Making the Claims Process Easier
What Consumers Should Know When Faced with a Claim
Filing an insurance claim can be one of the most frustrating processes during a crisis or following a major disaster. A delay in the claims process was the number one complaint of insurance consumers throughout the country in 2007. It is critical at these times you are prepared to provide all necessary information to your insurance company. To help you avoid problems getting your claims paid, the Division of Insurance offers these tips:
Read Your Policy
- Read your policy thoroughly. The policy is a contract between you and your insurance company.
- Be acquainted with what is covered, what's excluded, and what the deductibles are in your policy.
File Claims as Soon as Possible
- Do not wait to file your claim. Also do not let bills or receipts pile up. Call your agent or your company's claims hotline as soon as possible. Your policy might require that you make the notification within a certain time frame, and not filing in a timely manner could cause your claim to be denied.
Provide Complete, Correct Information
- Be certain to give your insurance company all the information they need. Incorrect or incomplete information can cause a delay in processing your claim and possibly lead to the claim not being paid in full.
- Keep copies and records of all correspondence and related documents between you and your insurance companies.
- Write down information about your telephone and in-person contacts, including the date, name and title of the person you spoke with and what was said. Also, keep a record of your time and expenses.
- If you are unclear what is covered or what a particular provision in your policy means, ask.
- If there is a disagreement about the claim settlement, ask the company for the specific language in the policy that is in question. Find out if the disagreement is because you and the insurance company interpret your policy differently.
- If this disagreement results in a claim denial, make sure you obtain a written letter explaining the reason for the denial and the specific policy language under which the claim is being denied.
Don't Rush into a Settlement
- If the offer made by an insurance company does not meet your expectations, you do not have to accept it. Further discussions may result in a more equitable settlement or a better understanding of the basis for the companies offer.
- If you have any questions regarding the fairness of your settlement, seek professional advice or contact the South Dakota Division of Insurance.
Auto and Homeowners Claims
- Auto and homeowners policies might require you to make temporary repairs to protect your property from further damage. Your policy in most cases should cover the cost of these temporary repairs, so keep all receipts. If repairs do not allow for the adjustor to see the damage, you could have difficulties getting your claim paid.
- Maintain any damaged personal property for the adjuster to inspect. Take photographs or video when possible of the damage before making temporary repairs.
Other Tips for Filing Auto or Homeowners Claims:
- Don't make permanent repairs. An insurance company may deny a claim if you make permanent repairs before the damage is inspected.
- If possible, determine what it will cost to repair your property before you meet with the claims adjuster.
- Provide the claims adjuster with records of any improvements you made to your property, if applicable.
- You may wish to ask the claims adjuster for an itemized explanation of the claim settlement offer.
Tips for Filing Accident and Health Claims
- If you suspect a provider is overcharging or question the billings, you can ask that health provider for an explanation or ask the insurance company to audit the bill and verify whether the provider properly billed.
Contact Your State Insurance Department
If you have a dispute with your insurer about the amount or terms of the claim settlement, you may contact us for assistance.
124 S. Euclid Ave., 2nd Floor
Pierre, SD 57501
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