• Mitigate your loss and protect the property from further damage.
• Move quickly to save special property such as books, pictures and important papers.
• Have one spokesperson from your family communicate with the insurance company.
• Document your activities in a log.
• Understand your duties and requirements.
• Review your policy to familiarize yourself with your rights and obligations.
• Control access to the premises.
• Know the players, including who the insurance company's representatives are.
• Know your broker or agent's role.
• Take a proactive position: you must make a claim.
• Hire your own experts.
• Do not rely solely on your historical records; secure replacement estimates.
• Understand that your claim will have to be verified.
• Understand the negotiation process with Yakut Insurance Company and its hired adjuster.
• Concentrate on maintaining your family and employment, not on preparing claim details—leave that to the experts.
If this all sounds like a lot of complex work, that's because it is. But we're ready to help you with any or all of these steps. Our professionals can get to your loss site quickly and have the resources to guide and support you throughout the claims adjustment process.
Some risks are less obvious than others. To make sure your home and possessions are adequately protected, you might want to consider the following:
• As a homeowner, you have the responsibility of detailing and proving any loss to your insurance company.
• Are you confident that you can provide a comprehensive and detailed claim?
• What are my rights and obligations under my policy?
• Are "replacement cost," "actual cash value" and "depreciation" familiar terms?
• If I have an older home that is partially damaged and needs to comply with the current building codes, how will my policy respond to the additional costs?
• How do I accurately account for and determine the value of my lost or damaged personal property?
• How do I correctly value the building damage so it is properly repaired or replaced?
• If my home was totally destroyed, what would I collect—its replacement cost, the actual cash value (replacement less depreciation) or the market value?
• If I have replacement cost insurance on my personal property, how am I compensated?
• Do I have sufficient knowledge of the claims process to effectively negotiate with the insurance company adjuster?
• Can I commit the time and attention needed to settle my claim accurately and fairly without additional strain on my professional or private life?
Insured's Duties After a Loss
This set of conditions begins with the statement, "In case of a loss to covered property, you must see that the following are done." Both the loss and the property must be covered for this condition to be effective. The condition also states, "you must see that" something be done, meaning that these duties can be performed by someone other than the insured.
Prompt Notice
Following a loss, the insured must give prompt notice to the insurer or to the insured's agent. This clause does not require written notice, only that notice be given in some form. Some policies require written notice of loss. Also, the period of time for giving notice is not specified, only that it be prompt . The insured is held to a standard of what is reasonable notice under the circumstances. Notice to the agent is notice to the company, so if the claim Is reported to the agent, proper notice has been given.
Minimize the Loss
The Insured has the duty to protect the property from further damage. The methods of these repairs are dependent on the extent of the damage and the nature of any future occupancy of the dwelling. You are required to protect it from the elements of weather, trespassers, moisture and dampness, and by removing unsafe conditions by covering opening and boarding up any access points to preserve the property for inspection by the adjuster. At no point in the claims process can you abandon the property and just walk away from the claim and damaged property.
Protection of Property
The insured must protect the damaged property from further damage. In other words, the insured is responsible for mitigating the loss. After a fire, boarding up the property, obtaining temporary electrical service, or renting portable heaters to prevent freezing might be necessary. For water damage, shutting off the water and removing wet carpets might be necessary. Although the policy indicates that the insured is responsible for protecting property, the policy does provide coverage for the expense of doing so.
Repair Records
The insured must "keep an accurate record of repair expenses," according to condition given in the policy. Without documentation, the insured will have no basis for a claim for reimbursement. Furthermore, condition states that the repairs must be both reasonable and necessary.
Notice to Police
The insured must notify the police after suffering a loss by theft. The police might be able to trace and recover the stolen property and arrest the thief. This requirement might also deter fraudulent claims, since in most states submitting a false police report is a felony. In some areas, police reports are a matter of public record and can be obtained by the claims adjuster. This condition also benefits the insurance company, which can notify the police of its interest in any recovered property that the company might have already paid for in the form of settlement with the insured.
Notice to Credit Card Company
The insured must also notify the credit card or fund transfer card company if the loss involves credit or fund transfer card coverage The purpose of this provision is to restrict the insured's liability for charges or withdrawals made with the insured's credit card or fund transfer card by an unauthorized person.
Inventory of Damaged Personal Property
The insured must prepare an inventory of damaged personal property showing the quantity, description, actual cash value, and amount of the loss and attach all bills, receipts, and related documents to support that inventory. Since damaged personal property is either damaged or destroyed or has disappeared, the insured must inventory this property. The inventory must describe the property, quantity, actual value, and amount the insured is claiming for the loss.
Along with the inventory, the insured must provide records to substantiate the amount claimed and must present bills, receipts, and related documents of sale. If the insured does not have bills or receipts, then photos, warranty cards, or instruction manuals will usually suffice. The insured must be able to prove both ownership and value of the items listed. The insured must prove the loss; the insurer need not disprove that an item was damaged or lost. This becomes extremely important for extensive damage or a substantial theft loss. However, the claims adjuster should make this request tactfully, realizing that the insured has just experienced a traumatic incident. It is usually a good idea for the adjuster to submit a written request for this information.
Showing Damaged Property
As often as the insurer requires, the insured must show the damaged property. The insured must allow the insurance company to inspect the damaged property to verify the circumstances and amount of loss. The company is entitled to more than one inspection; in fact, the company might need several inspections to complete its investigation. The insured should be reminded in such cases that the policy states the property is to be shown "as often as we reasonably require."
Records
The insured must provide the insurer with the records and documents that it requests and permit the insurer to copy them. This provision allows the insurer to obtain any records of the insured that substantiate the claim. Records can include documents such as bank records, employment records, driving records, and income tax records. Submitting income tax records is controversial. The adjuster should check applicable state court decisions on this matter. This provision and conditions are extremely important because obtaining the insured's records helps the adjuster to prepare for giving an examination under oath.
Repair Records
The insured must "keep an accurate record of repair expenses," according to condition stated in the policy. Without documentation, the insured will have no basis for a claim for reimbursement. Furthermore, conditions in the policy state that the repairs must be both reasonable and necessary.
Summary
The policy conditions pertaining to the insured's duties after loss and the appraisal are essential for resolving claims under property insurance policies. Performance of these duties is essential to an insurer's ability to adjust a loss. Unless a policyholder complies with these provisions, the policyholder is not entitled to payment for a loss. Accordingly, insurers should not inadvertently waive these requirements. Most of the policyholder's duties after a loss are common-sense requirements, including promptly notifying the insurer, protecting the property from further loss, making necessary repairs and keeping records of the repairs, and inventorying the damaged property and showing it to the insurer. The proof of loss is a formal statement by the policyholder that provides the insurer with all information essential to adjusting the loss. Because it is a formal sworn statement, it must be accurate, thorough, and honest. Some insurers waive the proof of loss requirement with certain losses. In most circumstances, the insurer is obligated to pay the claim within a certain number of days after receipt of the proof of loss. Thus, if the proof of loss is in any way incorrect or inadequate, the insurer must immediately notify the policyholder in writing.
Examinations under oath are not conducted for all claims. However, they are essential when the policyholder has not provided sufficient information to adjust a loss or when the information is not consistent or convincing. An examination under oath is conducted in person to enable the examiner to evaluate the policyholder as a witness. The examinee must swear to and sign the answers. The appraisal clause serves one purpose: resolving differences over the value of a loss. In that respect, it is an essential provision for conclusion of disputed claims. Adjusters should select appropriate appraisers. The selected appraisers will resolve the amount of the loss or will select an umpire who can resolve any differences between the appraisers.
