When to File a Claim and When Not to

When to File a Claim and When Not to

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To File or Not to File?
That is the question to discuss with your advisor

Most companies have a strong sense of when they should file insurance claims. For example, it’s rarely a good idea to file a claim when the loss is less than your deductible. You’ll end up paying the cost anyway, and the claim will count against your experience, potentially driving up premiums in the future. But the decision isn’t always that easy. Here are some tips to consider the next time you experience an accident or other risk issue.

When your driver isn’t at fault

What should you do when an employee has an auto accident but the other driver is at fault? This one can go both ways. If you file with your own carrier, you will have more control. You’ll likely be able to begin repairs and get your vehicle back on the road faster. You also may be covered for some things that the other driver’s insurance won’t cover. However, your claim will count against your experience with your carrier, and if you have many accidents, that could hurt you in the long run. Your partners at The Miller Group can help you assess the pros and cons.

When you don’t THINK you’re at fault

Often, nonprofits – especially those involved with foster care – will have clients who experience an injury or death while not in their care. Initially, they may not be inclined to notify the carrier, because it seems obvious that they are not at fault. But it’s not uncommon for a family to later file a lawsuit and name the nonprofit.

The same thing can happen with a construction claim. Say the general contractor alleges that the subcontractor has made an error, but the subcontractor knows it wasn’t their fault and doesn’t think about contacting their carrier to notify them of the allegation.

In both cases, it’s best to file a notice-only claim, so the carrier can do a preliminary investigation and begin to prepare for a potential suit. Most policies require you to notify the carrier in adequate time for a claim to be covered. So, failing to report in a timely manner could jeopardize your coverage.

Always file Workers Comp claims

Given how litigious our society has become, you can almost never go wrong by filing a Workers Comp claim. Handling such claims out of pocket to protect your experience rating (in states where it is allowed) is simply too complicated and fraught with additional risk. Also, for this type of coverage, denied claims don’t affect your experience rating. However, if you find you’re having certain types of injuries with some frequency, you might want to check in with our safety experts. They can help you analyze the claims and work on safety procedures to reduce them.

What happens when you file too many claims?

Sometimes you just can’t help the fact that you have excess claims, and it may make sense to simply take the hit of higher rates. You could also face cancellation of your coverage. Your Miller Group partners can work with you to decide when to pay claims yourself and can advocate with your carrier or identify surplus lines of coverage if cancellation is being considered.

Other filing mistakes to avoid
  • Failing to take protective action: For property claims, be sure to file immediately and take steps to avoid further damage. For example, if you had a fire that damaged the roof, you would want to get a tarp on the roof as soon as possible to prevent future damage. Failure to do so could result in the carrier refusing to cover that further damage.
  • Assuming having your insurance company work out the claim with the at-fault party will fix everything: It’s common to assume that everything will be fine if you’re not at fault and you ask your carrier to work out the claim with the other party (called subrogation). If the other party’s coverage is not adequate, you could be left holding the bag.

Still wondering whether to file or not to file? We are standing by to help you make that decision, manage roadblocks, set realistic expectations and help complete your filing.

By Stacey Smith, Claims Advocate The Miller Group
and Brad Miller, Director of Claim Analytics, The Miller Group

See also:

How Automation Will Impact Insurance Costs

Avoid Costly Claims: Are Your Subcontractor Certifications Compliant?

Safety Manuals & Policies: Don’t Get Caught Behind The Time

 

 

 

 

 

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