A roadblock in your insurance claim can always be nerve-wracking. Whether the insurance company has denied part of your claim or they have undervalued repairs and lost belongings, a disagreement can put a financial strain on you and your family.
When the insurer refuses to cover an expense, it is up to you to either pay for it or live without it. If that applies to major structural repairs, you can either wind up with a sizeable bill, or the bank may choose to keep what settlement you do receive and close your mortgage.
But you are not defenceless when you disagree with your insurance company. There are steps you can take to challenge the insurer and get a fair settlement.
#1 Hire an Insurance Lawyer or Public Adjuster
When you have a disagreement with your insurer over a major claim, you can turn to an insurance lawyer or a public adjuster in Ontario.
At the beginning of your claim, you likely began work with an insurance adjuster who evaluated the size and scope of the damage. This insurance adjuster works for the insurance company, whether they are an employee or independently contracted.
While this professional does not work for you, you can hire someone who does represent your best interests and can help you negotiate with the insurance company.
An insurance lawyer offers all of the services that a public adjuster does, but they can also help with more complicated claims, such as those that involve third-party liability or that will require pursuing the insurer in court.
You donot need to have a disagreement with the insurer before you should consider hiring an insurance lawyer. You may want their help to save you time and stress, as they can assist with managing paperwork and meeting deadlines at all times throughout the claims process.
#2 Identify the Source of the Disagreement
With the help of a public adjuster or insurance lawyer, identify the source of your disagreement with the insurance company. In many cases, it can be traced back to a simple misunderstanding or an error in calculating the true cost of repairs or belongings.
#3 Submit Evidence to Persuade the Insurer
It is possible to persuade the insurer to another conclusion, but you will need to provide evidence that supports your position that they should reconsider their decision. That evidence will depend on the nature of the claim. Some examples include:
- Paperwork or documents that should have been filed with the original claim, clearing up a misunderstanding. This might be proof that you did repairs on part of your home before a loss, proving that you were not negligent about maintenance.
- Receipts that show the value or replacement cost of lost belongings if the insurer has undervalued your claim.
- Estimates of repair work from a third-party contractor, particularly if your disagreement is about the cost or necessity of certain repair work.
An insurance lawyer can help you review your documentation or find a second opinion.
#4 Legal Challenge Against the Insurer
Suing your insurance company should be an absolute last resort, but it is an option if you are confident that you are in the right and the insurer owes you more money that you are entitled to based on the policy. You may also want to explore options such as dispute resolution that avoid going to court altogether.
