Consumer Rights

Right to Good Faith and Ethical Claims Handling

Consumers have the right to be treated fairly and honestly when they make a claim. The Unfair Insurance Trade Practices Act defines and prohibits Unfair Claim Settlement Practices. These practices are:

• Attempting to settle claims on the basis of a document that was altered without notice to, or knowledge or consent of, the insured;

•  Making a material misrepresentation for the purpose of settling a claim on less favorable terms than those provided in the policy;

• Failing to adopt and implement standards for the proper investigation of claims; 

• Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;

• Failing to acknowledge and act promptly upon communications with respect to claims;

• Denying claims without conducting reasonable investigations based upon available information;

• Failing to affirm or deny coverage of claims, the dollar amount or extent of coverage, or to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed;

• Failing to promptly provide a reasonable explanation in writing to the insured of the basis for denial of a claim or for the offer of a compromise settlement;

• Failing to promptly notify the insured of any additional information necessary for the processing of a claim;

• Failing to clearly explain the nature of the requested information and the reasons why such information is necessary; and

• Failing to pay undisputed amounts owed to the insured within 90 days after an insurer receives notice of a residential property insurance claim and determine the amount owed for a covered loss.  [Note: there are some exceptions for situations in which it would be impossible for some reason for the company to pay on time].

Right to Contractor Selection

Insurers may offer policyholders the option to select the services of building contractors that have contracts with the insurer to repair damage covered by the insurance policy. 

If a policyholder chooses to use one of these contractors, the insurer must guarantee the building contractor's work and may offer the policyholder any other terms, conditions or benefits. However, the insurance company is not liable for the actions of the building contractor.

Reference your Home State "Department of Insurance" which documents Statues, Rules, and Regulations related to Insurance. 

Right to Choose Contractor

Consumers have the right to have their home repaired by the contractor of their choice and are not obligated to use the contractor offered by the insurance company, unless the insurance policy specifically requires the policyholder to select a contractor from the insurer’s preferred vendors list.

Reference your Home State "Department of Insurance" which documents Statues, Rules, and Regulations related to Insurance.