Insurance Claims in North Carolina

What Are Insurance Claims?

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

As reported by Spectrum News 1, North Carolina can experience severe thunderstorms any time of the year. However, the most active times include the months of March, April, and May. This weather activity often leads to property damage and a sharp increase in property claims. An everyday example of how much destruction can occur comes from the Stanly News & Press. In March 2022, a storm ripped the roof off a home in Cottonville. Beyond those repairs, the water that enters your home can do as much if not more injury to a home.

How to File a Property Insurance Claim in North Carolina

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

As reported by the Consumer Financial Protection Bureau, you will meet with an adjuster after filing your claim. This individual has the task of determining what the company should or should not pay for in a settlement. In some cases, they may recommend reimbursement for a total loss.

Under North Carolina law, insurers should pay or give notice of a denial within 30 days. If they deny your property claim, they must present the good-faith reasons for their refusal. Legitimate justifications include eligibility problems, benefit limitations, and having deficient coverage. There are usually options for a round or two of appeals directly to the insurer. If these attempts fail, a court case may be the last option available.

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 North Carolina Department of Insurance has a checklist for reacting to an accident under current law. First, and most important, is pulling over to a safe spot and calling for help if there are injuries. If you haven’t already done so, notify law enforcement so they can investigate. Subsequently, you will need to complete a police report within the next 48 hours.

After filing a claim with your insurance, an adjuster will need to assess the damage. Depending on the circumstances, they may not pay you directly. Instead, they will find a conveniently located shop and pay them directly for repairs. In the event of a total loss, the payment will factor into a loan you may have on the vehicle.

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 North Carolina.

Health Insurance Claims

North Carolina 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 North Carolina?

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 claim, stress and worry can naturally follow. A denial of a prescribed treatment can mean weeks, months, or even years of legal disputes. Thankfully, help is available to North Carolinians. Smart NC is a service from the Department of Insurance that helps you through the appeals process. Furthermore, you can request an external review to verify that you have coverage. When these avenues become exhausted, scheduling a consultation with an attorney is often the next step.

Work with an Experienced Local Insurance Lawyer in North Carolina

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