Have you ever received one of those, "I'm sorry but there is no coverage for your submitted claim?"  Well, not so fast.  Everyone who buys insurance needs to understand a few simple rules about insurance claims.

Rule # 1:  Only your written contract of insurance is the reliable source as to whether you are covered or are not covered for any claim.  You might just want to read your policy.

Rule # 2:  No one is an authority on what is covered and what is not.  Insurance company claims adjusters are simply people hired to do a job.  Although I don't believe they are hired to deny every claim submitted they are encouraged to deny any claim that may be borderline.  Perhaps they need a little encouragement to re-read the policy.

Don't just accept the denial letter without discussing the claim with your agent or broker.  After all, they sold you the coverage.  There are many agents and brokers selling various insurance products.  Find a "Professional" broker who will sit with you and explain why the claim was denied or why they might disagree with the denial and fight the company on your behalf.  Keep in mind that most agents and brokers, especially in California, cannot adjudicate and settle claims however if they have the proper insurance education they can certainly attempt to reason with a claims adjuster.

Rule # 3:  Establish a good working relationship with your "Professional" agent or broker.  Don't just buy the lowest price, buy the relationship meaning that you can sit down and discuss your insurance needs and receive the advice you deserve.

Ross D. McEachron, CIC,CRIS, MLIS, CISR, CORS, PLCS, CLCS

Chairman, CFO