Dear Insurance Company: Don't even think about denying my claim! Great advice to follow!

   

 

Dear Insurance Company:
Don't even think about denying my claim!

My business career covers many industries, one of which was insurance. Yes, at one time I was an insurance salesman. It didn't take me long to realize three things:

1. Insurance wasn't my thing.
2. Sales wasn't my thing.
3. Insurance sales wasn't my thing.

Since my Clients know that I am available to them and their families for as long as they live, sometimes one will call me with an insurance problem. Here's a little help in working with insurance companies.

First, like any business, insurance companies are out to make a profit. They don't do that by paying claims. Their first line of defense against your claim is simply to deny it outright. Their thinking is that you'll accept their decision and go on your merry little way.

Ha! With my help, you're going to do anything but go on your merry little way.

If they deny your claim for whatever reason, ask them to reconsider. The second time around your claim will actually get "processed," meaning that you'll probably get more action than just a computer-generated letter denying your claim.

If they deny your claim because of "pre-existing conditions," that's a standard phrase used to deny claims. It doesn't mean anything unless you let it. Even if your policy excludes pre-existing conditions, if the insurance company didn't send anyone out to look at everything, they can be taken to task. Call them on it with this little tidbit that has worked for me and my Clients 100% of the time:

Dear Mr. Insurance Company:

You had the opportunity to inspect the [roof/water heater/whatever] prior to issuing a policy and accepting my premium payments. Since you did not do that, the fact that you issued a policy and accepted my premium payments mean that you warranted that the [roof/water heater/whatever] was in insurable condition, including any pre-existing conditions. Please forward to me at [address] either a check for [repair/replacement] of the [roof/water heater/whatever] or a refund of all my premium payments from [date of coverage commencement to current date]. Thank you.

Sincerely,

Paul McCartney

Copy: State insurance commissioner

Modify as necessary.

I know what you're thinking: "Well, sure, Paul McCartney is going to get some action." You can, too! Simply replace his name with your name!

Send a copy by overnight mail to the insurance company and the second copy to the insurance commissioner in your state.

Insurance is regulated in all 50 states, so even though you might not have an "insurance commissioner," there is still some Top Dog somewhere who is in charge of your state's insurance industry.

Once the insurance company understands that they have a serious and knowledgeable policyholder on their hands, it's far less expensive to just send you a check and be done with it.

Every time I do that for one of my Clients, one of two things happens:

1. A check arrives in their mailboxes by overnight delivery a day or two later.
2. Policyholder gets a phone call telling them that their claim has been approved and that a repairperson will be there tomorrow.

My greatest success so far was a check for $11,950 for plumbing problems. All she had to pay was her $50 deductible, which had been deducted from the $12,000 plumber's invoice.

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