Property owners who experience an insurance loss frequently ask us when they should turn to an attorney for help. If claims are handled properly, an attorney should not need to be involved. The unfortunate reality is that not all claims are handled appropriately by all insurance companies. If the insurance company is unreasonably delaying payment, denying claims, acting improperly or if something just does not feel right with the response from the insurance company, oftentimes having your own attorney is the only way to level the playing field.
Level the Playing Field With Minnesota Property Insurance Claim Lawyer
While all claims are different, in general, a policyholder should seek legal help under the following circumstances:
• There has been no agreement on the claim and it is approaching 2 years from the loss. Under most policies in Minnesota, a policyholder only has two years from the date of the loss to either resolve the claim or pursue legal action. The failure to do so could cause the loss of valuable legal rights.
• The insurance company is demanding an Examination Under Oath (“EUO”). A EUO is a court-like proceeding that is typically held in the insurance company’s attorney’s office. The insurance company’s lawyer will ask the policyholder questions about the claim under oath and a court reporter is present to type of a transcript of the questions and answers. That testimony can (and will) be used against an insured later if the claim does not resolve. Policyholders have the right to be represented by their own legal counsel at these proceedings and should exercise that right.
• There are insurance policy coverage defenses being raised. An insurer has the right to argue that the insurance policy does not have to pay for a particular type of loss or damage (called “policy exclusions”) or that the policyholder has not met all of his or her duties under the policy in seeking to avoid payment. Typical policy exclusions include prior damage, wear and tear, construction defect and lack of maintenance. Typical duties raised include lack of cooperation, failure to allow inspections of the damage, and issues with a “proof of loss” form. If the claim cannot be settled, a court proceeding to work out coverage issues is often necessary.
• If the insurance company has an attorney, there is a reason. The claim has escalated and, typically, policyholders do much better if they have their own legal advocate helping them navigate the issues.
• There is involvement, or talk of involvement, by the insurance company’s Special Investigation Unit (“SIU”). SIU is an insurance company’s fraud investigation team. If the insurer is raising a fraud allegation, having an attorney is very important because the penalties can be severe if fraud is proven.
• If the insurance company or you as the policyholder demand that a monetary dispute be resolved by “appraisal” under the insurance policy. At the appraisal stage, sometimes an attorney is necessary. Each case is different and, depending on the issues, many times an attorney can help you obtain your best possible appraisal result.
• If the insurance company has not paid an appraisal award, you will need an attorney to ask the court to compel that payment.
• If you are unhappy with the appraisal process that led to the appraisal award and believe there are grounds to set the award aside or modify it, you will need an attorney. In Minnesota, the parties typically have a strict time limit to challenge the award in court. Since the reasons for modification are limited and the timeframes short, prompt consultation with an attorney that knows insurance claims and insurance law is necessary.
This list is not meant to be exhaustive. If you believe you might need legal counsel, feel free to call our office for a free 30-minute consultation. We will provide you with straightforward advice about your claim.