What Does an Insurance Agent Do After a Claim?

No one enjoys making an insurance claim. Something bad happened. You need it fixed. Soon. So much to do! Repair a car or building. Run a business. Get a temporary vehicle. Find a place to live or work. Heal from an injury. Replace damaged or stolen property. Deal with another party after the accident. Stress!

It’s an inconvenience you didn’t need. But, that’s why you bought insurance, right? It’s time for policy to do what it promises: fix you.

Insurance is a Two-Party Contract

Your insurance policy is a written contract between you and your insurance company. No one can change it after a claim. Your contract makes you responsible for certain things. The insurance company too. The policy specifies what’s covered, what’s not, and how losses are paid.

If you purchased your policy from an agent, they can help you through the process. But some things you have to do yourself.

In an Insurance Claim, Only YOU Can:

  • Make a statement about what happened to insurance companies
  • Prove your loss
  • Choose a contractor or repair shop (some companies have preferred contractors or shops, but cannot force you to use them)
  • Accept or reject a settlement

 

Only YOUR ADJUSTER Can:

  • Determine whether your policy covers your loss
  • Decide who’s at fault in claims involving more than one party
  • Evaluate and pay claims

 

Some claims never involve anyone but you and the insurance company.  You report it directly to the insurance company. The claim is minor. Settlement is simple. Everything goes smoothly. Other claims are more complex.

You never know which kind of claim you will have. That’s why it’s good to have an agent on your side. Not to mention for the advice they can give you the 99.9% of the time when you’re NOT having a claim.

 

What Use Is an INSURANCE AGENT after a Claim?

A good insurance agent:

  • Helps you decide whether to make a claim at all.  Is your claim clearly not covered? If it is clearly covered, what’s your policy deductible? Is your insurance cost likely to increase if you make this claim? How much? An agent can answer these initial questions so you can decide whether you want to make a claim at all.
  • Is your insurance sherpa. There’s a lot to know and remember. Report your claim to your insurance company or someone else’s. Protect your property. Gather information you’ll need later. Find a temporary solution until the adjuster can take over. An experienced agent is your sherpa in foreign territory.
  • Is your claim cattle dog. Haven’t heard from your adjuster? Waiting for an appraisal? Having trouble preparing the reports the insurance company needs? A good agent can pull things together and herd your claim in the right direction.
  • Has clout with the insurance company. Agents help their clients to find good insurance companies. So insurers want to be on the agent’s “good list”. A trustworthy and knowledgeable agent earns the respect of the insurance company. They can use that to advocate on your behalf. An agent can’t create coverage where there isn’t, but they can influence the process.
  • Is an “insurance translator”. A good agent can explain the gobbledy-gook in that letter from your adjuster. They can tell you why the offered settlement may be different than you expected. They can explain to the adjuster, using insurance terms, it if it’s wrong. Your agent can even translate in real time, meeting with you and the adjuster face-to-face, to resolve issues.
  • Helps insurance companies get better. Want to let your insurance company know how your claim went? Compliment your adjuster? Complain about the company’s preferred service provider? Rave or rage about the service you received? Share advice for how to make it better? A good agent has a pipeline to the insurance company, and knows where to send the feedback to get the most impact.

 

If you Need Help, ASK!

Don’t assume that your agent knows how your claim is going. Insurance companies don’t routinely communicate with agents during a claim. If you need help, ask your agent. At Noyes Hall & Allen Insurance, we ask our clients if they need help a week after they file a claim on their policy. Many don’t need help. But for those who do we’re able to jump in and assist where needed. We believe that helps our clients’ claims go smoother than they might otherwise.

Do you own a business or live in the Portland Maine area? Looking for an experienced agent who represents several insurance companies? An agent who can help you choose the right insurer and be available if you have a claim? Contact a Noyes Hall & Allen Insurance agent in South Portland at 207-799-5541. Or just click “get a quote” above. We offer a choice of Maine’s preferred business and personal insurance companies. We’re independent and committed to you.

Do Hurricanes and Wildfires In Other States Affect Maine Insurance Rates?     

 

Insurance companies pool risk. They collect money from many people to pay the losses of a few who have claims. Everyone’s rates go up or down, depending on the insurance company’s experience. More claims paid = higher rates.

 

You may be wondering:

  • How much do hurricanes, wildfires and other disasters affect insurance rates?

  • Do disasters in other states affect my insurance rates in Maine?

 

It’s helpful to understand how insurance companies price their product. Insurance rates are recommended by insurance company actuaries. They project how much money the insurance company must collect to pay claims and make a profit. This requires complex modeling and formulas. Actuaries recommend rate changes to a special committee of company executives. The committee compares the actuary’s recommendation to the company’s profitability and growth targets. They agree on a proposed rate change, and submit it to Maine insurance regulators.

The regulator’s job is to make sure that insurance rates are:

  • Adequate to pay claims
  • Not excessive
  • Not unfairly discriminatory.

Regulators may approve or deny the rate change, or ask for more information.

 

What Factors Affect Insurance Rates?

At its simplest, insurance is “money in…money out.”

Money In = Premium Collected

Cheap insurance rates may leave the insurance company with insufficient money to pay claims and make a profit. Rates that are too high may send customers fleeing to other insurers.

Money Out = Losses 

The most important determinant of insurance rates. More losses than expected puts pressure for the insurance company to raise rates. Fewer losses puts downward pressure on rates.

 

But here’s the rest of the story:

Insurance Company Financial Strength – Well-managed insurance companies keep adequate reserves to pay claims on a rainy day. Insurers with strong financials can weather a bad year without huge rate increases. Weaker ones need more frequent rate adjustments. The best way to learn the financial condition of an insurance company? A.M. Best tests the financial strength of insurers and assigns them a letter grade.

Type of Insurance Company – Mutual insurance companies are owned by their customers. After they pay claims, mutuals store their profits to pay future claims. Other insurance companies are stockholder owned. Stockholders expect a return on their investment. Investors pressure executives of publicly held companies to improve profits every quarter. This can lead to larger or more frequent rate increases to stay ahead of current losses.

Reinsurance – Almost every insurance company is also an insurance consumer. They buy insurance against “the big one”. This is called reinsurance. Most companies reinsure against annual total losses exceeding a certain amount. This dampens the impact of multiple hurricanes, fires or other disasters in one year.

Generally, larger insurers buy less reinsurance than smaller ones. Smaller insurers have less surplus, and thus are more vulnerable to catastrophic losses.

Of course, reinsurers are also insurance companies. They must collect more premium if they suffer unexpectedly large claims. Insurance companies pay different reinsurance rates based on their individual loss experience.

Do Disasters in Other States Affect My Insurance Rates?

Probably not as much as you think. Maine insurance regulators only allow insurers to file rates based upon Maine premium and losses. Claims that a company pays in California or Florida are not baked into Maine insurance rates.

But:

Insurance companies factor nationwide overhead costs into Maine rates. Cost like advertising, salaries – and reinsurance. Since events outside Maine influence reinsurance costs, they influence Maine customers’ rates. Just less than you might expect.