Tricks of the Trade
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FACTS ABOUT THE INSURANCE INDUSTRY
• Each year, homeowners file about 7 million non-catastrophic claims
• The average homeowner claim is between $5,000 and $6,000
• A typical homeowner files a claim once every 7 to 10 years
• Over the last 20 years, payout on claims has dropped almost 30% from
  an average of 70 cents per dollar to less than 50 cents
• Industry reserves plus surplus capital now total almost $1 trillion
• U.S. insurance rates have increased an average of 17% over the past 10 years
 
 
THE PROCESS GAME
Each insurance company has its own system for dealing with claims. Generally the process is divided into three phases:

• The Litmus Test
• The Analysis
• Negotiation & Resolution

“The Litmus Test”– Comprises three activities: Notification, Coverage and Fraud.

This phase is important. If you don’t pass the “Litmus Test” you don’t have a claim. Insurance companies use this phase to determine if your damage is covered by your policy and whether fraud is involved.

If the damage is covered and there is no fraud, the carrier must accept liability. The Litmus Test is usually short term—a matter of days or weeks.

“The Analysis”– The evaluation of damage.

Once the carrier accepts the claim, it determines how much the repair will cost. Usually the amount of damage determines how long this phase takes. Regardless, the insurance adjuster is trained to do at least two things: one, appear concerned for the insured with compassion for their situation; and two, reduce the carrier’s cost however possible. To read more about how insurance companies control losses see Case Studies »

After gathering measurements and related details of the damage, the adjuster will enter the information in a company program to estimate a dollar value of your loss. To resolve the claim, the adjuster must get you to agree to that number. At the same time, the company must show a liability on their books for that estimate.

Now the process usually slows down. Insurance companies take their time informing customers of their Loss Estimates. The reason? Simple. The insured is frustrated and tired of waiting, may have paid out of pocket for some repairs and is eager to get a check. Insurance companies bank on this strategy.

Here is where MySmartClaims goes to work for you. With information generated by our professional software, homeowners can take the upper hand. They can protect themselves and their families during the next phase.

“Negotiation & Resolution” – Includes Subrogation, Litigation Management and Salvage.

Insurance adjusters may be nice. They may be helpful. But don’t forget: they work for the insurance company. They are highly trained. They are skilled negotiators. Their goal? Keep the payout small.

A stipulation in your policy helps level the playing field. You are under absolutely no obligation to accept the carrier’s estimate. Therefore, the insurance company is always prepared to negotiate that estimate. Appropriately, the homeowner should never blindly agree to the estimate. Would you pay an invoice without reviewing it? Unlikely. And we do not recommend that you accept any carrier’s initial estimate without careful review.

Now is when MySmartClaims is most valuable. Prepare to feel very smart. And very effective. Our program enables you to review the insurance company claim without knowing any adjuster skills. It applies built-in rules that depend on your answers to simple yes/no, multiple choice or fill-in-the-blank questions. MySmartClaims is easy to use and intuitive. And, because it’s available on-line 24/7, you can quickly get back to your adjuster with a new estimate. Your new estimate.

Remember, at this point the insurance company has agreed to the liability. MySmartClaims doesn’t change the scope of the damage. And because the information you enter is taken from the carrier’s estimate, all the adjuster can do is dispute the amount.

Here is where the negotiations begin and you have an opportunity. Even if you’re a bad negotiator, you will at least get the insurance company’s original offer. Better negotiators will agree to settle in-between the two figures. In our experience, once you give the adjuster the MySmartClaims report, they begin to understand something. You have the same kind of information they do. You have an objective, professional detailed report of their loss estimate. And you don’t want to leave money on the table.

 
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MySmartClaims is not a public adjuster and does not act on behalf of an insured in negotiating for or effecting the settlement of a claim or claims for loss or damage under any policy of insurance. MySmartClaims provides the customer software that they can use to generate a report and assess whether their insurance company’s loss estimate was appropriate.
© 2008 SmartClaims.com, LLC. All rights reserved. MySmartClaims.com™ Insurance Recovery system (V2.1)