Insurance Claims in Sioux Falls, SD

What Are Insurance Claims?

Filing an insurance claim in Sioux Falls, South Dakota can be a stressful process. Every policy is different, and insurance companies may not pay you what you deserve. In some cases, hiring an insurance claim attorney 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 Sioux Falls, South Dakota property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your 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 FEMA, Sioux Falls homeowners face the risk of damage from severe winter storms, tornadoes, flooding, hail, and thunderstorm winds. In fact, the risk of tornado damage in Sioux Falls is much higher than the state average and the national average. Consequently, it is advisable to check which perils your homeowner policy covers. Be aware, standard policies do not cover flooding. However, Sioux Falls homeowners can choose to buy coverage from the National Flood Insurance Program.

How to File a Property Insurance Claim in Sioux Falls, South Dakota

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 the South Dakota Division of Insurance, a delay in the claims process is the number one complaint of insurance customers throughout the country. In South Dakota, insurance companies are required to respond to all claim communications within 30 days. According to Policy Genius, South Dakota does not set a specific time for payment of claims. Although most claims are paid within 30 days, this is not a legal obligation. If you have filed a claim and do not receive a response, you can contact the insurer to verify they received your claim.

Additionally, the Division provides tips for Sioux Falls homeowners to help ensure the process goes smoothly. Some of these tips include:

  • File claims as soon as possible
  • Provide complete, correct information
  • Keep records
  • Maintain any damaged property for the adjuster to see
  • Take photos or video before making temporary repairs
  • Don’t rush into a settlement

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?

Sioux Falls drivers should be aware of the South Dakota laws governing car accidents. For example, drivers must notify the Sioux Falls Police immediately if the accident involved injury, death or property damage of at least $1,000 to any one person’s property. You must also notify the police if the accident as a whole generated $2,000 or more in damages. Be aware, failing to do this is a Class 2 misdemeanor.

Next, you should notify your insurance company of the accident. According to WalletHub, South Dakota is an at-fault state for car insurance. This means the at-fault driver’s insurance pays for the other driver’s medical and repair bills up to the limits of the policy. Additionally, you have 3 years from the time of the accident to sue the at-fault driver. Consulting with an experienced Sioux Falls attorney can help determine if this is the right path forward.

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 Sioux Falls.

Health Insurance Claims

Sioux Falls, South Dakota 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 become 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 Sioux Falls, South Dakota?

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 health claim is denied in Sioux Falls, you have several ways to dispute the decision. According to Coverage Rights, your first step is to file a grievance with your insurer. This means you can request a full and fair review of its decision within 60 days. If you request an expedited grievance, the process should take no more than 72 hours. If the grievance process fails, you have 4 months to request an external appeal with the South Dakota Division of Insurance. You also have the option to file a complaint with the Division or the South Dakota Attorney General. Finally, consulting with an experienced Sioux Falls attorney can help determine if you have grounds for a lawsuit.

Work with an Experienced Local Insurance Lawyer in Sioux Falls, South Dakota.

If your health insurance provider refuses to honor a claim, seek out a qualified Sioux Falls 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 South Dakota 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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