Common Insurance Conflicts and Their Resolutions

By  //  February 27, 2021

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Accidents and misfortune can occur at any moment. That’s why we buy insurance policies to ease our life in the time of need. But claiming insurance is not a piece of cake often. There can be various unfortunate events that block the path to our claims.

Today, we will talk about one of those circumstances. Here a conflict arises between the insurance company and the insured person. We’ll be discussing the point of conflict and the ways to resolve them effectively.

Conflict of Interest

Commonly three types of conflicts of interest can occur between the insurer and the policyholder. They are:

■  Unwillingness to settle for the fair claim

■  Disturbances in the insurer’s claims supply chain

■  Insurance company protecting both parties of a claim

Each of these three cases will be described briefly below.

Unwillingness to Settle for the Fair Claim

This practice is often seen in various cases. Property claims suffer the most of it. Let’s be honest; insurance companies are trying to run a profitable business. When a policyholder tries to claim the full and fair settlement, it goes towards the company’s expenses.

That can create significant tension between the company and the client. The company tries to dismiss the claim with policy wording and vague details that the policyholder is not familiar with. And there occurs this specific kind of conflict. For such claim settlement, public adjusters should be hired by homeowners.

Disturbances in the Insurer’s Claims Supply Chain

The root of this problem lies beneath the layers of the company’s claim supply chain. The supplier may try to justify the appointments with procedural fulfillment and cost-effectiveness. This results in the policyholder’s struggle to raise the voice. Although these issues will never disappear, adoption at working in a non-financial way may relieve some conflicts.

Insurance Company Protecting Both Parties of a Claim

This kind of conflict arises when two parties of a claim are protected by the same insurance company. Road accidents may be an excellent example of realizing this conflict.

The damaged vehicle and the vehicle that initiated the damage of them may be protected by the same insurance company. But the complex structure that lies beneath the company takes more time to realize the problem; thus, dealing with it can be delayed severely.  One of two reasons contributes to this conflict.

Underestimating the conflict of interest at play within a supply chain.

Misjudging the controls put in place to resolve the conflict of interest.

Resolving The Conflict of Interest

To claim your settlement, one must solve the conflicts beforehand. We recommend the following four-step process to resolve the disputes.

#Step 1: Go through the policy again.

Read through the agreement you received from the insurance company. Mark out the clauses that apply to you. Also, learn why your claim can get dismissed. Get a clear picture of the facts and circumstances of each claim.

#Step 2: Get clarification about the policy.

After reading the policy, determine if you are clear about each and every wording of it. Understand the intention of the wordings and get a clear picture of what you have consented to and excluded. Also, research the reasonable expectation of coverage.

#Step 3: Investigate and document your resolve.

Find out if there’s another coverage consideration other than the relevant policy language. Also, make sure if there’s any evidence that may or may not conflict with policy language. If your research confirms the company’s claim denial, your claim may vanish instantly. However, if there’s any alternate resolve according to your study, assemble the documents to present to the authorities.

#Step 4: Plead your case.

Now you should plead your case to the insurance company so that the scale becomes heavier in your direction. Present the tweaks and facts that you gathered. Be prepared to defend your side and also listen to the arguments of the company. The reasonable expectation of coverage is.

Hire an Adjuster

This step-by-step process may overwhelm you at any moment. And you already are in enough pickle. So we highly recommend you hire a public adjuster. A public adjuster can research the conflict and take the necessary steps to solve the disputes.

This way, you can concentrate on what you do best and get the rightful claim you deserve. The public adjusters work on behalf of you and only charge you a negligible percent of your request. So hiring an adjuster may be pretty suitable for your benefit.

A public adjuster can make a huge difference in your claim when you are in terrible shape. But before hiring, you should do your homework first. And some imposters try to scam you.

So you may be ready for any situation, but when you ask for a license and previous work reference, you may get a clear idea about it. And before believing anything, do your research first. And always hire your professional from a trusted source. That way, you can avoid the wrong impressions and get the higher benefit that you deserve.