If you file a claim with your insurance company, think before you speak.  Saying the wrong words can cause your claim to be delayed or denied.   It is understandable that you may want to explain what occurred.  However, insurance adjusters pick up on certain “trigger” words that can indicate a claim requires additional review.  Therefore, it is best to stick to the facts when discussing your claim with your insurance company.  Avoid these 12 words which are commonly used by “over talkers” and can hinder even the most legitimate claim.

1.       Sorry

There is no need to admit fault or assign blame.  Let the police officer make a report that will detail who was involved and assign blame as appropriate.

2.       Whiplash

Whiplash claims are the bane of insurance companies due to their propensity for fraud.  Consequently, they are reviewed carefully.  Don’t try to self-diagnose. Let your doctor determine what injuries you have.

3.       Intentional

Insurance covers accidents.  It does not cover intentional acts.  If you purposefully break your car window to get your keys, you are liable for the damage.

4.       Customized

Some modifications to vehicles will void your insurance policy.  In addition, most insurance companies will not cover customization or upgrades or limit their coverage to a few thousand dollars.

5.       Breakdown

If you breakdown on the side of the road, it likely is not included in your auto insurance coverage. Some policies cover mechanical breakdown as a separate rider. If you have this type of insurance be sure you understand the fine print.  Does it include roadside assistance and a rental car?  What is the coverage limit for repairs?

6.       I’m Fine

Saying you are “fine” directly after an accident can undermine your claim if you have legitimate medical problems from the accident.  Do not comment on your medical condition after an accident.  Go to your doctor and determine if you have any issues.

7.       Ride-share

Renting out or your car or carpooling can void your policy.  If you plan to engage in these types of activities, check with your insurer first to ensure you have adequate coverage.

8.       Off-Premises

If a sewer leak on a neighboring property caused flooding to your home, it may not be covered because the problem started off your property.  Do not comment on how you think the damage occurred to your home.  Simply report the damage and let the inspector determine where the problems began.

9.       Coincidence

Insurance companies do not believe in coincidences.  If you have an unusual set of facts, don’t try to blame it on coincidence.  State your case clearly and simply.  Of course, if you are trying to engage in fraud, don’t even start the conversation.

10.   Termites

Termites are not covered by homeowner’s policies even though they cause $5 billion worth of property damage each year. Therefore, schedule a yearly maintenance check to ensure you don’t have a costly—and uninsurable—claim.

11.   Mold

Mold is not covered in a homeowner’s insurance policy unless the mold arose from a covered event, such as a pipe bursting.

12.   Experimental

Generally, medical insurance will not cover experimental treatments. Therefore, do not comment on the type of procedure you are having.  Let your doctor’s office or hospital bill your insurance company and answer any questions about the procedure.

Before you contact your insurance company to make a claim, ensure that you are calm and able to think clearly.  It is helpful to read your policy before you call to ensure you know what is covered and not covered.  Remember, you paid for this policy and it is your right to claim the funds owed to you.  If you do not feel you are obtaining adequate assistance from your insurance company, contact us at 702-333-1111 so we can help you get you what you deserve.

Bighorn Staff

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