Public Adjuster?
Why do I need a Public Adjuster?
You need someone who is looking out for your interests. The adjuster your insurance company hired has his employer’s interests in mind. Plus we increase the settlement amount (aka: get you more money). We will typically increase the claim settlement by anywhere from 30% up to 300%
What types of losses does Advocate Adjusters work with?
Fire, Pipe Break/Bursts, Water Damage, Burglary, Vandalism, Vehicular Building Damage, Building Collapse, Explosion, and various types of damage caused by a Natural Disaster. There are a variety of coverage types included in the typical insurance policy, including: Buildings, Contents, Loss of Rental income, Living Expenses, and interruption of Income from a business.
Will hiring Advocate Adjusters delay the claim process?
On the contrary, a Public Adjuster should serve to expedite your claim. Our team will work closely with you and your insurance company to properly prepare and file your claim in a timely fashion.
How is Advocate Adjusters compensated?
We charge a fixed percentage of the insurance settlement. The size of the contingency will be determined by the size of your loss. Each claim is unique and will be individually evaluated to determine the contingency fee that will be charged.
At what point in the claim process should I hire Advocate Adjusters?
We strongly recommend that you call us before you call your insurance company or agent. Doing so ensures that you will get the professional help you need immediately. Many people are tempted to represent themselves, this can be detrimental to your claim. Once insurance companies take a position, it can make the process more difficult. However, you can enlist our services at any time throughout the claim process.
Is my insurance company required to work with Advocate Adjusters?
The short answer is, yes; you are entitled to representation. Signing a contract with Advocate Adjusters insures that we become a legal party to your insurance claim, thus guaranteeing our ability to represent you.
Will my policy be canceled if I hire Advocate Adjusters?
No. It would be a serious violation of state good faith laws if your insurance company were to cancel your policy based off hiring representation. Such action would be considered discriminatory.
Illinois Good Faith Laws
What constitutes an improper claims pra<br /> ctice in Illinois?
Practices like knowingly misrepresenting policy facts, failing to acknowledge communications, not attempting good faith settlements, and refusing claims without reasonable investigation are considered improper.
How are improper claims practices addressed by Illinois law?
The law includes penalties and procedures for handling such practices, including the issuance of cease and desist orders, suspension of certificates, and possible civil penalties.
What practices are prohibited in property and casualty claims?
Practices like denying claims without proper basis, advising claimants to claim under their own policies when liability is clear, and failing to settle claims where responsibility lies with others are prohibited.
How does Illinois law protect the confidentiality of claimants' information?
Insurers must protect the confidentiality of claimants’ information and are prohibited from disclosing personal data without consent, except as required by law.
What record-keeping requirements exist for claims in Illinois?
Yes, insurers must maintain claim files that are comprehensive and detailed, including all documents related to a claim.
How are disputes over claim settlements handled in Illinois?
Disputes are often resolved through arbitration or litigation. Insurers must provide a reasonable explanation to the insured for any delay in payment or settlement of a claim.
What actions are considered improper claims practices under Illinois law?
Practices like knowingly misrepresenting policy facts, failing to acknowledge communications, not attempting good faith settlements, and refusing claims without reasonable investigation.
What are the penalties for engaging in improper claims practices in Illinois?
Penalties include cease and desist orders, suspension of certificates, and civil penalties up to $250,000.
What practices are prohibited in handling property and casualty claims?
Prohibited practices include denying claims without basis, advising claimants to claim under their own policies when liability is clear, and failing to settle claims where responsibility is evident.
How does Illinois law handle claim delays?
Unjustified delays in claim processing or settlement can be considered unfair practices, subject to penalties.
Are auto insurance claims regulated for settlement fairness?
Yes, insurers must offer fair and reasonable settlements based on the damages and terms of coverage.
Is explanation required for denied insurance claims in Illinois?
Insurers must provide a detailed explanation for any denial of a claim or a lower settlement offer.
How are claims with multiple insurers coordinated?
Insurers must coordinate to resolve claims efficiently, especially in cases where multiple policies are involved.
What is the role of the Illinois Department of Insurance in claim disputes?
The Department may investigate claims practices and ensure compliance with regulations.
Are there special rules for handling health insurance claims?
Health insurers must adhere to timely processing and fair settlement practices, similar to other insurance types.
How are claim delays addressed under Illinois law?
Unjustified delays in processing or settlement can be considered unfair practices, subject to penalties.
Are auto insurance claims regulated for settlement fairness?
Yes, insurers must offer fair and reasonable settlements based on the damages and terms of coverage.
Is explanation required for denied insurance claims in Illinois?
Insurers must provide a detailed explanation for any denial of a claim or a lower settlement offer.
How are claims with multiple insurers coordinated?
Insurers are required to efficiently coordinate in resolving claims involving multiple policies.
What is the Illinois Department of Insurance's role in claim disputes?
The Department investigates claims practices and ensures regulatory compliance.
Are there special rules for handling health insurance claims?
Health insurers must adhere to timely processing and fair settlement standards, similar to other insurance types.
How does Illinois law address claims with delayed reporting?
Claims reported late must still be handled promptly and fairly, but insurers may consider the impact of the delay on the investigation and settlement process.
What guidelines exist for insurers communicating with a claimant's legal representative?
Insurers must respect the claimant’s choice of legal representation and communicate directly with the representative in a professional and timely manner.
How are supplemental claims (additional damages discovered after initial settlement) handled?
Insurers are required to reassess and adjust the claim if necessary, based on the additional damages discovered after the initial settlement.
What is the process for handling claims involving ambiguous policy language?
In cases of ambiguity, policy language is often interpreted in favor of the insured, and insurers must handle claims accordingly.
Are there special considerations for handling claims from vulnerable or elderly claimants?
Yes, insurers should provide additional care and assistance to vulnerable or elderly claimants, ensuring their claims are handled sensitively and respectfully.
How are conflicts of interest in claim handling addressed?
Insurers must avoid conflicts of interest in claim handling and should have policies to manage situations where a conflict may arise.
What procedures are in place for handling claims in the event of insurer insolvency?
In case of insolvency, claims are typically handled by a state guaranty fund or through a court-appointed receiver to ensure claimants are protected.
How are disputes regarding policy interpretation resolved?
Policy interpretation disputes are often resolved through arbitration, mediation, or, if necessary, litigation, with the goal of finding a fair interpretation based on standard insurance practices and policy language.
Are there specific rules for electronic communication and documentation of claims?
Yes, electronic communications and documents must adhere to the same standards as traditional formats, ensuring accuracy, confidentiality, and proper record-keeping.
How does Illinois law address claims involving pre-existing damage or conditions?
Claims involving pre-existing damage or conditions must be carefully assessed to determine the extent of the insurer’s liability, considering the terms of the policy and the condition of the item before the covered event.
What are the guidelines for insurers in cases where multiple claims arise from a single event?
In situations with multiple claims from a single event (e.g., a natural disaster), insurers must handle each claim on its merits while efficiently managing the increased workload.
How are claims related to business interruption handled?
Business interruption claims require a detailed analysis of the insured’s financial records and the direct impact of the interruption, aligning with the policy’s terms.
What is the role of a public adjuster in Illinois insurance claims?
Public adjusters, licensed by the state, represent claimants in negotiating settlements with insurers, ensuring fair representation for the insured party.
How are claims involving environmental damage assessed and settled?
Environmental damage claims require a thorough investigation to assess the extent of damage and liability, considering environmental laws and policy provisions.
What are the responsibilities of insurers in cases of fraudulent claims by third parties?
Insurers must investigate suspected fraudulent claims diligently, report them to appropriate authorities, and ensure legitimate claimants are not unduly affected.
Are there specific guidelines for handling catastrophic events with a large number of claims?
In catastrophic events, insurers must have plans to handle large volumes of claims efficiently, including mobilizing additional resources and providing clear communication to affected policyholders.
What procedures are in place for handling claims in the event of insurer insolvency?
In case of insolvency, claims are typically handled by a state guaranty fund or through a court-appointed receiver to ensure claimants are protected.
How are disputes regarding policy interpretation resolved?
Policy interpretation disputes are often resolved through arbitration, mediation, or, if necessary, litigation, with the goal of finding a fair interpretation based on standard insurance practices and policy language.
Are there specific rules for electronic communication and documentation of claims?
Yes, electronic communications and documents must adhere to the same standards as traditional formats, ensuring accuracy, confidentiality, and proper record-keeping.
How does Illinois law address claims involving pre-existing damage or conditions?<br />
Claims involving pre-existing damage or conditions must be carefully assessed to determine the extent of the insurer’s liability, considering the terms of the policy and the condition of the item before the covered event.
What are the guidelines for insurers in cases where multiple claims arise from a single event?
In situations with multiple claims from a single event (e.g., a natural disaster), insurers must handle each claim on its merits while efficiently managing the increased workload.
How are claims related to business interruption handled?
Business interruption claims require a detailed analysis of the insured’s financial records and the direct impact of the interruption, aligning with the policy’s terms.
What is the role of a public adjuster in Illinois insurance claims?
Public adjusters, licensed by the state, represent claimants in negotiating settlements with insurers, ensuring fair representation for the insured party.
How are claims involving environmental damage assessed and settled?
Environmental damage claims require a thorough investigation to assess the extent of damage and liability, considering environmental laws and policy provisions.
What are the responsibilities of insurers in cases of fraudulent claims by third parties?
Insurers must investigate suspected fraudulent claims diligently, report them to appropriate authorities, and ensure legitimate claimants are not unduly affected.
Are there specific guidelines for handling catastrophic events with a large number of claims?
In catastrophic events, insurers must have plans to handle large volumes of claims efficiently, including mobilizing additional resources and providing clear communication to affected policyholders.
What authority does this regulation have?
This regulation is promulgated by the Director of Insurance pursuant to Sections 154.5, 154.6 and 401 of the Illinois Insurance Code, which empower the Director to make reasonable rules and regulations for enforcing insurance laws.
What is the scope and purpose of this regulation?
It sets minimum standards for claims handling by insurers in Illinois to define practices that, if committed frequently, indicate unfair claims practices.
How does the regulation provide for examinations?
Insurers’ claim files are subject to examination by the Director of Insurance based on factors like the complaint ratio and questions of legal compliance.
What documentation must be maintained in claim files?
Detailed documentation must be maintained to permit reconstruction of the insurer’s activities related to each claim.
How does the regulation define "reasonableness"?
Reasonable promptness means a maximum of 15 working days from receipt of communication. A reasonable claim investigation starts within 21 working days.
What practices does the regulation prohibit?
Prohibited practices include forcing polygraphs, denying claims based solely on phone interviews, and requiring release of all claims in exchange for payment.
What life insurance claims practices are required?
Insurers must search for other policies upon death claims and inquire about alternative insured names. Unresolved claims for over 45 days require a written explanation.
What disability claim settlements are prohibited?
Settling a partial-coverage disability claim on a percentage basis that is unreasonable, or pressuring lump sum settlements.
What auto claim settlements are not allowed?
Advising claimants to claim under their own policy when liability is reasonably clear.
Can an insurer abandon a salvaged vehicle without permission?
No, the insurer cannot abandon the salvage to a towing or storage service without the service’s permission.
When must storage fees be covered under additional living expenses?
When personal property limits have been exhausted but coverage exists under additional living expense.
What prompt search is required for life insurance death claims?
Insurers must search for other policies on the deceased insured and investigate possible additional coverages.
What notice is required for long-unresolved life insurance claims?
If unresolved after 45 days, a written explanation must be provided to the claimant.
What disability lump sum settlements are restricted?
Lump sum settlements requiring the i
nsured to give up future benefits without adequate justification.
When can a liability claim not be denied for failure to exhibit property?
Only when properly documented in the claim file per policy provisions.
Is there a requirement for insurers to provide claim forms and assistance?
Yes, insurers are required to provide necessary claim forms, instructions, and reasonable assistance to claimants for the filing of a claim.
Yes, insurers are required to provide necessary claim forms, instructions, and reasonable assistance to claimants for the filing of a claim.
Practices like knowingly misrepresenting policy facts, failing to acknowledge communications, not attempting good faith settlements, and refusing claims without reasonable investigation.
What actions are considered improper claims practices under Illinois law?
Practices like knowingly misrepresenting policy facts, failing to acknowledge communications, not attempting good faith settlements, and refusing claims without reasonable investigation.
What are the penalties for engaging in improper claims practices in Illinois?
Penalties include cease and desist orders, suspension of certificates, and civil penalties up to $250,000.
What standards govern prompt claims investigations?
Insurers must adopt reasonable standards to begin inquiries within 21 working days when liability is reasonably clear.
What explanations must accompany compromise offers or claim denials?
Reasonable written explanations citing the specific policy provisions or law.
When must insurers provide notice of delays on accident, health or life claims?
If unresolved after 45 days, written explanation must be sent with Department of Insurance contact details.
What disability claim settlements are not allowed?
Settling mixed-coverage claims unreasonably or pressuring lump sum settlements.
Can liability claims be denied solely for not exhibiting property?
Only if properly documented as a policy condition violation.
When must insurers cover storage fees under additional living expenses?
If personal property limits are exhausted but additional living expense coverage exists.
What standards apply to prompt claims investigations?
Reasonable standards to begin inquiries within 21 working days when liability is reasonably clear.
What must accompany compromise offers or claim denials?
Reasonable written explanations citing the specific policy provisions or law.
Can phone interviews justify claim denials?
No, phone interviews must be documented to support any denials.
What additional policy search is required for life insurance claims?
A search for other policies on the deceased and investigation of additional coverages.
When must notice be given for delayed life, health or accident claims?
If unresolved after 45 days, written explanation must be provided with the Department of Insurance contact details.
What disability claim lump sum settlement practices are not allowed?
Settling mixed-coverage claims unreasonably or pressuring lump sum settlements.
Are liability claimants allowed to be advised to claim under their own policy?
No, not when liability is reasonably clear.
Can an insurer abandon an insured's salvaged vehicle without permission?
No, permission from towing and storage services is required.
What documentation must be provided to support claim denials?
Documentation supporting the reasons for denial and violation of policy conditions.
What settlement practices are considered unfair claims practices?
Misrepresenting facts, failing to acknowledge communications, not pursuing good faith settlements, denying claims without investigation.
What penalties may be imposed for unfair claims practices?
Penalties can include cease and desist orders, license suspension, or civil fines up to $250,000.
What claim records must be available for regulatory examinations?
< span style="font-weight: 400;">Insurers must provide claim number, type, dates of loss, payment, denial or closure.
What documentation is required in claim files?
Documentation allowing recreation of the handling activities related to the claim.
Do electronic claim records meet documentation requirements?
Yes, if the records are accessible from CRT or micrographics and convertible into hard copies.
What additional search must be done for life insurance death claims?
A search for other policies on the deceased and investigation of additional coverages.
When must written notice be given for long-delayed accident, health or life claims?
If unresolved after 45 days, written explanation must be sent with Department of Insurance contact details.
What lump sum disability claim settlements are deemed improper?
Settlements based on unreasonable percentages for partial coverage conditions.
Can property claims be denied solely for not exhibiting property?
Only if properly documented as a violation of policy conditions.
Is it permissible to advise liability claimants to claim under their own policy?
No, not when liability is reasonably clear.
Can an insurer abandon an insured vehicle's salvage without permission?
No, permission is required from towing and storage services.
What life insurance search is required upon notice of insured's death?
Search for other policies on the deceased and investigate additional coverages.
What is the timeframe for providing a claims decision?
Within a reasonable time, typically 30-60 days depending on complexity.
When can one claim fulfill multiple policy obligations?
If identified by the insured and policies contain similar coverage.
What guidelines apply to the settlement of auto insurance claims?
Insurers must provide reasonable and fair settlement offers based on the damages and coverage terms.
Are insurers required to explain claim denials in Illinois?
Yes, insurers must provide a detailed explanation for any claim denial or settlement offer.
How are claims involving multiple insurers handled?
Insurers must coordinate to resolve claims efficiently, especially in cases where multiple policies are involved.
What is the role of the Illinois Department of Insurance in claim disputes?
The Department may investigate claims practices and ensure compliance with regulations.
Are there special rules for handling health insurance claims?
Health insurers must adhere to timely processing and fair settlement practices, similar to other insurance types.
How does Illinois law address claim delays?
Unjustified delays in claim processing or settlement can be deemed as unfair practices and subject to penalties.
Are auto insurance claims regulated for settlement fairness?
Yes, insurers must offer fair and reasonable settlements based on the damages and terms of coverage.
