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When making an insurance claim, what you say can mean the difference between a fast payment check and a lengthy process that could result in less reimbursement than you expected.
Words used in incorrectly could result in a claim delay or even denial. By no means does this mean you should lie to your insurance company or misrepresent the facts. That can result in fraud and your claim will surely be denied. But using the right words to describe your problem is important.
Not too long ago Nager found water in his Euclid office building creating a mess and destroying client files. "We managed to come in one day and find a built in swimming pool in our basement," said Dave Nager.
Nager did what any of us would do. He called his insurance provider to make a claim and while on the phone he used a word we'll call a "claim stopper."
That word is flood. It tops our list of words never to use when filing an insurance claim.
Jerrett Dunbar of the Ohio Department of Insurance said, "What you and I consider a flood is not what an insurance company considers to be a flood."
Dunbar said "flood" is a technical term for when waters rush from the outside in. What Nager had was a sump pump backup. But with just one word the damage was done and his claim was denied because he didn't have flood insurance.
Dunbar said, "Now an insurance company is going to go, 'Wait you don't have flood insurance. You aren't covered,' and that's what causes a delay in the claims process."
The next "never say word" happens on the highways and byways. A split-second decision that can not only break your car, but your wallet.
"Even if it's just saying, 'I'm sorry. I didn't see you there,' could be construed at a later date as an admission of fault," said Dunbar.
If you are in a car accident, never say "sorry." It can make a problem on the road even worse down the road.
You can say something like, "Is everything OK? Are you hurt? Can I call someone for you?" But never apologize, or admit to anything. That can delay your claim. Also, don't offer speed or distance estimates unless you were literarily staring at the speedometer or measured the distance yourself.
The red flag words continue at your doctor's office or dentist. Pay attention when submitting a claim with your health insurance provider. Words like "experimental, investigational, or clinical trial" could result in a denial.
Another no-no "whiplash." "Unless a doctor has looked at you and said you have whiplash, then you don't know what happened," said Dunbar. Keep in mind that claiming an ailment that "isn't" can also be considered a fraudulent claim, whether it's intentional or not.
Dunbar suggests, "Just be honest. Tell them exactly what happened. Don't try and put your own spin on it."
It's a lesson Nager learned the hard way. It took a full year to collect a $100,000 in damages. In the end his claim worked out.
Source: NewsNet5.com
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