Insurance Claims in Connecticut

What Are Insurance Claims?

Filing an insurance claim in Connecticut can be a stressful process. Every policy is different, and insurance companies may not pay you what you deserve. In many cases, hiring an insurance claim lawyer 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 Connecticut property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your Connecticut 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. 

Connecticut’s Insurance Department (CID) recommends reviewing your homeowner, renters, or condominium policy yearly. In fact, it is important to do this prior to the start of the Atlantic Tropical Storm season which runs from June 1 through November 30. Keep in mind, windstorm or hail deductibles may not be mandated by insurers in Connecticut. Additionally, the imposition of a hurricane deductible can only be applied during the period:

  • Commencing not earlier than when the National Hurricane Center (NHC) issues a hurricane warning for any part of Connecticut
  • Ending 24 hours after the NHC’s termination of the last hurricane warning or last status downgrade, whichever is earlier

How to File a Property Insurance Claim in Connecticut

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

According to Connecticut’s Office of Legislative Research, you must immediately notify an insurer of any loss and provide proof of the loss within 60 days. Generally, the insurer must pay the value of the loss within 30 days after you file proof of loss, and you both must agree on the value of the loss. If you and your carrier fail to agree on the value of the loss, then each party has 20 days to select an appraiser. The appraisers determine the actual cash value and submit any differences to a neutral umpire. Once the insurer accepts the evaluation, they must notify the insured within 30 days of their intention to repair, replace, or rebuild the destroyed property.

It is advisable to consult with an experienced Connecticut attorney if you want to sue your insurance carrier over a property loss claim denial. Keep in mind, you must file suit within 24 months after the inception of the loss. As well, Connecticut law prohibits an insurer from setting a time limitation on suits that is less than one year from when the loss insured against occurs.

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.

What Do You Do After a Car Accident?

Connecticut law is very clear on what to do if you have been in a car accident. Specifically, the accident must be reported if there is death, injury, or property damage of more than $1,000. Consequently, you should stay at the scene of the accident and call 911. The report must be filed with the Commissioner of Transportation within five days.

Since Connecticut is an at-fault state, you can seek compensation from the at-fault driver’s insurance company. In addition, you can, if necessary, initiate a lawsuit. The car accident report can be crucial to determining the outcome of your claim. Specifically, the report serves as substantial evidence against the negligent party’s account of events. Your Connecticut attorney can help you obtain a copy of the report from the local law enforcement agency. As well, they can help you understand the legal implications of the report.

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 Connecticut.

Health Insurance Claims

Connecticut 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 be 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 Connecticut?

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.

Unfortunately, filing a supposedly straightforward claim can be fraught with surprises. In 2020, The Connecticut Mirror reported the story of a Norfolk resident who underwent neurosurgery. When he submitted his medical bills for coverage, Aliera Healthcare refused to pay the $280,000 he owed, saying he had a pre-existing condition. However, the man had never before experienced symptoms. Of note, Aliera Healthcare is a religious health care sharing ministry, which is a cheaper, less regulated alternative to traditional insurance. Connecticut’s Insurance Department has issued a cease-and-desist order against the company, but Aliera is appealing the order.

Work with an Experienced Local Insurance Lawyer in Connecticut

If your health insurance provider refuses to honor a claim, seek out a qualified Connecticut 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 Connecticut state lines.

Submit a request online or call us today at (866) 345-6784 to get in touch with an experienced lawyer in your area!

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