Most Successful Insurance Claim Arguments
When presenting a claim to the insurance company, you will need to have some viable arguments to support your claim. Now, since this process is so unique to each individual PA, not everyone will approach the matter in the same way.
On top of that, the arguments I usually make when presenting the claim may not be even similar to the ones you do. And, as such, my most successful insurance claim arguments may not work the same way for you.
That being said, sharing some of my most successful insurance claim arguments may help you decide which arguments you should emphasize when presenting your own claims.
It can potentially change your perspective and encourage you to try some new things out. So, with that in mind, here are my most successful insurance claim arguments.
Arguments on the estimate
Initially, we can make a clear distinction between arguments made on the estimate itself and the arguments made on the policy. So, first, we’ll be discussing some of the most common – and personally my most successful arguments made on the estimate.
When you write an estimate, you need to make sure it includes everything you’ll be making an argument for. Make sure you’re thorough in this process as the last thing you want is for the estimate to go through only to have your client encounter other issues later on that should have been covered as well.
Of course, the insurance company is going to try and contest you on some of these things, so what you need to do is make sure you have rock-solid arguments to support your claim.
Remember, your client is your most important person in this context and you, as a PA, need to ensure that you always have your client’s best interest in mind.
One of the most common things I usually get fought on is continuous flooring. If there’s continuous flooring throughout the house, it needs to be written up.
Simply put, there’s no way you can repair damage on continuous flooring without compromising its original look. Or rather, the only way you can do so is by replacing the floor entirely.
Most often, the insurance company will argue that if there’s any type of threshold in between the rooms they don’t need to pay for the entire floor to get replaced.
However, just because there’s a threshold, that doesn’t mean that changing only the flooring in the area where the damage occurred won’t compromise its entire look.
Line of sight
The similar thing goes for the line of sight. If a client’s home looked a certain way before the damage occurred, you need to ensure that the same applies after repairs.
So, if – for instance – your client had an entrance area flooring covered in tiles but the rest of the flooring is continuous hardwood flooring, you need to make sure that after the loss gets paid for their home still looks the same.
The argument that can be made here is that your client probably bought the house due to this unique design element, so they most likely would like to see it not being changed or compromised.
Usually, the insurance company will try to pay only for damaged baseboards. For instance, if there was water damage in your bedroom and you have continuous flooring throughout your home, the insurance company will try to cover only the damaged baseboards in that particular room.
So, as a PA, I always write up all of the baseboards throughout the house. The argument that can be made here is quite similar to the first one.
Simply put, you can’t really detach and replace only certain baseboards without compromising the original integrity of the entire floor.
On top of that, you can’t really expect to have every single baseboard in the house detached and reset without damaging or compromising them in the slightest. So, replacing baseboards is the only logical way to go.
So, every time I write up flooring and baseboards, I always make sure to add 10% dry wall as well. The reason is simple – when changing the baseboards and flooring, chances are that the drywall will suffer some damage as well.
Therefore, you’ll also need to have some kind of drywall on your estimate. I always try to stick to the 10% because that’s the most realistic amount of damage the drywall will suffer.
Things may get a bit more complicated if the walls are textured so you need to make sure you account for that as well. Even though this damage was not the direct result of the initial damage, it still needs to be addressed and taken care of properly.
Granite countertop and kitchen cabinets
The same argument can be made when there’s any type of damage in the kitchen. Usually, the insurance company will only offer to pay for damaged cabinets.
However, when your client was buying their house or their kitchen cabinets, they bought it as a cohesive set. So, only replacing certain parts of that set doesn’t really make sense as then it will no longer actually be a set.
Therefore, you need to ensure that you insist on replacing kitchen cabinets as a whole. Refacing kitchen cabinets is also a weak argument an insurance company may try to throw into the mix.
The reason this shouldn’t be a viable option is due to the fact that such solutions are never sustainable and durable in the long run. It’s no different with granite countertops.
If you consider how heavy yet delicate they are, it becomes quite obvious how easy it is for them to get damaged if they were to be detached and reset.
Arguments on policy
There are many different policy arguments that can be made depending on the type of policy your client has signed. But you’ll mostly be dealing with the homeowner policies.
Long-term pre-existing damage
For instance, in Florida, the majority of policies allow for 14 days. What this means is that if the insurance company feels like the damage has been going on for more than 14 days, they will say that it can’t be covered.
But unlike the dwelling policies, the homeowner policies will usually state that if a client doesn’t notice the damage – due to the fact that it’s hidden or inaccessible – the policy will still cover the damage.
So, if the damage has been going on for more than 14 days but it wasn’t easily noticeable up until the point where the loss occurred it still needs to be covered. On top of that, there really is no way to determine with absolute certainty exactly how old the damage is.
Therefore, make sure you know exactly which type of policy you’re dealing with so that you know how to shape and make your arguments.
Water damage limits
Again, in Florida, the water damage limit is set to $10,000. And now the most common argument that I usually make is accessibility. In order to access the damaged area, you’ll most commonly have to do it through the floor or walls.
The problem is that the access itself doesn’t fall underwater damage. So, make sure you have those two completely separated so that you can later on writing both of them up, particularly because the access damage costs can sometimes greatly exceed the water damage costs.
Of course, as I mentioned in the beginning, these were just some arguments that I personally made that turned out to be quite successful.
Again, your arguments may vary completely depending on the particular situation you’re in. So, feel free to share your own experiences and some of your tips and arguments in the comments.
It’s time to take full control of your claims. Of your business. Of your life.
A community can help you get there faster. It can offer support during these tough times. Inspiration. Guidance.
Together, we can get you to where you want to be.
What are you waiting for?