Insurance Claims in Wisconsin

What Are Insurance Claims?

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

Wisconsin residents know that severe weather is a factor of living in this part of the country. Blizzards, tornadoes, and thunderstorms can damage properties across the state. In fact, according to a WEAU13 News story, there were 34 tornadoes in Wisconsin in 2021. Fortunately, most homeowners policies will cover damages from these types of storms. However, the major exception is flooding. For flood damage, you will need to have a separate policy through the National Flood Insurance Program.

How to File a Property Insurance Claim in Wisconsin

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 Consumer Guide from the Wisconsin Office of the Commissioner of Insurance, your claims process will begin in one of two ways. In some cases, your insurer will have you complete a proof of loss form to document the damage. However, in other situations, they may send an adjuster to your property before you complete any forms. Either way, Wisconsin law requires the insurance company to accept or deny your claim within a reasonable amount of time.

If the insurer denies your claim or offers you an unreasonably low settlement, you have several options. Your first step should generally be to contact the insurer and try to negotiate. In addition, they may have an internal appeals process available. If this does not produce an acceptable result, you can contact the Wisconsin Office of the Commissioner of Insurance to file a complaint.

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?

Under Wisconsin statute, you must immediately contact the police if your accident involves injuries, property damage over $1,000, or damage to state property over $200. If the police respond and file an accident report, you do not have to file your own report. However, if the police do not file a report, you have 10 days to notify the Wisconsin Department of Transportation.

You should also contact your insurance company right away. Wallethub reports that Wisconsin is a tort or at-fault insurance state. This means that the at-fault driver’s insurance pays for all damages. However, in many accidents, one driver is not solely at fault. In this situation, any driver who is less than 50% responsible can collect at least partial compensation from another at-fault driver.

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 Wisconsin.

Health Insurance Claims

Wisconsin 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 Wisconsin?

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.

Sometimes an insurance company may not want to cover the treatment that your doctor thinks is best. However, recent Wisconsin legislation may make it easier to get coverage, especially for prescription drugs. The new law limits the practice known as step therapy. This is a controversial insurance practice that requires patients to try a less expensive treatment first, before the insurer will cover the doctor’s recommended treatment.

Work with an Experienced Local Insurance Lawyer in Wisconsin

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