When to hire a pro to settle an insurance claim

A pen and a pair of glasses on a health insurance policy claim form. iStockphoto

(MoneyWatch) A few days ago I wrote about how to challenge the first offer from your insurance company in respect to a claim you have filed. In that column, I stressed the importance of carefully reviewing the adjuster's report and using the documentation you gathered to make your case for a larger settlement.

But if you have a very large insurance claim or there is a significant difference between what the adjuster says the insurance company will pay and what you believe should be paid under your policy, you may want to consider getting a professional to help.

Public adjuster
One such claims professional is a public adjuster, or PA. This is a person who is licensed to represent insured claims for the purposes of seeking a full and timely settlement. When there is a dispute over a claim, the burden of proof is on the insured. A public adjuster will document the loss, gather supporting replacement cost information and negotiate with the insurance company to maximize your settlement. You can find out more about PAs at the National Association of Public Insurance Adjusters website.

When to lawyer up
If your insurance company is digging in its heels and you are getting nowhere, you may have to resort to hiring an attorney. Don't seek the counsel of just any lawyer, but instead seek an attorney who specializes in the practice of law in the areas of "Plaintiffs Insurance Coverage" or "Bad Faith Litigation." The insurance company will use a very skilled insurance defense attorney to represent them and your attorney should be a worthy opponent. Check with your county bar association and ask for a referral for attorneys who specialize in this area of the law.

The downside with hiring a PA or an attorney is that you will pay additional costs. PAs and Plaintiffs Insurance Attorneys typically charge either a fee as a percentage of your settlement proceeds (10 to 33 percent) or hourly rates that can range from $75 to $350 per hour.

As should be done before hiring any professional, ask for and check client references of any PA or attorney before you agree to retain their services.

The following excerpt from a policy holders web site sums it up: "If you can communicate effectively in writing and in person with your insurance company, with confidence, polite aggression, and insistence on your rights, you may not need an attorney (or a PA)... If you are feeling frustrated, angry or anxious or are unsure about your rights, a qualified attorney (or PA) can help."

  • Ray Martin

    View all articles by Ray Martin on CBS MoneyWatch»
    Ray Martin has been a practicing financial advisor since 1986, providing financial guidance and advice to individuals. He has appeared regularly as a contributor on the CBS Early Show, CBS NewsPath, as a columnist on CBS Moneywatch.com and on NBC-TV's morning newscast TODAY. He has also appeared on the Oprah Winfrey Show and is the author of two books.

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