Insurance Claims in Delaware

What Are Insurance Claims?

Filing an insurance claim in Delaware 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 Delaware property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your Delaware 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 Jerry Insurance, the most common causes of property loss in Delaware include water damage, wind damage, and flood damage. Specifically, Delaware is located on a peninsula and has an average elevation of only 60 feet above sea level. Consequently, the state is vulnerable to powerful storms. Since flooding is not included in a standard policy, Delaware’s Department of Insurance recommends buying a flood insurance policy through the National Flood Insurance Program.

How to File a Property Insurance Claim in Delaware

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

Time is of the essence when you are recovering from storm damage in Delaware. Fortunately, Delaware Code mandates a timetable for insurers to process homeowner claims. For example, a Delaware insurance company must acknowledge and respond within 15 working days to communications regarding your claims. The carrier must also promptly investigate the loss within 10 working days of receiving your claim. The insurer cannot deny a claim without conducting research into all available information. Furthermore, the insurer must accept or reject your claim within 30 days after proof of loss statements have been received by the insurer.

Be aware, according to the Delaware Department of Insurance, your carrier can decide not to renew your homeowner policy for a variety of reasons. According to the Delaware Department of Insurance, some of these reasons include:

• Three or more weather-related claims have been made during the 36 months immediately preceding the expiration of the current policy period

• Two or more non-weather-related claims have been made

• You failed to make necessary changes or repairs that change or increase the risk

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?

Delaware Code governs the duty of drivers involved in collisions that result in property damage, injury, and/or death. First and foremost, you must stay at the scene. In fact, you must stop as close to the scene as possible without obstructing traffic. You must also ascertain if there are any injuries or deaths involved and call 911. If the collision results in injury or death, or the property damage is $2,000 or more, you must report the collision to the police.

The Delaware Department of Insurance recommends exchanging insurance information with the other driver(s) and calling your insurance company while on the scene. This is because Delaware is a tort state that also requires drivers to have no-fault insurance. Consequently, you can use your personal injury protection insurance to pay for your own injuries. However, you are not limited when it comes to filing a claim with the at-fault driver’s carrier, or suing the at-fault driver for compensation.

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 Delaware.

Health Insurance Claims

Delaware 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 Delaware?

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, you can do everything by the book when filing a mental health claim and still be denied coverage in Delaware. In fact, Delaware’s Department of Insurance (DOI) fined four major insurance groups in Delaware $1.3 million dollars for denying mental health claims. The fines were part of a two-year investigation into complaints from Delaware policyholders who reported unequal coverage of mental health medication and services. According to ABC47, the DOI believes that the denials were part of a strategy to boost profits. Specifically, the insurance companies did not pay for the relatively higher priced medications and services, knowing that many claims would not be disputed.

Work with an Experienced Local Insurance Lawyer in Delaware

If your health insurance provider refuses to honor a claim, seek out a qualified Delaware 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 Delaware 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!