After you suffer a major loss, most of the time, your first course of action will be to file an insurance claim. Major losses might be incurred from theft, flooding, fire, or another kind of calamity. If the loss was unexpected, it might have left you shaken and emotionally vulnerable. Filing your insurance claim is the first step to regaining control of your life. But you aren’t a legal expert, so you aren’t sure what rights you have. You’re also worried about putting your trust in your insurance company.
There’s ample reason to distrust your insurance company. Your financial needs and the financial interests of your insurance company are constantly conflicting. Your goal is to receive the maximum possible payout to compensate for the damages you suffered. Your insurance company, meanwhile, doesn’t want to pay for your damages because doing so makes them lose money. It’s almost guaranteed that, even if they don’t refuse payment outright, your insurance company will do everything in their power to pay as little as possible.
Even if you’ve sunk a good sum of money into your claim service and insurance, your insurance company will still work against you. You might need to fight to get what’s rightfully yours. When you take on the fight, you might also need professional help on your side. It’s a sad commentary on our society that people sometimes need to hire a lawyer to fight for their rightful insurance compensation, but that’s just the world we live in.
An experienced insurance disputes lawyer will understand how to navigate and interpret your insurance policy. They’ll also know how to protect your legal rights during the negotiation proceedings. If the insurance company completely refuses a payout, your lawyer will help you understand your legal recourse options going forward. The attorney’s end goal is to make sure your claim is paid in a timely manner, in the full amount you need.
Before you contact an attorney, you should get a copy of your insurance policy. The following elements are particularly important:
The policy’s “Declarations Page”
All endorsements
All riders
Generally, you’ll find the Declarations Page on the first few pages of your policy. This page explicitly states what dollar limits apply to each coverage category. It goes on to list whatever endorsements and riders that you’ve invested in on top of your basic policy. Endorsements and riders are extra coverage that you’ve purchased.
Every addition to your policy will have its listing beside a coded letter, number, or combination of the two. You should do a review of the basic coverage categories. Generally these will include “Dwelling,” “Personal Property/Contents,” and “Loss of Use” or “Additional Living Expenses.”
What if a dispute arises?
If you’ve made your claim and sat down with your insurance adjusters, and the adjusters have raised a dispute, it’s time to consult a lawyer. Insurance adjusters are trained to pressure you into taking the lowest possible payout, even if you’re entitled to more compensation. Your attorney can protect your rights, negotiate your terms, and give the insurance company a run for their money.
It’s a good idea to hand disputes over to attorneys, especially if you find yourself getting frustrated and upset. When you’re rattled, you lose your ability to present rational and coherent cases. Your attorney can act as an emotionally neutral party who advocates in your best financial interests.
You don’t necessarily need to let your lawyer do all of the talking. An insurance claim negotiation is different from a criminal interrogation. If you want to continue communicating with your insurance adjuster, you can ask your attorney to advise you on your rights. However, if you’ve done your best and still aren’t being treated with fairness, your attorney can take the problem off your hands.
After the dispute has reached a point where attorney intervention is necessary, it’s time to let them take over the situation. Most lawyers will insist that you cease to communicate with the insurance adjusters and let them handle the negotiations. This is best for your legal case, and it’s also best for your peace of mind.
Will you have to bring a lawsuit against your insurance company to receive compensation?
You shouldn’t have to. When you file a small dollar claim, the majority of insurance companies will pay it without raising a dispute. Most minor disputes can be solved through basic negotiations. Even if the insurance company is being stubborn, New York has regulations and laws that protect consumers. It’s illegal for an insurance company to force their consumers to file a lawsuit to receive their agreed-upon policy benefits.
Three popular litigation alternatives are mediation, arbitration, and appraisal.
With mediation, both the claimant and the insurance adjuster will work with a neutral third party to negotiate their dispute. The process is an informal and voluntary means of conflict resolution.
Arbitration can be either binding or non-binding. This conflict resolution method has more formality than medication. The third party arbitrator will dictate the solution, or they will work with the involved parties to reach a compromise.
Appraisal is used when a dispute has arisen over the value of an insured loss. The appraiser will collect the relevant information to give a neutral estimate on the value. This value is the amount that the insurance adjuster will pay for your claim.

If you face a major loss and need to file an insurance claim, it is important to understand your rights and protections. Insurance companies may not have your best interests in mind, so seeking help from an experienced insurance disputes lawyer can be beneficial. They can help you understand your policy, protect your legal rights, and navigate any disputes that may arise.

To prepare for a potential claim or dispute:

1. Obtain a copy of your insurance policy, specifically the Declarations Page, endorsements, and riders.
2. Understand the coverage categories, such as dwelling, personal property/contents, and loss of use/additional living expenses.
3. Seek legal advice from an experienced lawyer if a dispute arises with your insurance company.
4. Consider alternative dispute resolution methods, such as mediation, arbitration, or appraisal.