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Umbrella Insurance Claims

As soon as you have notice of a claim, or possible claim, that could invade the threshold of your umbrella limits, you should put the carrier on notice of all of the facts and circumstances surrounding the claim. Notify both the primary and the umbrella carriers and proceed as instructed.

If an Umbrella carrier disputes the coverage, proceed as you would under the Homeowners liability section of this website.

 

 

Negotiating: If your insurance company denies or terminates a disability claim it will send you a letter explaining why. The letter will quote the language in your policy, or the facts surrounding your claim that are the basis for the denial. If you disagree with your company's decision, you should take the matter up with a claims manager or supervisor. Think through the reasons for your disagreement carefully and talk to the manager or supervison about the situation. If that fails, put your thoughts in writing. It is often wise to obtain advice from an insurance expert before writing this letter.

In addition to the above, most disability policies provide for an appeal process within the company. This, more formal, process bumps the claim to a higher level within the company. 

 

Mediation: Mediation is a process whereby an independent third party, chosen by the agreement of both sides and experienced (in this case in insurance matters), steps in and tries to facilitate a resolution of the disagreement. Mediation, unlike certain types of arbitration, is not binding. No decisions are made by the mediator. Instead the mediator simply tries to bring the two opposing sides together in a joint effort to avoid litigation.

There are professional mediators available through organizations such as The Judicial Arbitration and Mediation Services (JAMS), and other organizations which promote mediation services.

Be sure your mediator is objective and does not have a built-in tendency to favor one side or the other.

 

Statutes of Limitations and Contractual Limitations: Statutes of limitations are laws setting time limits for the filing of civil lawsuits. The time limits differ according to the state you reside in and according to the type, or theory, of the lawsuit in question (negligence, breach of contract, intentional infliction of mental distress and bad faith can all have different statutes of limitations). Contractual limitations, on the other hand, are provisions in contracts which may alter or change a state's statutes of limitations. You should be aware of both your state's statutes of limitations and of any contractual limitations in your insurance policy. Both types of limitations restrict your ability to sue if you disagree with a decision your insurance company has made. If you do not file a lawsuit within the time period set forth, you may lose all of your rights to contest any adverse decision)(s) made regarding your claim.