Insurance Claims in Cleveland, OH
What are Insurance Claims?
Filing an insurance claim in Cleveland, Ohio can be a stressful process. Every policy is different, and insurance companies may not pay you what you deserve. In some cases, hiring an insurance claim attorney is necessary. This page breaks down the nuances of different types of insurance claims.
What Is a Property Insurance Claim?
A homeowner’s insurance policy is an agreement to protect the home from damage under specific occurrences. When you as a policyholder suffer a loss, you should find a dedicated Cleveland, Ohio property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your property.
If the insurer denies coverage or delays, policyholders should consult a property insurance attorney about a bad faith claim. If your claim goes to court and you win, you can often recover your court costs, attorney fees, and coverage benefits. There is also the possibility of recovering more money depending on the state laws under which you file your claim.
What Types Of Damage Claims Apply to Property Insurance?
Specific geographic regions impact the design of insurance policies. For example, Florida property insurance policies have more provisions for hurricanes versus earthquakes.
According to the Ohio Committee for Severe Weather Awareness (OCSWA), Ohio suffered 20 tornadoes in 2020 alone. Losses from these events generally fall under windstorm peril in most policies. However, flooding can also commonly lead to losses. Consequently, Ohio’s Department of Insurance recommends that Cleveland homeowners purchase flood insurance from the National Flood Insurance Program (NFIP). Your home will be covered for flood damage 30 days after your application and premium are received by the NFIP.
How to File a Property Insurance Claim in Cleveland, Ohio
After you suffer a loss, you must contact your insurer as soon as possible. Taking this step begins the insurance claim process and gets things moving along. You need to notify your insurance company in writing or over the phone. From there, your insurer appoints a claim representative.
What to Expect Afterwards
Ohio Administrative Code governs the time the state gives insurance companies to pay or deny a claim in Cleveland. To start, your insurer must acknowledge the receipt of your claim within 15 days of receiving notification. Acknowledgment can include making payment or providing the necessary claims forms and instructions. Additionally, the insurer must accept or deny a claim within 21 days of the receipt of your proof-of-loss forms. If you do not dispute the settlement offer, payment should arrive within 10 days.
Keep in mind, the claims process is not always straightforward. If more time is needed to investigate the claim, the insurer must notify you within the 21-day period and provide an explanation for the need for more time. Furthermore, the insurer has a continuing obligation to notify you in writing at least every 45 days. They must provide an update on the status of the investigation and any extra time required.
What Is an Auto Insurance Claim?
Auto insurance claims involve requesting compensation from an auto insurer after an accident. Car accidents are incredibly stressful, especially if there are uncooperative responsible parties. However, your insurer’s job is to work on your behalf to secure compensation for repairs, injuries and other expenses.
According to the City of Cleveland, you should call 911 immediately after an accident that involves injuries. Generally, if there appears to be at least $400 in property damages, you should contact the Cleveland Police Department. If the accident is outside the city, you can contact the Ohio State Highway Patrol. Remember, never admit any level of fault or sign any release forms.
Your next step is to contact your insurance company. According to WalletHub, Ohio is an at-fault state. This means the driver who causes an accident uses their insurance to pay for the other driver’s bills from the crash. When you file a claim with the other person’s provider, this is known as a third-party claim.
Auto Claims Adjuster
Your auto insurance company will assign a claims adjuster to your claim report. Your adjuster acts as your representation in any mediation between you and all other involved parties. This insurance representative bears responsibility for investigating the claim and seeing that you receive compensation for any repairs or injuries.
Whether there are repair claims, personal injury claims, or you are dealing with someone who does not have insurance, your auto insurance adjuster should see you through the process. Your claims adjuster may recommend a garage to handle your vehicle repairs. They may also make arrangements for a rental vehicle if required. The most important thing to note is that your auto claim adjuster is your primary point of contact regarding the status of your claim in Cleveland.
Health Insurance Claims
Cleveland, Ohio policyholders file health insurance claims when they seek reimbursement for medical services or treatments. When you obtain a medical service from a provider, your health insurance carrier should become notified directly. If there are any discrepancies in your claim, consider hiring a health insurance claim specialist attorney.
How Do You File a Health Claim in Cleveland, Ohio?
There are two ways to file a health insurance claim on your behalf. The first is the medical facility notifies your insurer for you. You may be able to walk out of the facility without spending anything, but that depends on your policy. The other way is to file a health insurance claim yourself. Taking this route can occur when a health provider you use is not in your provider network. The facility may still file the claim on your behalf, but you may need to file it yourself.
If your insurance carrier denies your prescribed treatment, it can be worth fighting back. News 5 Cleveland reported the story of a Cleveland man who needed a cancerous brain tumor removed. His health insurance provider denied the procedure, saying it was experimental and investigational. His family fought back by obtaining an external review of the claim. The right to an external review is a free service all health plan issuers must provide once the internal appeals process has been exhausted. In the end, an independent organization reviewed the man’s case and overturned the denial.
Work with an Experienced Local Insurance Lawyer in Cleveland, Ohio.
If your health insurance provider refuses to honor a claim, seek out a qualified Cleveland insurance claim attorney’s help. An insurance claim attorney can help if you have been improperly denied coverage or sent a bill for a service you never received. We can even help you connect with an attorney across Ohio state lines.