Insuring Your Business - December 2013: Insurance Coverage for Food Claims: Communicating with Your Insurance Company

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One of the most frustrating aspects of dealing with a food insurance claim can be communicating with your insurance company adjuster. Knowing your insurance company’s obligations to you can help reduce the frustration.

 

Many businesses look at their insurance companies as partners. Businesses pay a significant sum every year in insurance premiums. In turn, insurance companies promise to cover a number of potential liabilities facing the business. But, keep in mind that insurance contracts are complex legal documents and that your insurance company will use that language (that it drafted) to reduce or deny its obligations to your business. In fact, legally, the mere fact that there is a contractual relationship between your business and your insurance company does not create any special relationship or require the insurance company to give you any special consideration.

 

Fortunately, the law does offer regulations that help business policyholders. These regulations require insurance companies to do the following:

  • Every insurer must, within 10 days, acknowledge receipt of notice of a claim.
  • An insurer must complete its investigation of a claim within 30 days, or notify you as to why it could not complete its investigation in that time.
  • If the investigation of the claim cannot be completed within 30 days, the insurance company has a continuing obligation to advise you of the reasons for the delay in investigating your claim, and to provide you with a reasonable timeframe for completion of your claim analysis.
  • An insurance company must accept or deny a claim within 15 days of receipt of a properly executed proof of loss.
  • All claim denials must be in writing.
  • If a claim denial relies upon language in your policy, the insurance company must cite the specific language in your policy which supports its reasons for denial.

In our experience, insurance companies frequently violate both the spirit and the letter of these regulations. The good news is that reminding insurance companies of their obligations under these regulations usually results in improved responsiveness. Keep these regulations in mind the next time you have trouble receiving a response from your insurance adjuster. 

Topics:  Claim Denial Letters, Insurers, Investigations, Premiums

Published In: General Business Updates, Insurance Updates, Products Liability Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© McNees Wallace & Nurick LLC | Attorney Advertising

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