When Things Go Wrong
Nobody wants to file a claim, but knowing the process before you need it makes a difference. Handle claims properly and you'll recover what you're owed. Handle them poorly and you'll leave money on the table or get denied entirely.
Immediate Response
Safety comes first. Secure the scene. Get medical attention for anyone injured. Prevent further damage if you can do so safely.
Then document everything while it's fresh. Take photos and videos from multiple angles. Get contact information for witnesses. Write down what happened, what time it happened, and what conditions existed. Your memory fades quickly. Notes taken within hours are vastly more reliable than recollections weeks later.
Reporting the Incident
Contact your insurance agent or carrier immediately. Same day if possible. Most policies require prompt reporting, and delay can result in denied claims.
Have your policy number ready. Know the date, time, and location of the incident. Be prepared to describe what happened and who was involved. List any injuries or damages you're aware of. Provide witness contact information.
Early reporting preserves evidence and gets the claims process started while details are clear.
Evidence Preservation
Keep everything that might be relevant.
| What to Preserve | Why It Matters | |-------------|----------------| | Photos and videos | Visual proof of conditions | | Contracts and scope documents | Establishes responsibilities | | Safety records and training logs | Demonstrates due diligence | | Maintenance records | Shows proper equipment care | | All correspondence | Documents communications |
Don't throw away, repair, or alter anything connected to the incident until the insurance company tells you it's okay. Evidence that gets destroyed can sink an otherwise valid claim.
Working With the Adjuster
An adjuster will be assigned to evaluate your claim. Their job is to determine what happened, whether coverage applies, and how much should be paid.
Be honest and complete in your answers. Incomplete or inaccurate information creates problems that compound later.
Provide documentation promptly when requested. Delays in getting the adjuster what they need slow down your claim resolution.
Keep a log of every conversation. Date, time, who you spoke with, what was discussed. This protects you if there are disputes about what was communicated.
Don't admit fault or make promises about what you'll do. Stick to the facts of what happened.
Ask the adjuster about their timeline and process so you know what to expect.
Documenting Your Losses
For property damage claims, get multiple repair estimates when possible. Document replacement costs with receipts or quotes. Track any business interruption losses from downtime. Keep receipts for temporary repairs or mitigation efforts.
For liability claims, gather all facts about the incident on your end. Collect your own documentation. Cooperate fully with the investigation. Let the insurance company handle communication with claimants. Don't make side deals or agreements with injured parties.
Following Through
Claims don't manage themselves. Stay engaged throughout the process.
Return calls and emails from adjusters promptly. Provide additional information as requested. Track the claim status and follow up when timelines slip. Escalate to supervisors if you're getting unreasonable delays. Contact your agent if you have concerns about how the claim is being handled.
Common Denial Reasons
| Reason for Denial | How to Prevent It | |--------|-------------| | Late reporting | Report immediately, same day | | Policy exclusion | Understand your coverage beforehand | | Premium non-payment | Keep coverage current, set up autopay | | Material misrepresentation | Be accurate on applications and claims | | Insufficient documentation | Document everything, preserve evidence |
Most denials are preventable. Know your policy before you need it.
When to Involve Your Agent
Your insurance agent advocates for you. Reach out when you're unsure whether something is covered before you file a formal claim. Contact them if adjuster communication is poor or unresponsive. Get them involved if you disagree with a coverage determination. Escalate through your agent if the claim is taking unreasonably long. They can intervene if you're being treated unfairly.
Good agents fight for their clients. That's part of what you're paying for when you work with specialists who understand construction.
Disputing Claim Decisions
If your claim is denied or the payment seems low, you have options.
Request the denial in writing with specific policy language cited. Review your policy carefully against their reasoning. Gather additional evidence that supports your position. Submit a formal appeal through the carrier's dispute process. Escalate to the California Department of Insurance if the carrier is acting in bad faith. Consider legal counsel for significant disputes.
Don't just accept a denial or lowball settlement without understanding why and evaluating your options.
Learning From Claims
Every claim teaches something. After resolution, analyze what happened. Could you have prevented the incident? Should you update procedures or training? Does the claim reveal gaps in your coverage that need to be addressed?
Talk to your agent at renewal about what you learned. Adjust your practices and coverage as needed.
Common Questions
How long do I have to file a claim?
Report immediately. "Prompt" notice is required by most policies, and waiting weakens your position even if it doesn't technically exceed a deadline.
Will filing a claim raise my premiums?
Often yes, particularly for liability claims. But an uncovered loss is usually worse than a premium increase. That's what insurance is for.
Can I hire my own contractor for repairs?
Usually yes, but get approval from the adjuster first, especially for larger repairs. They may want to inspect before work begins or require competitive bids.