Your Insurance Carrier Won’t Cover a Loss – Now What?

An insurance policy is a legal contract that exchanges an insurance company’s obligation to pay for certain losses if the person covered by the policy pays a required premium. This holds true whether the policy covers your home, car, boat, life, airplane, jewelry or business. If there is a serious dispute between you and your insurance carrier regarding the coverage of a loss, a courtroom often becomes the setting for resolving the matter, but not always.

To Sue or Not to Sue?

In many instances, filing a lawsuit is unavoidable. For instance, when a person seeking coverage has his claim denied, a lawsuit may be the only action that is available. But seeking satisfaction in court can be its own problem. Court calendars (dockets) are often backed up so it could take months or even years before a hearing can take place. Trials may be followed by one or more appeals. The legal expense can be staggering, involving court costs, filing fees, attorney costs, research costs, fees for expert witnesses and a host of other expenses. Time and cost considerations are great incentives for finding other methods to resolve disputes.

Alternative Dispute Resolution

When disagreeing about the amount that should be paid for a loss, mediation and arbitration are popular alternatives to suing your insurance company. Each is a form of Alternative Dispute Resolution (ADR) since they are alternatives to going to court.

  • Mediation – This process involves the two parties meeting to discuss their situation with the help of a mediator. The mediator typically has special training and a legal, financial or similar background. As a disinterested party, the mediator studies information from both sides of an argument. Mediation sessions begin with each party fully explaining their position to the other party and the mediator. It is critical that each party is able to explain their side of the issue without interruption. The mediator then discusses each party’s position in private. Afterwards, the mediator shuttles between the parties and tries to negotiate a settlement. The most important features of mediation are that the process is voluntary and the disputing parties are actively involved in reaching a solution.
  • Arbitration – This is a method that is frequently required by an insurance policy provision. Under arbitration, you and the insurance carrier each select a representative (arbitrator). Once the arbitrators are selected, they agree on another arbitrator who acts as the arbitration judge. The three persons discuss the merits of the situation and, once any two of the three persons agree on a settlement amount, the process ends. Arbitration differs from mediation in two important respects. First, the disputing parties are bystanders, waiting for a decision to be made by their selected representatives. Second, arbitration is (generally) binding on both parties.

If you are in a dispute with your insurance carrier, no course of action is perfect. Considering the cost and time involved with lawsuits, it makes sense to take advantage of other options to handle high-stakes disagreements. If you need more information, Peoples First is able to navigate you towards an advisable way to reach agreement with your carrier.

September is National Preparedness Month

September is National Preparedness Month, which reminds us to review our insurance policies to determine what perils are and are not covered, as well as to decide which risk management steps to take to lessen the potential impact of a loss.

Nearly the entire  East Coast felt the recent Virginia earthquake to some degree. While there was little to no damage in Rock Hill and the rest of York County, it was a reminder that we are not immune from natural disasters (if this year’s storms hadn’t already convinced you). Couple the earthquake with Hurricane Irene’s near-miss of South Carolina, and things could have been much worse for our state.

From an insurance perspective, it is very important for you to know that while your standard homeowners policy covers many causes of loss, earthquakes and floods are usually not included; these typically need to be purchased separately. Even if your home is not in a flood zone, a hurricane or heavy rain could still cause damage. As Ann Roberson, spokeswoman for the South Carolina Department of Insurance, states, “Everyone lives in a flood zone. It just depends how severe the flooding might be.”

We are not out of the woods with natural disasters yet. We are in peak hurricane season, and winter, which brings snow and ice storms, is not too far away. It is never too early to start thinking about how to prepare for these events. If you need help reviewing your policy or need tips on how to prepare for a natural disaster, call us today.

Helping Navigate Workers Compensation

Our client had a workers compensation claim when their employee was severely injured. The insurance company was investigating the claim and things were at a complete standstill. The claimant was 30 days post accident with no answers regarding coverage from the company. Peoples First had numerous conversations with the Industrial Commission and was able to successfully advocate for our client. We spoke with the insurance company and impressed the importance of handling this claim correctly and they conceded by moving forward and accepting compensability.

How We Advocated for a Client after a Fire

Our insured had a large fire which destroyed storage building housing multiple pieces of equipment and tools. Due to policy limitations, the company was restricting certain areas of coverage. Peoples First researched the carrier position and demonstrated their position was flawed. As a result, our client received and additional $64,000 in coverage.