Theoretically, resolving an insurance claim for damage to your property should be easy. You notify your insurer, they send an adjuster to assess the damage, and then you will eventually be sent a check that is the correct amount you will need to restore your home to its pre-loss condition, minus whatever deductible you agreed to pay as determined by your policy. However, things are not quite as simple in reality.
Often, insurers will attempt to underpay or even deny many of the claims made against them. Sometimes, a property owner can negotiate a settlement with the insurer that will allow them to repair all of the damage. However when this is not possible, the homeowner will need to make use of one of the below dispute resolution processes available to policyholders. It is important to check your policy as which of the four remedies you will be able to pursue may be restricted by your policy or by the laws in your state.
The remedies available to policyholders are Litigation, Mediation, Appraisal, and Arbitration. We will briefly describe each remedy below, along with some brief thoughts from our managing attorney, Daniel Tighe.
Litigation is the formal process of resolving disputes by filing or answering a complaint through the civil court system. The American system of justice relies on adversarial parties making their best arguments to reach a resolution, or ultimately having a Trial in front of a Jury who will return a verdict in favor of the prevailing party.
Daniel’s Thoughts: A lot of people think “litigation” is going to court like you see on TV. Although a small minority of matters will end up in a trial, litigation is simply an organized system of handling disputes. In your case it means we can use the tools of civil procedure to compel your insurance company to communicate, answer questions, produce documents, and move the claim along.
Mediation is a structured, interactive process where an impartial third party neutral assists disputing parties in resolving conflict through the use of specialized communication and negotiation techniques.
Daniel’s Thoughts: Importantly, the mediator is tasked with helping to resolve the dispute, but does not have the power to make a ruling or decision unless that is specifically agreed to. In most mediations, the parties must both agree to resolve the matter.
Appraisal is a process of finding the approximate value of your claim by impartial, properly qualified persons. Generally, either party may invoke appraisal. Typical appraisal provisions allow each party to select its own impartial appraiser, and if those appraisers cannot agree on a value for the loss, they will pick an umpire to help resolve the dispute.
Daniel’s Thoughts: Appraisal is generally used in cases where the dispute is over the value of the loss, not where dispute is over whether or not the damages are covered by the policy at all. It’s important to understand that the appraisal process takes control out of the hands of the policyholder, who is stuck with the amount that the appraisal process comes up with, even if they disagree.
Arbitration is a formal and binding procedure for dispute resolution. Traditionally, a single arbitrator is selected by the parties and that arbitrator will decide if a party is entitled to damages, and if so the amount of those damages. Once the arbitrator determines the award, the party seeking damages is barred from seeking court remedies and cannot challenge the arbitrator’s determination.
Daniel’s Thoughts: Arbitration has historically favored large insurers who select the same arbitrators over and over again, creating a financial incentive for that arbitrator to rule favorably for the insurer. It is a binding, uncertain outcome and generally does not favor the policyholder.
Each of the above dispute resolution processes have their pros and cons. As a law firm with a track record of success, we strongly feel that litigation offers policyholders the greatest amount of control and leverage in the dispute process when they are not being treated fairly by their insurance company. If you are currently engaged in a property damage dispute with your insurer, or were recently underpaid on a property damage claim, give us a call so that we can discuss your situation. We can evaluate your options and let you know how we might be able to assist you.