Insurance Investigation

When The Insurance Investigation Becomes Unreasonable

It is a fact that insurance companies are bound to responsibly and properly investigate all claims.  Further, all insurance investigations are required to be conducted in a timely and reasonable manner.
 
But when claim handling processes become burdensome, taxing, and unreasonable, this can be a signal that a legitimate insurance investigation has turned to illegitimate delay tactics.  If you sense that this has occurred in the handling of your insurance claim, you must protect yourself from probable lowball offers, or even a potential insurance claim denied.

In order to protect yourself, you must assume the power to challenge the direction of the claim.  You must arm yourself with the knowledge to distinguish the difference between a good faith claim investigation and an illegitimate bad faith claims handling scheme.

Cooperation

The insurance investigation is grounded in your Duty To Cooperate.  All insurance policies include a "Duties" clause which affirms your obligations to cooperate in the claim investigation.  This clause, of course, only applies if you have filed a claim with your own insurance company, and you must comply.  But even if you have filed a liability claim with an at-fault, adverse carrier, it is generally to your advantage to cooperate.  However, if you sense that the investigation has become unreasonable, or not in your best interests, you should reconsider that voluntary cooperation.

What must be distinguished is that cooperation means adhering to an insurance company's reasonable requests for particular claim related items and documents.  If you believe that those requests are becoming unreasonable, you could be in for a very long, unpleasant process.

Here are some additional investigative processes that can result in the delay of your insurance claim.  Again, while the company has a duty to investigate, they also have a duty to settle claims in a timely manner.

The Ongoing Claim Investigation

Ongoing insurance investigations are sometimes necessary, especially if parties are refusing to cooperate.  As long as the insurance company is legitimately and actively investigating your claim, there is nothing improper about a more lengthy investigation.

The "ongoing investigation" becomes alarming if your adjuster can offer no progress on the disposition of the insurance claim.  This is not to say that you are entitled to every detail of the investigation, (although you can certainly try) but you are certainly entitled to a reasonable explanation of the claim delay.

Special Investigations Unit (SIU) Referrals

The SIU investigation is a valid means for the investigation of suspected insurance fraud.  These investigations become troubling, however, when shady insurance companies utilize them as nothing more than a means to evade claim payments or to bolster claim denials.

If you sense the insurance investigation related to your claim is not being conducted in a fair and timely manner, follow this claims advice from a genuine insurance expert.

• Cooperate
  Use cooperation to your benefit.  It is much more difficult for the insurance company to defend suspect actions if you have complied with all reasonable requests.

• Maintain Contact With Your Adjuster
  You need to be assertive yet courteous.  Contact the adjuster as often as you feel is necessary.  Collect as much information as possible regarding the status of your insurance claim, always documenting the results. 

Unreasonable demands must be met with determination and, most of all, with the knowledge to overcome the obstacles that drive an unfair insurance investigation.

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