After sustaining damage to a home, many homeowners want to know what steps they should take in order to submit a claim to their insurance carrier. The purpose of this information is to provide a general overview of how to submit a claim. Each policy is unique and you should read yours carefully to determine your rights and obligations under your policy. For specific information concerning your own policy, you should contact your agent or company directly.
- Notify your insurance agent or company as soon as possible. In the case of a theft loss, you should also notify the police.
- Take the necessary steps to protect the property from further loss. This includes making reasonable and necessary repairs. Keep accurate records of repair expenses including the time you and your family spend in doing repairs.
- Document your damage. Separate the damaged personal property from the undamaged property. Prepare an inventory of the damaged property. This inventory should include, if possible, the quantity, description, value (actual cash value (ACV) or replacement cost as appropriate), name of mortgage company or lienholder, and bills or receipts if available. Although it is not a requirement of the contract, we recommend consumers photograph or make a video the damage. This can be helpful in the event of a dispute.
- Work with the insurance company adjuster or representative in the investigation of your claim.
- Allow the company to see the damaged property and submit to examination under oath, if necessary.
- Provide access to your records.
- Submit a statement of loss (proof of loss) within 60 days from the company's request or in the case of a National Flood Insurance Program (NFIP) policy, within 60 days from the date of loss.
Insurance companies must:
- Respond promptly to the notice of loss. The company generally assigns an adjuster within 24 to 72 hours from the receipt of the notice of loss. The company claims adjusters will call you to arrange a time to inspect the damage.
- Work with the consumer in the investigation of the claim.
- Make a good faith effort to promptly, fairly and equitably settle the claim.
- Issue the claim payment jointly to the insured (in the case of a commercial policy, the first named insured) and the mortgage company or lienholder if one is listed in the contract.
- Workmanship of a repair contractor - after reaching a settlement and receiving the payment from your insurance company, it is up to you (and your mortgage company or lienholder) to contract for repairs. Generally, the insurance company at this point does not have an obligation to guarantee the quality of repairs. That is a matter between you and the contractor. The possible exception to this is when the company (i.e. adjuster or representative) has actually arranged for a contractor on your behalf. In that case, the company may become responsible for the quality of workmanship.
- Fraud and misrepresentation - many insurance contracts have language included which allows the insurance company to void either a specific coverage or all coverages if the consumer makes fraudulent statements or misrepresentations at the inception of the contract or in the process of making a claim. This is consistent with state law.
- Disagreements regarding coverage or value - if a disagreement arises between the policyholder and the insurance company regarding coverage or amount of damage, we recommend that the policyholder make every effort to work with the company to resolve the concerns and to reach an agreeable settlement. This may require your contacting the supervising claims manager. If your efforts do not resolve the matter, you may file a complaint with the North Dakota Insurance Department or you may consult an attorney and take appropriate legal action as necessary. The Department will investigate any complaint and will assist you in every way possible as permitted by law.
- Public adjusters - public adjusters contract with consumers to perform a damage assessment of the loss and represent the consumer in their claim with the insurance company. Public adjusters commonly represent to consumers that the consumer will obtain a greater recovery from their insurance company if the public adjuster is engaged to assist them. They generally charge a fee of 10 to 20 percent of the total amount of the settlement. The Department requires that all public adjusters obtain a license as an insurance consultant. Consumers are cautioned to weigh carefully the need to contract with a public adjuster. Aside from the cost of such services and the fact that an enhanced settlement cannot be guaranteed, such an arrangement may well delay the time it takes to get your claim settled.