On Behalf of | Aug 22, 2022 | Insurance Law |

Dealing with home repairs after property damage may be complicated, but a claim denial makes this situation even worse. Policyholders should know their rights.

Disputing a denial or settlement

Policyholders hold rights under Nevada’s insurance law. But they need to take steps to contest a claim denial or low settlement offer.

Read the policy and determine if it covers the disputed damage and whether any dollar limits apply. The insurance company had to provide an explanation for the denial and cite applicable policy terms.

Sometimes, insurance carriers may send several checks to cover the damage. You may need to contact the company if you receive a check which appears low.

If you believe you can contest the denial or settlement, gather evidence to support your claim. For example, an independent contractor can verify that the damage was caused by a covered problem and not poor maintenance. A public insurance adjuster may help negotiate with your insurance carrier.

You may also file an appeal with your carrier. Include a written explanation of your case, estimates, photographs, and other documents.

At home visits

If there is a dispute, you may ask the adjustor to inspect your house again and obtain second opinions from independent contractors or other professionals. Arrange a meeting at your damaged property with the insurance adjustor, independent contractor, and other professionals so they are looking and discussing the damage.   

Insurance department

Filing a complaint with the Nevada Insurance Department may be another option. While it may not have the ability to resolve all claims, it can help assure that the carrier acted legally.

Mediation

Mediation involves hiring an unbiased person or mediator to work with the parties to reach an agreement. It is typically a fast but nonbinding process.

Insurance representatives are trained to participate in mediation while policy holders are usually inexperienced. Carriers may also use mediation to test the strength of the policyholder’s case and never enter an agreement.

Appraisals

Appraisals are an option for resolving disagreements over the extent of damage and repair costs in settlements. Each party selects its own appraiser, such as a public adjuster, contractor or other professional. Each party pays their adjustors and divide other costs.

Appraisers review home and other property damage and try to reach an agreement on the amount owed. An independent third party selected by the appraisers, an umpire, breaks deadlocks and decides the final award.

Appraisals decide damage costs and not whether the carrier must pay those costs. Appraisals do not resolve coverage disagreements or other policy disputes.

Attorneys can assist parties in this process. They can work to protect their rights.

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