Insurance

Claims process and how it works for commercial and residential properties

Southern California commercial and residential property damage claims recovery law firm

Now What?

The claims

process

Under the regulation of the State Department of Insurance, you have the right to receive a fair adjustment on a claim. The insurance company is obligated to compensate you for your losses. You have no obligation to accept a low-ball offer and/or delays of processing your claim.

        STEP ONE

 

Notify your homeowner’s insurance company

Your insurance policy contract requires you to report the property damage claim to them promptly. Failure to do so within the stated time limit in your contract could possibly result in the denial of your claim. It is important to note that even if you must evacuate the premises of your property, you still must contact your insurance company as soon as possible. Depending on your insurance company, this can be done over the phone or online.

However, almost always your phone calls are recorded and sadly as most of clients are clueless about this process, wrong choice of words or explanations will have dire consequences on your claims outcome.

Consider this Real Life Case Example

Our client had noticed a generous water leakage in her kitchen from her refrigerator's water line.  The leak had reached the living and dining room.

 

While she was reporting the incident she was asked if she had noticed any water leaks in the week before her current incident.  A week prior to this she had noticed a nominal amount of water on her kitchen floor near the refrigerator area which she reported in her statements about the current huge water leak.

Two weeks later she received a denial letter from her insurance company stating her that her claim was denied because per her own statement the duration of the leak had exceeded over a week, and per her policy an "ongoing leak over seven days would not be covered".

My preliminary investigation showed that the previous leak had nothing to do with her current leak, and in fact it was a normal amount of discharge to automatic defrosting by the her refrigerator responding to a temperature change due to device failure within her refrigerator.

While we revived her claim and her damages were compensated, the currently insured property owners need to understand the urgency of effective communication with their insurance companies even in initial stages that seem routine and inconsequential.

 

Once you notify your insurance company, of your claim,  we will oversee an extensive, in-depth process that will require great attention to detail and a sufficient amount of time and preparation on your behalf. The claims process involves:

  • Contacting Your Insurance Company

  • An Evaluation of the full Scope of your Damages 

  • Negotiations Toward Resolution and Settlement

For this first phase of the process, you will need the

following information:

  • Name

  • Address

  • Insurance Policy Number

  • Claim Type (fire damage, water damage, appliance breakdown hurricane, earthquake, etc.)

  • Description of Damage to your Home and Personal Property

Don't be surprised as you are no expert to assess the full extent of your damages, insurance claim operators drill you to describe the scope of damages.  Obviously almost always most insureds describe what they can see.  As insurance company and their claim adjusters are under no obligation to determine your full scope of visible and hidden damages, underpayment of your claim is only a natural consequence to follow.

 

Consider this example how a lack of proper description without having an experienced observer initiate your claim can and will lead to under compensation for your loss.  

 

Plumbing line failure and upstairs bathroom leak is observed by the insured.  After initial claim report describing water reaching the bedrooms and upstairs hall, restoration company initiates wall, carpet and floor removal of certain designated areas of upstairs and since the downstairs ceiling also showed visible sign of water bubbles, ceiling drywalls were removed as well.  Client had eventually received a check for rebuilt of the damaged areas in the sum of $31,000.00

 

Upon hearing my Radio show on 670 A.M. they contacted to see if they were fairly compensated.

None of the insurance adjusters or their experts had investigate the structural integrity of the upstairs floor joists despite the fact that the wet framing were puffed and expanded by millimeters.  This repair estimate alone was $160,000.00

They say this is not a longing matter but ironically sometimes they are.  I am sure some of you have seen movie or sitcom scenes when  there is a party where everyone is tipsy and feeling good, and suddenly the entire ceiling erupts in front of astonished guests.

Technically, this is one of the reason for structure failure when not addressed and remedied.

Claims Process

Despite a general assumption that calling in a claim is a simple handing over Of information such as; name, address  and policy information, in reality this is a highly complex process that has to be done very carefully.   Please read this section before calling in your claim.

Kouros Lahooti

Attorney at Law

CONTACT

Max Insurance Recovery

Law Offices of Kouros Lahooti

CONTACT

Max Insurance Recovery

Law Offices of Kouros Lahooti

OUR ADDRESS

21550 Oxnard Street

Suite 300

Woodland Hills, CA 91367

Email: claims@lahootilaw.com
Tel:  818.300.5777

 

For any general inquiries, please fill in the following contact form:

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