Insurance Claims in Missouri

What Are Insurance Claims?

Filing an insurance claim in Missouri 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 Missouri property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your Missouri 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. 

Missouri residents have to deal with several types of severe weather that can damage their property. In the warmer months, tornadoes pose a serious threat. In fact, kq2 News reports that a St. Joseph family lost their home recently when an EF1 tornado tore their roof off. When the weather turns colder, winter storms can be equally devastating. Fortunately, according to the Missouri Department of Insurance, most homeowners policies cover damage from both spring and winter storms.

How to File a Property Insurance Claim in Missouri

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

Everyone wants their claim settlement as soon as possible, so they can make repairs. Under Missouri’s Unfair Claims Settlement Practices Act, the insurer has 10 days to provide all the necessary forms. Once your forms are complete, they must deny or accept the claim within 15 days. However, they do not have to offer a settlement amount at that time. The investigation can sometimes take many months, especially after a major disaster. Nevertheless, the insurer must update you on the status of the investigation at least every 45 days.

Once your insurance company offers a settlement, you must choose whether to accept it or not. If you do not accept, you may want to try negotiating with the insurance company for a better offer. It can sometimes be helpful to hire a public adjuster if you disagree with the company adjuster’s findings. If you cannot reach an agreement, you could file a consumer complaint with the Department of Insurance. Your Missouri attorney may also recommend arbitration or litigation.

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?

The first thing most people do after a car accident is to call 911. In fact, under Missouri law, you must call the police right away if there is property damage over $500 or any injuries. In addition, if any of the parties did not have insurance, you must file an accident report with the Missouri Department of Revenue.

You should also report the accident to your insurance company. According to wallethub, Missouri follows the fault doctrine for car insurance. This means that the at-fault driver’s insurance should pay for the damages. This system can take longer, since the payout has to wait for a fault determination. On the other hand, unlike in no-fault states, Missouri drivers can file a lawsuit right away if they want to. This can allow for compensation not only for economic damages, but for things like pain and suffering.

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 Missouri.

Health Insurance Claims

Missouri 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 Missouri?

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 insurer denies your claim, it is almost always worth the effort to file an appeal. In fact, a large number of appeals can even result in a policy change. For example, Modern Healthcare reports on a recent change in Anthem’s policy for covering emergency room visits in Missouri. A 2017 policy led to a large spike in claim denials. However, more than 62% were reversed on appeal. Because of this, Anthem made changes to its policies and the denial rate fell to almost 0%.

Work with an Experienced Local Insurance Lawyer in Missouri

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