Insurance is a common purchase. Many people buy insurance to protect themselves in the event that they suffer a loss or damages in their home or business. Some people buy long-term healthcare insurance to be able to pay for that care, if it is needed. Under the law, automobile and health care insurance are mandatory. The insurance policy is the written agreement between the insurance company and the policyholder. It states what premiums to be paid, the specific risks covered and the maximum amounts that will be paid. It also contains exclusions, which are the losses that are not covered. The company’s claims procedures are in the policy. Consumers should read the entire policy before they file it away to make sure they have the insurance coverage they intended.

Often people contact me after their insurance company has denied their claim. The company may have refused to pay a direct claim or refused to provide a legal defense in a third-party claim. One of the most common reasons why insurance companies say they deny policyholders’ claims is that the loss notice was made late. Even 30 days between the time of a loss and a report to the company may be considered late. Another reason for a claim denial is that the type of claim is excluded from the policy. For example, a claim for stolen jewelry might be denied where a homeowner’s policy had a specific jewelry exclusion. Failure to timely pay premiums is another cause for denial.

The Katter Law Firm has successfully sued insurance companies to enforce a client’s rights under the insurance policy, even after a denial. However, it’s very frustrating and expensive for clients to have to go to court to obtain the very insurance benefit they thought they had when they purchased the policy.

Here are five guidelines to help you make sure that your insurance policy provides the coverage that you intended.

1. Read the entire policy to make sure that it provides the exact type of risk and loss coverage you wanted. If coverage that you desire is missing or excluded, send a written inquiry to your broker or insurance company demanding an explanation.
2. Be certain that you know how a claim is to be reported and how long you have to report it. Follow those requirements.
3. Keep copies of all communications with the broker or insurance company, including any attachments or enclosures you send. Keep written notes of your telephone conversations with them.
4. Pay your premiums on time!
5. If you are unable to follow any of the four previous suggestions, ask for a friend or relative to help.

Ron Katter
Katter Law Firm
Phone: 866-LAW-HELP
Alt Phone: 212-809-4293