Insurance Claims in Massachusetts

What Are Insurance Claims?

Filing an insurance claim in Massachusetts 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 Massachusetts property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your Massachusetts 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 majority of property insurance claims in Massachusetts are for water or wind damage. Keep in mind that in standard homeowners insurance policies, water damage specifically excludes flood damage. Most policies will cover damages for things like burst pipes. However, you would need a separate flood policy for weather-related flooding. In addition, not all threats are predictable. For example, Mass Live reports that residents are still recovering from the massive gas explosions in 2018.

How to File a Property Insurance Claim in Massachusetts

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

Unlike some states, Massachusetts does not set a specific time limit for the insurance company to accept or deny your claim. However, the Massachusetts Division of Insurance states that the insurer must respond and settle your claim as soon as possible. If they are dragging their feet, you may be able to file a consumer complaint against them.

In addition, your settlement offer should be fair and reasonable under the terms of your policy. If you disagree with the offer, the state’s Division of Insurance offers several recommendations. One of these is to attempt a resolution directly with the insurance company. Some companies may be willing to work with you to reach a compromise. You could also request arbitration or an external appraisal. If all else fails, you may want to consider filing a lawsuit.

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?

Most people know to call 911 after a serious accident. However, Massachusetts law requires additional reporting in some cases. If there were any injuries, or if the damages total at least $1,000, each driver must file a crash report with the Registry of Motor Vehicles. This is mandatory regardless of who was at fault for the accident.

In addition, according to the Division of Insurance, Massachusetts is a no-fault insurance state. This means that your own policy will cover your damages, regardless of who caused the accident. In addition, you cannot seek damages from the other driver unless you meet certain criteria. However, if you sustain major injuries or your medical bills exceed $2,000, you gain additional options. These may include filing a third-party claim with the at-fault driver’s insurance or even filing a lawsuit.

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 Massachusetts.

Health Insurance Claims

Massachusetts 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 Massachusetts?

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.

This process can be confusing, and many people receive a shock when they find out what their insurance doesn’t cover. Adding to this problem is the huge increase in the use of telehealth as a result of the COVID-19 pandemic. The Boston Globe reports that, despite some new legislation, telehealth coverage is still creating disputes between providers and insurers. A Massachusetts insurance attorney may be able to help you navigate this relatively new area of healthcare law.

Work with an Experienced Local Insurance Lawyer in Massachusetts

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