Beware: These gaffes may cost you your insurance claim
So, you’re looking to file an insurance claim?
If that’s the case, check yourself before you wreck yourself, claim-wise, by avoiding the lingo and language insurers don’t want to hear when consumers file a claim. Certain phrases, terms and short statements made by insurers filing a claim may seem harmless to Main Street consumers, but make no mistake, insurance companies have their radar up when customers file a claim.
Say the wrong thing, and that claim’s chances of paying out can go down significantly, as insurers will go to great lengths to avoid paying off a claim.
“There are just some things you shouldn’t say, and conversations you shouldn’t have with insurance companies,” says Patricia Russell, a certified financial planner with FinanceMarvel, a nonprofit financial planning organization. “In that case, it’s often better to say nothing.”
Even more problematic, there are multiple ways insurance claim filers can trip themselves up.
“Stating that you accept fault, that an incident was intentional or discussing an injury before it has been medically diagnosed can lead to significant issues for an insurance claim,” says Brent Weiss, CFP, co-founder and Chief Evangelist at Facet Wealth, in Baltimore, Md.
“Your words matter and can be used against you at a later stage in the settlement,” Weiss says.
Avoid these verbal miscues when generating an insurance claim
When the rubber meets the road, and you’re talking to your insurer about a claim, take a step back and make sure you avoid these unenforced, but all too common “dialogue” errors:
- Don’t say: “I am sorry, it was my fault.” When you say you’re sorry or apologize as if an accident was your fault, you risk confusing your role in the car accident. “That’s especially the case if it wasn’t your fault, says Tony Arevalo, an insurance specialist at Carinsurance.net. “Once you admit your fault, nothing prevents the insurance adjuster from using your statement against you.”
- Don’t say: “I’m fine, nobody’s hurt.” “Do not tell your insurance adjuster that you weren’t hurt until you have had an opportunity to take a medical evaluation by a professional, Arevalo adds. “If you say that you (or the others involved) are alright, your later manifestations of injury might not be assigned to the accident,” he says.
- Don’t say: “What a coincidence.” The word “coincidence” rings a big, red alarm in your car insurer’s ears. “If you left your car for days in a vacant area and suddenly got surprised by the damage done to your car, it will sound very suspicious to your insurance company,” Arevalo adds. “If anything unusual happens, speak clearly and concisely about the circumstances; do not offer your own interpretation.”
- Don’t say: “I don’t have a lawyer.” According to Russell, you’ll want an attorney backing you up on an insurance claim, and insurers hope you don’t. “Your insurance company is more likely to accept your claim if you have a personal injury lawyer,” she says. “A personal injury lawyer can help you get more money in some cases.”
- Don’t say: “I accept the settlement.” You might have huge medical bills and are missing time from work, and want to get the full amount that you deserve, and quickly. But that doesn’t mean you have to accept the insurer’ first settlement offer. “It is a good idea to talk to a lawyer, especially in a personal injury claim, before you accept anything from the insurance company,” Russell says.
- Don’t use the term “In my opinion.” Don’t assume anything with an insurance claim and avoid voicing an opinion. “Insurance companies need the facts, not what you think happened,” Russell says.
- Don’t give an official statement: Never let an insurance company record your statement. “That statement could easily be misinterpreted,” Russell says.
Avoid these specific words completely.
There are actual, specific words you shouldn’t use when discussing an insurance claim with an insurer – these are at the top of the list:
- “Sorry.” Never admit fault, Russell advises. “Keep your mouth shut. After an incident that leads to an insurance claim, you might not be thinking clearly, so never say you are ‘sorry.’
- “Whiplash.” Never use the term “whiplash”, either. “Many people try to use whiplash when wanting the insurance company to pay,” Russell says. “Before assuming your injuries, you need to see a doctor and get an opinion from an expert.”
- “I admit.” Don’t admit you were texting or speeding in an auto insurance claim, says Russell. “In some instances, the insurance company will not cover these claims,” she says.
- “Fine.” Don’t say you or another party involved in an insurance claim are “fine.” Don’t assume all parties involved are not injured,” she adds. “Some injuries will not show up until later. Before you assume you are okay, see a doctor just to make sure.”
- “Termites.” Many home insurance policies do not cover damage from termites, Russell notes. “To deal with termites, make sure you schedule an inspection each year.”
- “Mold.” “Your homeowner’s insurance will not cover mold, so don’t mention the term,” Russell says.
- “Experimental.” Healthcare companies usually will not cover experimental treatments. “They only want to cover claims that they are sure will work,” Russell notes. “Your healthcare needs to be medically necessary.”
Don’t make these insurance mistakes.
There are words to avoid and actions to avoid when filing an insurance claim. Don’t make these moves when filing a claim with your insurance company:
- Don’t: Delay filing or giving notice. If notice is late, an insurer may have a right to deny coverage. “A late notice impedes their ability to investigate and mitigate the loss,” says Damian J. Arguello, an attorney at the Colorado Insurance Law Center.
- Don’t: Agree with everything the adjuster says. It’s okay to go along with the insurance adjuster says, but Arguello advises “seeking advice from your agent or attorney before agreeing or signing anything.”
- Don’t: Fail to keep detailed documentation. Make sure to keep detailed notes of everything that happens and every call with every person you deal with on a claim with dates and times,” says Arguello.
- Don’t: Lie. Insurance companies have amazing investigative resources. “Consequently, You will likely get caught if you lie,” Arguello says. “For example, saying you’re unable to work but your Instagram page shows you waterskiing can cost you with an insurance company.”
Things you actually should say to an insurance company
Insurance claims experts say there are some things that are a good idea to mention when talking to an insurance company.
- Just state the facts. Say exactly when the accident happened and the location of the accident, Russell says. “Tell them the facts on what happened,” she advises.
- Inform your insurer about any witnesses. Witnesses are reliable sources when it comes to insurance companies. “They are not traumatized and can give a more dependable account of what occurred,” Russell adds.
- Report anything suspicious. If you notice anything that really doesn’t add up, tell your insurance company. “They will probably find out sooner or later, anyway,” Russell notes.
- Don’t make unforced errors when filing an insurance claim. Filing an insurance claim is serious business for insurance companies, and it should be serious business for you, too. That’s why you need to step up your game and keep your claim process, clean, efficient and effective every step of the way. If you don’t, your insurance company will only be too happy to capitalize on your mistakes, and take money that could have been yours right out of your pocket.
Dealing with an insurance company doesn’t have to be terrible. After all, they are meant to be in service to you, just bear in mind these useful do’s and don’ts.