There are insurance policies for almost everything. Californians know that celebrities hold insurance policies to their own body parts even. Automobile insurance is the most familiar, but there is also homeowners insurance, which is also well known. Home-buyers are sometimes required to purchase homeowners insurance before they can move in.
Homeowners insurance covers a wide variety of different events. Fires, floods, theft, and dog bites are just a few. Both liability (coverage for negligence of the homeowner) and losses (damages that homeowners incur) are covered. There are exclusions and exceptions. Delays, denials, and confusion can be anticipated.
Every policy is different; attorneys can assist in pursuing a first party claim, particularly if the insurance company has issued a denial. A first party claim is when a policyholder pursues a claim pursuant to the policy purchased. For example, a first party claim could be made when a home is burglarized, and there is a provision that covers items stolen.
Since insurance law is based on case law, statutes, and regulations, there are a myriad of ways a policy can be interpreted. It is important, however, to know some basic principles. Here is a non-exhaustive short list:
1) Once a claim is reported, the insurance carrier must provide basic information to the policyholder — like limits, benefits, coverages, exclusions, and other provisions in the specific policy in place.
2) An insurer must explain why a claim has been denied, and provide a basis for that decision. For example, if a claim was denied because the insurer did not have an opportunity to inspect the premises, it would have to show that a request was made and the request was denied.
3) Before an insurance carrier can ask for a “release,” it must explain the legal consequences of having the claimant execute the release, i.e. forever barring the claimant from pursuing the claim further in court, or in arbitration.
4) The insurer must respond within 15 days if a claimant asks for information related to his or her claim. An insurer cannot ignore its own insured.
5) All insurance companies must investigate a claim with diligence, thoroughness, and in good faith. The insurer cannot delay a claim when there is sufficient, reasonable information to conclude the claim.
Pursuing a homeowners insurance claim can be daunting. It is important to know your rights and to be aggressive. It is extremely wise to contact an experienced attorney.