Rules to Follow When Making an Insurance Claim

  1. Know the terms of your policy before you make the claim
  2. Review the correct policy period declaration’s page and policy before you make the claim. Read it, read it and then read it again!
  3. Know who the named insured is.
  4. Know who additional insured’s are.
  5. Know that if you run a business out of your home the homeowner's insurance policy may be voided.
  6. Know that if when you bought the insurance you did not tell them about other people living in your house that your auto or homeowner's policy may be voided.
  7. Know that if other people have a set of car keys and regularly drive your car the insurance may be voided.
  8. Know that if an uninsured person lives in your house and is the accident driver your insurance may be voided.
  9. Know that you do not understand the insurance policy as well as the adjuster taking your statement.
  10. Know that you may need legal advice if any of these situations fit you.

Here is an example of what I am talking about.

Let us say you intend to file a claim for either an auto accident or one that was at your house. What advice can I give you?

Terms you should know: Home owner’s insurance is for your house and we will abbreviate it by the letters HO. Cars and trucks are insured with an auto casualty policy and we will refer to this as an auto policy.

Insurance companies don't charge a "fee" they charge premiums. The underwriting department at the insurance companies evaluates risk and depending upon the risks involved either they will or won't sell you insurance; if they will sell you insurance then underwriting assigns the premium based on risk. Which means if you don't disclose what the insurance company considers a risk they will look for a way to void your policy.

With a HO policy the risks involve who lives there and what the home is being used for or what is going on in the home.

With auto insurance the risks have to do with where you drive, how much you drive, on which roads and who usually does or is likely to drive the car. We have a case where Progressive voided the policy following an accident/claim because allegedly the named insured did not disclose that his brother regularly drove the car and allegedly had a set of keys. According to Progressive the brother is a risk that Progressive did not rate and could not rate because the named insured never disclosed it. When you have someone living with you on a regular basis you have to disclose their name and status when applying for auto insurance. Failing to do so gives the insurance company the right to void the policy. This prohibits people from getting insurance for a low premium while having ten people regularly driving the car for the cost of one premium. It should make sense to you but if this is new to you it may not.

Homeowners Insurance Can Get Complicated

If you are running a business out of your home, that business can present different risks. Those risks may include the following. Tenants sue because they expect you do certain things for them like shovel the walks, etc. Those are a totally different risk, then say your wife living with you or a sister who lives with you on a temporary basis. Tenants also cook on more than one stove can all burn your house down. Tenants invite other people into your home who add additional risks. In one case we recently looked at, but would not take, State Farm denied coverage after a house fire. The lady was operating a candle business out of her home and caused a fire in a trash can outside of the home, resulting in it burning down the house. That candle business presented a different risk and she failed to let the insurance company know about it either when she applied for insurance or after the insurance was bound.

As a property owner or the possessor of the premises, you are obligated to make the premises safe or to warn those who are invited or expected to be on your property. (Guests or the postman) Any defect that is open and obvious you do not have a duty to warn unless it cannot be made safe, such as the only way onto the property. You owe no duty to those trespassing unless the defect is a trap, like an open well.

In Sheets the court also stated that it "imposes upon owners and occupiers only the duty to exercise reasonable care in the maintenance of their premises for the protection of lawful visitors. Among the factors to be considered in evaluating whether a landowner or occupier has exercised reasonable care for the protection of lawful visitors will be: (1) the foreseeability or possibility of harm; (2) the purpose for which the entrant entered the premises; (3) the time, manner, and circumstances under which the entrant entered the premises; (4) the use to which the premises are put or are expected to be put; (5) the reasonableness of the inspection, repair, or warning; (6) the opportunity and ease of repair or correction or giving of the warning; and (7) the burden on the land occupier and/or community in terms of inconvenience or cost in providing adequate protection."

Know your policy, the language in it and how your personal situation may change the coverage and void your insurance. For additional information call and make an appointment with one of our lawyers.

Other ideas for reading about insurance:

Steve Lombardi
Iowa personal injury, workers' compensation, motorcycle, quadriplegic, paraplegic, brain injury, death
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